What to do/check next...non-existent libido

[cja]

So here I am, a good 6-7 months into this TRT and while I tell myself I am good, I am only lying to myself and others. Sure I have lost anxiety, and trust me I am thankful for that, but aside from that I dont see a whole lot of positives.

Let me ask some questions, I want to gauge where others are at, maybe I am just expecting to much from TRT.

1. Libido, does everyone have it? I did for a good month or two, but since then its been gone. My penis feels like a numb extremity. I can literally flick it and almost not feel it at all. So when I do manage to have sex I stay rock solid and the climax is weak when it finally happens. What comes out is also not normal at all, but thats another topic...

2. Fatigue, I would still rather lay down then get up and do some of the many things that need to be done. When I do attempt to do something I get drained rather quickly, and feel I have earned the afternoon nap. I did not feel this way during my honeymoon period with TRT, anyone else?

3. Irritability, I try my hardest here. I know what a ass I have been to those around me. So even when I am irritated these days I fake it. It has to be written all over my face though, one can not simply fake they are not irritated, lol.

4. Dry skin, at one point my skin was oily, more so around the eyes and nose. Now my skin is dry, I have dandruff and a type of Seborrheic Dermatitis. From what I read this may be related to DHT.

5. Lab work, having been reading on DHT and Prolactin I searched my labs and do not see any of these tests have been run. I am a Defy patient, and see other Defy patients with these labs, must I request them?

These are just a few questions I have. I recently had a protocol change, and instead of improving my TRT I am beginning to wonder if I have made it worse. I feel the AI is to blame for many of my TRT issues, when I had my window of greatness, I had a higher E2 level. But while this was high I had water retention, pretty bad too. The worse part is I am having morning erections, this proves I am getting good REM type sleep, and that it does work. I am just not in the mood at all. I know that sexual function starts in the brain, even porn and masturbation is blah. This is exactly the way I was Pre-TRT. No desire at all, just plowed through the day waiting for bed time, sleep is the highlight of my day again. I am nearly ready to stop the whole TRT and just start over at 50 mg e3.5d with no AI. Let me reiterate, if I did start over I would go daily, 15mg Test C daily NO AI, and GCH @ 200ui 3 times a week. While typing I just had a flashback to when I began taking HCG, how it used to make me a animal, chasing the wife around the bed, lol. I want this back!


latest lab work (did not fast, and taking meds that raise Triglycerides) http://imgur.com/0lrF5V4
70mg e3.5d Test C
HCG 400ui e3.5d
AI .22mg 3 times a week
didnt take my DHEA during this period


new protocol, no labs yet
44mg Test C Mon-Wed-Fri
HCG 300ui Mon-Wed-Fri
AI .22mg Mon-Wed-Fri
DHEA 25mg nightly

 

[Vince Carter]

Quite a few guys dont get along with DHEA, or HCG I'd suggest dropping DHEA entirely and cutting back the HCG use to 250 E3.5D. Regarding Defy's labs they are cost conscious and you do need to ask for DHT and Prolactin inf you want them, those aren't typical standard type tests. Beyond that your numbers look fine...you shouldn't have cut back your dose from 140 - 132 you should have just split the 140 three ways, many guys dont feel good until they can >1000 trough. Free T could be better but that can be tied to your dose drop and just "ok" trough.

 

[cja]

Is there a online calculator that gives a T to E ratio? Its seems to be the lower I take my E level, the worse I feel.

 

[Vince]

There are many things you could try, to help you get dialed in. One would be stop taking your AI, another if you feel a lot worse on TRT, maybe you should stop.

 

[cja]

Its not so much that I feel a lot worse, its that I've felt a whole lot better. And slowly it seems that things are backsliding to the Pre-TRT feelings. Maybe I need to increase instead of decrease the test C like V.C. stated. The whole switching to 3 weekly injections was to eliminate some AI, but I havent done that. I am kicking myself for not pulling labs at the point I felt like superman, had I known the battle I was facing I would have.

 

[rhino5169]

Quite a few guys dont get along with DHEA, or HCG I'd suggest dropping DHEA entirely and cutting back the HCG use to 250 E3.5D. Regarding Defy's labs they are cost conscious and you do need to ask for DHT and Prolactin inf you want them, those aren't typical standard type tests. Beyond that your numbers look fine...you shouldn't have cut back your dose from 140 - 132 you should have just split the 140 three ways, many guys dont feel good until they can >1000 trough. Free T could be better but that can be tied to your dose drop and just "ok" trough.

VC, in my quest to soak up knowledge im curious as to what the issues that some have have with DHEA are>
Thanks

 

[Vince]

One issue with DHEA, it will raise your estradiol levels and some have a hard time sleeping when taking it before bed.

 

[Vince Carter]

One issue with DHEA, it will raise your estradiol levels and some have a hard time sleeping when taking it before bed.

Yep seems to go to E very easily, in some guys.

 

[Vince Carter]

Its not so much that I feel a lot worse, its that I've felt a whole lot better. And slowly it seems that things are backsliding to the Pre-TRT feelings. Maybe I need to increase instead of decrease the test C like V.C. stated. The whole switching to 3 weekly injections was to eliminate some AI, but I havent done that. I am kicking myself for not pulling labs at the point I felt like superman, had I known the battle I was facing I would have.

Its a really long journey, a marathon, it's typically months to a year before a guy gets things fleshed out to where they feel good, and just because other guys take things like DHEA, Pregnenolone, etc etc doesn't mean that you need those, too. Some guys don't use HCG, though that's a less advisable track to follow.

 

[CoastWatcher]

Is there a online calculator that gives a T to E ratio? Its seems to be the lower I take my E level, the worse I feel.

No, there is no such calculator. Please don't become obsessed with the T:E ratio. It is a single data point that a patient and a doctor will consider when evaluating estradiol. It's certainly not a hard and fast rule.

 

[cja]

I think going forward I will do the 48mg 3 times a week as recommended at the follow up. I am experiencing some anxiety again, it came on while heading to the beach about a hour ago. Had to pull over, get wife to drive and everything. I haven't felt that in a long time, and surely didn't miss it none.

 

[JPB]

As mentioned the DHEA and/or the HCG do not agree with some people. Wean yourself from those and compare symptoms.

 

[cja]

Back at home and going back and looking at my labs. On April 26th I did lab work, I felt fine at this point, the labs that were in the OP. After seeing the DHEA at 120 I began to take the DHEA. I took it nightly after dinner and it seemed to help me sleep. From that point I began to slowly deteriorate, for lack of better words. I have read where DHEA can raise E2 levels. I am fairly certain my E2 is not high, I have had a E2 of 48 before and I feel nothing like that today. If anything it has dropped due to the smaller more frequent injections, and the small decrease in Test C. I will be in touch with Defy soon, I had a PM already, Thank You.

 

[lowe2sucks]

if oral DHEA makes you feel bad try DHEA cream no problems with DHEA cream here.
By the way what was your protocol when you felt your best?

 

[cja]

I was doing fairly good at 70mg e3.5d, and AI three times a week, HCG at 400ui also at e3.5d, no DHEA.

The whole point of more frequent injections was to eliminate AI, or hopes of anyway. That hasnt happened though.

 

[lowe2sucks]

so you started to feel worse after adding DHEA? if that's the case then I would simply discontinue DHEA. maybe your body doesn't need it just like mine doesn't need pregnenolone and i can't tolerate it even smallest doses. hcg gives me same reaction so I can't use it

 

[cja]

Fairly certain DHEA played a roll in it yes.

HCG doesn't agree with you? When I first began HCG it was amazing, now its just another hole I tear in my skin. Don't believe I've had any unwanted effects from it though.

 

[lowe2sucks]

first dose for me produced euphoric kind feeling then i just started to feel like an ass as far as I remember I get same from pregnenolone.

 

[cja]

I need to add some information, I am on a opiate as well and this is the cause on my secondary hypogonadism. However now that I am taking testosterone via injections, I wonder if I have been low my entire life. I was late too puberty, never had any real gains when working out. I spent a year working out at the age of 18-19, solid routine and watched my buddy blow up like crazy, while I only "cut up" what little muscle I already had. I know for a fact he wasnt juicing either, we were in a very controlled environment.

Anyway, I know the opiate can and does effect my treatment, but when I say libido I mean desire/thoughts. It is like I dont even think about it. This is exactly how I was Pre-TRT, thoughts of sex were non-existent. Today I do not have any troubles getting and maintaining erection, I only have no desire to do so. I have tried self stimulation both with and without porn, same results. The opiate I am sure can give bad days, and good days when it comes to sexual desires, but for desire to just be "off" I find it hard to blame just the opiate here. Especially when Ive had a solid 2 months of a strong libido/desire in weeks prior. I dont want to take SSRI as I am slowly coming off the opiate, maybe this plays a part in everything as well, idk. Typing this brings me to a realization that solely blaming the DHEA 25mg is kind of crazy as well.

I am sure we will get it all squared away, it is going to just take more time with me, thats all. I need to learn to be more involved with my treatment and my Dr's. They are there to help me, but they dont know what is wrong if I dont speak up.

 

[madman]

I need to add some information, I am on a opiate as well and this is the cause on my secondary hypogonadism. However now that I am taking testosterone via injections, I wonder if I have been low my entire life. I was late too puberty, never had any real gains when working out. I spent a year working out at the age of 18-19, solid routine and watched my buddy blow up like crazy, while I only "cut up" what little muscle I already had. I know for a fact he wasnt juicing either, we were in a very controlled environment.

Anyway, I know the opiate can and does effect my treatment, but when I say libido I mean desire/thoughts. It is like I dont even think about it. This is exactly how I was Pre-TRT, thoughts of sex were non-existent. Today I do not have any troubles getting and maintaining erection, I only have no desire to do so. I have tried self stimulation both with and without porn, same results. The opiate I am sure can give bad days, and good days when it comes to sexual desires, but for desire to just be "off" I find it hard to blame just the opiate here. Especially when Ive had a solid 2 months of a strong libido/desire in weeks prior. I dont want to take SSRI as I am slowly coming off the opiate, maybe this plays a part in everything as well, idk. Typing this brings me to a realization that solely blaming the DHEA 25mg is kind of crazy as well.

I am sure we will get it all squared away, it is going to just take more time with me, thats all. I need to learn to be more involved with my treatment and my Dr's. They are there to help me, but they dont know what is wrong if I dont speak up.

Neurotransmitters play a strong role in libido especially dopamine. Dopamine has a positive effect on libido where as serotonin dampens libido. An imbalance in neurotransmitters whether due to genetics or drug abuse can kill the sex drive. Dr. Marino has an article stating that on trt in the beginning/honeymoon period there is a surge of dopamine in the brain which increases ones drive/libido but eventually as one reaches a steady state testosterone blood levels it actually desensitizes dopamine receptors over time as oppose to when one produce testosterone naturally with the peaks/valleys which also causes dopamine/other neurotransmitters to increase/decrease keeping the receptors sensitive to the natural highs/lows of testosterone. Dopamine is a neurotransmitter that you cannot keep constantly elevated as it will down regulate after some time due to the constant surge. I need to find article. I think balanced neurotransmitters play a strong role in one having a healthy libido.