TRT and Low Libido

[Smokin Joe]

I have been consistent with TRT for about four months now. Two injections a week @ 40mg each.
Total T at 616, Free T @ 13.0 and Estrogen @ 20. Best its been for me in years but I have no sex drive.
It seems that when my T tanked to 215 back in 2012 due to improper program administration, I haven't been able to recover.
Sex was all I ever thought about most days and now it's far apart.
TRT has improved my energy and focus at work but I really would like to rev up sexually.
My wife and I have always have an excellent sex life together and I sure would like to pick up where I left off and then some.
I am on no meds, lots of supplements and drink only in moderation on the weekends.
I know that this subject has been discussed here before but I would appreciate some in put as there is so much information to process on this site.
Thanks again.

 

[James]

Yes, this has been a common topic of late. You don't show ranges, but your free T looks like it might be low. You'll hear: check SHBG, albumen, and libido is complex and dependant on many things. All very true! That's tough because libido truly is influenced by so many things.

 

[HarryCat]

There are no easy answers. I've been struggling with this myself for a couple of years. Keep reading through this site there is a lot of info.
A couple of things to check might be DHT and prolactin. I've read of guys adding a transdermal T preparation to their injectable version to try and increase DHT if it is low.

I've also read that Dr. Shippen says that if a 9AM fasting prolactin test is greater than 5.0 then taking cabegoline might help.

 

[Smokin Joe]

Thanks for the quick response.
Believe me I will continue to research as this a major part of my that I miss. I was hoping that TRT was the magic bullet but it appears that it may just the start of a long drawn out process.

 

[James]

Thanks for the quick response.
Believe me I will continue to research as this a major part of my that I miss. I was hoping that TRT was the magic bullet but it appears that it may just the start of a long drawn out process.

Smokin Joe - with all due respect, is it possible you are over thinking it? I'm guilty of that myself. I think we all go through cycles in all areas of life, where you can do the exact same thing that has gotten you positive results in the past, and have it not work for a spell, then eventually it starts working again. Just my 2-bit psycho bable.

 

[Mocha]

How old are you, Smoking Joe?

TRT is pretty close to being a magic bullet, but it's not one. There are several variables to the libido equation and TRT is simply one of them.

Here are some of the things that affect libido (independent of T levels):

Chronic stress -- financial, health, family. Worrying about a lack of libido could lead to stress as well (a vicious loop).
Pornography -- there's a lot of research about dopamine levels going out of whack due to excess porn. Young men in early 20s have lost their libido due to this.
Purposelessness -- this is a big one, but it's highly underrated. Do you feel upbeat about your work and your contribution?

I don't know your background, so my recommendation is generic: Sometimes, just cutting back from all kinds of sexual activities for 60-90 days cures libido issues. Have you tried this? Sex is great, but so is abstinence (this is not the moral horseshit sort of abstinence -- this is simply to re-sensitize the brain to sex).

If your tests find no biological issue, perhaps you could give it a shot. Take your mind off it for a couple of months.

 

[Smokin Joe]

I am 54 years young and in pretty good shape. Retired Air Force and working an excellent Federal job now.
Some porn occasionally but not excessive-actually not as much as I would like, HA hA.
I don't think that I am over thinking it as I just don't have the drive part of it. Would not hurt to analyze it though.
My erectile quality flopped-No Pun-about the same time the drive thing happened (2012) so I really don't know. I do know that I have a love-hate relationship with Viagra though. Love the action but it leaves me washed out for two days at least.
I'll continue to study it and not stress it for sure. I don't usually stress about a whole lot as I learned how to manage stress after it almost killed me years ago.
Cool talking to you guys about this though as all insight helps.

 

[Gene Devine]

Joe - Tell us more about yourself like age, general health, lifestyle, stressors...things like that.

Good comments on here thus far; and I am one for the "over thinking" it as well. Over thinking "it" will crush libido.

Labs: Take a look at Prolactin and DHT.

Even mid to elevated Prolactin will crush libido in some men. I found taking .25 mg of Cabergoline (suppresses Prolactin) twice a week on injection days had a huge impact on my libido...crazy in fact.

Caber does two things for men; it lowers Prolactin which rises just after orgasm so you can orgasm again in one session much faster. BUT more importantly it's a Dopamine agonist which is critical for libido.

DHT is all things male; it's converted from Testosterone via 5-ar enzyme. Some men don't convert well to DHT and this can play on libido as well.

Need to understand your estrogen ranges and whether or not when tested you got the "Sensitive" estrogen assay...this is very important. The standard default E2 assay is designed for women and will over estimate a mans serum levels of the same. Thus, if you are 20 pg/ml on the standard assay you could be actually far below that and would point to your low libido and erection quality. Are you taking any meds to manage estrogen like an aromatase inhibitor by any chance?

For men on TRT the usual culprit to low libido is either suppressed E2 due to over use of an AI or very elevated E2 as well.

 

[Smokin Joe]

Thanks Gene. The crazy range is what I'm looking for if possible. Will check DHT again as it was around 40 I believe last time.
Also wanted to thank you for your response when I posted High PSA. Got results today and down to 2.3 from 10.4. I did not stop TRT until I tested PSA consecutively for several weeks. I am thankful and blessed it worked out.
I'll order some new test specific ranges. No meds other than T. Some supplements and a few beers on the weekend.
Sure wood like to get the ride back one more time.

 

[Gene Devine]

Joe - You posted that estrogen was 20; is that in pg/ml and what was the lab reference range?

Was the estrogen lab the standard lab or was it the "Sensitive" lab?

Glade to hear about your PSA

 

[Smokin Joe]

Standard lab from Lab Corp. Result as of July 23014 is 20.3 pg/ml with a range of 7.6 to 42.6 pg/ml.
I have some results from my Endo that I will look back at because the Prolactin seems to be in question for some reason but I can't remember. I'll check and post.

 

[Gene Devine]

Standard lab from Lab Corp. Result as of July 23014 is 20.3 pg/ml with a range of 7.6 to 42.6 pg/ml.
I have some results from my Endo that I will look back at because the Prolactin seems to be in question for some reason but I can't remember. I'll check and post.

Ok, so your estrogen lab used Lab Corps standard default and not the "Sensitive" lab.

Therein could be your issue Joe.

The standard default lab is designed for women and not men and can/will over estimate your E2 serum levels; I have seen blood work where both labs were performed and see the delta in both with my very own eyes.

The standard E2 lab is useless for a man and the fact that it presented you at 20 pg/ml could be that you are actually much lower than that in reality and why you are presenting with symptoms.

Discuss this with our Physician.

There's more information on this subject in the stickies in the Testosterone forum.

 

[James]

Ok, so your estrogen lab used Lab Corps standard default and not the "Sensitive" lab.

Therein could be your issue Joe.

The standard default lab is designed for women and not men and can/will over estimate your E2 serum levels; I have seen blood work where both labs were performed and see the delta in both with my very own eyes.

The standard E2 lab is useless for a man and the fact that it presented you at 20 pg/ml could be that you are actually much lower than that in reality and why you are presenting with symptoms.

Discuss this with our Physician.

There's more information on this subject in the stickies in the Testosterone forum.

Professionals need to educate themselves on the sensitive test. I go to a place that specializes in testosterone replacement therapy and they were absolutely clueless about this test until I talk with them about it.

 

[Smokin Joe]

10-4. I understand and will discuss with both Life Extension and Lab Corp.
I agree that if a company and or a Doctor is going to administer a program on this nature it should be the best.

It is amazing that in the standard medical community how much is actually not know about Hormone Replacement-both Male and Female.

I'll check it out and as I am in a hurry to correct this the best way that I can so as to enjoy.