Hi guys,
here you have a follow up on my TRT journey.
43 y/o. Lean and active/healthy lifestyle.
Started in March due to deep fatigue, focus, low mood and ED symptoms that had been going on for several years already (ED since my mid 20s). Blood test confirmed very low T, probably due to primary HG. No other major health issues.
The urologist made me start with 100mg Test cyp IM every 2 weeks. Didn't feel any change. After about one month we switched to 250mg every two weeks. That resulted in a huge boost followed by a crash. Couldn't stand the ups and downs of such infrequent injection protocol, plus the doctor didn't seem experienced enough on the topic, so I decided to change to an endo.
We started with 100mg EW in April, progressed to E5D, and for the past 4 weeks I've been injecting 50mg on M-W-F, shallow IM with an insuline needle.
Just got my latest blood panel. Blood extraction right before my Monday morning shot, so I guess that would be my lowest point, after the weekend.
--->Keep in mind that I live in Spain, where the range of blood tests available is kind of limited compared to the US.
Free T: 18.60 pg/mL (3.64-19.30)
17 Beta Estradiol: 55 pg/mL (<56)
Prolactine: 8.1 ng/mL (3.5-19.4)
SHBG: 39.3 nmol/L (13.5-71.4)
Vit D: 22.10 ng/mL (30-100)
Magnesium: 1.83 mg/dL (1.80-2.60)
How do I feel? What changes have I experienced so far?
Generally speaking I feel great on 150mg a week. 50mg x 3 shots a week makes me feel very stable. Definitely better mood. Gained some good weight. More physical energy and libido/sex interest went up.
No symptoms of high estradiol other than hard nipples most of the time. Not painful though. Just slightly more sensitive than before starting TRT. I tried Zinc supplementation (30-40mg every day) for a few weeks but felt more tired, headache, brain fog, so I dropped it.
ED still there though. Not as bad as before, but I still need some extra help through Viagra (usually 50mg at the time) or Cialis (20mg) if I want to function properly in bed. Without ED pills I have no problem getting aroused but the erection is usually weak and inconsistent (lots of ups and downs).
Also, no morning wood at all on 150mg T a week. No spontaneous erections during the day or at night. Actually I haven't had a spontaneous morning erection in probably 20 years. The only exception, when I got my first 250mg shot. After that shot I remember waking up at night with a strong erection and getting morning woods for 4-5 days after that single shot.
Right now I feel great. I'm at the top of the range as far Free T goes, and Estradiol is pretty high too, although asymptomatic. Any increase in T dosage would probably cause high E symptoms, I guess.
So my questions is. How do I improve my ED problem? Should I ask the endo about AI medications to lower E? A better T/E ratio would help with ED?
Standard treatment here in Spain is usually just T, once a week, without any AI or HCG.
I'd love to keep it as simple as possible, but at the same time I feel there's a lot of margin for improvement on the ED front.
Any ideas?
I'll see the endo in a few days and I'll keep you posted, hoping this can help other members.
Thanks for all the help and support!
here you have a follow up on my TRT journey.
43 y/o. Lean and active/healthy lifestyle.
Started in March due to deep fatigue, focus, low mood and ED symptoms that had been going on for several years already (ED since my mid 20s). Blood test confirmed very low T, probably due to primary HG. No other major health issues.
The urologist made me start with 100mg Test cyp IM every 2 weeks. Didn't feel any change. After about one month we switched to 250mg every two weeks. That resulted in a huge boost followed by a crash. Couldn't stand the ups and downs of such infrequent injection protocol, plus the doctor didn't seem experienced enough on the topic, so I decided to change to an endo.
We started with 100mg EW in April, progressed to E5D, and for the past 4 weeks I've been injecting 50mg on M-W-F, shallow IM with an insuline needle.
Just got my latest blood panel. Blood extraction right before my Monday morning shot, so I guess that would be my lowest point, after the weekend.
--->Keep in mind that I live in Spain, where the range of blood tests available is kind of limited compared to the US.
Free T: 18.60 pg/mL (3.64-19.30)
17 Beta Estradiol: 55 pg/mL (<56)
Prolactine: 8.1 ng/mL (3.5-19.4)
SHBG: 39.3 nmol/L (13.5-71.4)
Vit D: 22.10 ng/mL (30-100)
Magnesium: 1.83 mg/dL (1.80-2.60)
How do I feel? What changes have I experienced so far?
Generally speaking I feel great on 150mg a week. 50mg x 3 shots a week makes me feel very stable. Definitely better mood. Gained some good weight. More physical energy and libido/sex interest went up.
No symptoms of high estradiol other than hard nipples most of the time. Not painful though. Just slightly more sensitive than before starting TRT. I tried Zinc supplementation (30-40mg every day) for a few weeks but felt more tired, headache, brain fog, so I dropped it.
ED still there though. Not as bad as before, but I still need some extra help through Viagra (usually 50mg at the time) or Cialis (20mg) if I want to function properly in bed. Without ED pills I have no problem getting aroused but the erection is usually weak and inconsistent (lots of ups and downs).
Also, no morning wood at all on 150mg T a week. No spontaneous erections during the day or at night. Actually I haven't had a spontaneous morning erection in probably 20 years. The only exception, when I got my first 250mg shot. After that shot I remember waking up at night with a strong erection and getting morning woods for 4-5 days after that single shot.
Right now I feel great. I'm at the top of the range as far Free T goes, and Estradiol is pretty high too, although asymptomatic. Any increase in T dosage would probably cause high E symptoms, I guess.
So my questions is. How do I improve my ED problem? Should I ask the endo about AI medications to lower E? A better T/E ratio would help with ED?
Standard treatment here in Spain is usually just T, once a week, without any AI or HCG.
I'd love to keep it as simple as possible, but at the same time I feel there's a lot of margin for improvement on the ED front.
Any ideas?
I'll see the endo in a few days and I'll keep you posted, hoping this can help other members.
Thanks for all the help and support!
Last edited:
