Where to start?

[Mrs. Robinson]

Not sure where to start here... My husband and I have been married over 4 years during which his lack of libido became glaringly obvious from the start. We've suspected low T for a long time and did get a blood test done a few months ago, altho not conclusive enough. Only measurement is total T which came in at 449. He is 23 yr old, (19 when symptoms became apparent). I've read enough on forums to know we're probably wasting our time with general practitioners, and plan to proceed with Defy Medical for treatment options. Now my question here is: we'd like to conceive in 6 months or so, more or less depending how soon we're ready. I know TRT seriously affects sperm count. Would it be better to just forget about treatment until after conception? If he suffers from low T is his sperm count already low and our chances slim? (Though our odds are certainly slim now, abstinence is 100% effective.) Or get a sperm analysis first to see what we're dealing with now? Waiting does seem like the easiest option almost, but some days I'm not sure I can take it waiting that long for him to finally have an interest in sex. His lack of arousal does have a serious affect on my self esteem, hard as I try not to. I would love if he would be the one trying to find answers, but it doesn't seem to bother him much, although he is willing to pursue treatment.

 

[Systemlord]

He will likely need HCG to be part of your husband's protocol, HCG is used together with TRT to maintain fertility. Younger guys seem to be more sensitive when their testosterone starts dropping into the 400 range than an older guy in his 40's. You'll be in good hands with Defy Medical, they really know their stuff! They can also treat women's hormonal symptoms once the enter the premenopausal state, their aren't many doctors out there that know how to do that successfully. It could be a thyroid issue causing his symptoms, this can cause low testosterone symptoms.

It's not always easy for a guy to admit he has a problem with his manhood, they often ignore the symptoms and live in a sort of denial. Also when a man suffers low T symptoms they have no motivation in life to do anything about it, it's mental as well as physical. Your husband is lucky to have someone who cares enough to help him through this, you'll have your husband back soon enough. Just know it can take months to see significant changes in his symptoms, it can take several months to get on a protocol that works for him.

I'm curious to see what his SHBG would be, high SHBG binds up free testosterone which would be very similar to low T, I suspect it could be a combination of borderline acceptable T levels and high SHBG. Total testosterone is a reservoir for free testosterone, high SHBG decreases free testosterone.

 

[Vince]

Only 23 years of age, you guys may want to try to increase testosterone naturally if you can. I would look into Low Dose Clomid, if you decide to be on TRT, HCG is definitely something to consider along with your TRT.

What are your LH, FSH and DHT?

 

[Henry]

HCG is not perfect. It's an LH analog so he's get that but he still needs FSH for full sperm production. HCG does have FSH but for the full FSH, he'll need HMG along with HCG and his TRT. The best thing is to get a sperm analysis done and then get some sperm frozen. That's what I did. Let me give you an example. I started with 75M sperm before TRT. Now, I've been on TRT for 4 years with HCG for all those years. I froze sperm just in case but my count went down to 20M. I'm still at the 20M limit for fertility but it still went down.

Also, start with the basics. How's his blood work? Thyroid? At 23, does he really want to be injecting for the next 60 or so years? How is his weight? Diet? Does he drink or smoke? Any street drugs? Sleep apnea? Does he sleep well? Try to fix other things and see a doctor that will try to find and fix the problem instead of jumping on TRT out the gate. TRT is great, but if you can get your T level up naturally, that's optimal.

 

[lowe2sucks]

you can also freeze sperm it's an option. or use hcg with HMG with trt that will preserve fertility
The libido improvement on trt may be not immediate it could take couple of months for all the effects to kick in because hormones work slowly the sooner he will start the sooner you both will enjoy improved sex life

 

[Henry]

Only 23 years of age, you guys may want to try to increase testosterone naturally if you can. I would look into Low Dose Clomid, if you decide to be on TRT, HCG is definitely something to consider along with your TRT.

What are your LH, FSH and DHT?

Great advice right here. TRT should be the last resort since there are other issues that may arise and fertility is one of them. Now, I froze sperm but, with freezing sperm, you'll need a Fertility Doc to get pregnant. That's not cheap, and not many insurance companies cover this so think about the money aspect of it. It's not as simple as getting a tube of your frozen sperm, unthawing it and then inserting it. Also, HCG is cheap, but HMG is EXPENSIVE!!!! How do I know, I went through all that, sperm freezing, ICSI, HCG, HMG, etc. I paid alot of money. I don't know your financial situation so think about that. If you do get on TRT, talk to the TRT doc and the Reproductive Endocrinologist that will be doing your sperm sample and possible sperm freezing.

 

[Mrs. Robinson]

Also, start with the basics. How's his blood work? Thyroid? At 23, does he really want to be injecting for the next 60 or so years? How is his weight? Diet? Does he drink or smoke? Any street drugs? Sleep apnea? Does he sleep well? Try to fix other things and see a doctor that will try to find and fix the problem instead of jumping on TRT out the gate. TRT is great, but if you can get your T level up naturally, that's optimal.

I can't speak on the blood work levels, SHBG or free testosterone, since the one blood test he had done didn't specify any of those. I've seen the thread on the $29 test on here (from Defy), would that test measure all these levels?

I'm not aware of any other health issues. He is really tall and slender (6'4" and 180 lbs), does not drink, smoke, or use any drugs. Diet wise, we could definitely both improve on that, but that is likely the lowest on his priority list. Neither of us cook hardly, and he's not a fan of 'health food'. No symptoms of sleep apnea. We are both night owls and consequently rarely get to bed as early as we should, so may be a small lack of sleep.

Mainly the symptoms that have presented themselves are libido, or lack thereof, tiredness, general lack of motivation, and in the past, we did slightly suspect depression, which was somewhat job related at the time. He's never had a problem keeping an erection, just not easily aroused. If we can treat this naturally, yes that would be great. What vitamins does he need to take? He currently takes a daily multivitamin, along with a good vitamin D, magnesium, saw palmetto, and probiotic. I just don't have a lot of confidence with all those testosterone booster pills I see on the market. He tried one bottle once and ended up throwing it away.
Unless our finances change drastically for the better next year, sperm banking and fertility treatments will be difficult to afford. Our insurance does not cover any fertility treatments, what's more is they won't cover a pregnancy achieved through treatments either (would have to be through vaginal insemination if we did freeze sperm). Is it worth freezing for maybe 6 months? Probably wouldn't hurt to give natural treatments a shot for those months and then check into TRT if its not working?

 

[Mrs. Robinson]

Only 23 years of age, you guys may want to try to increase testosterone naturally if you can. I would look into Low Dose Clomid, if you decide to be on TRT, HCG is definitely something to consider along with your TRT.

What are your LH, FSH and DHT?

Clomid with TRT, or by itself? I'm curious, I've read a lot of older guys say they take HCG along with TRT, but what it the purpose if they have no plans to conceive? Does it make TRT more effective?

 

[Logan45]

Not sure where to start here... My husband and I have been married over 4 years during which his lack of libido became glaringly obvious from the start. We've suspected low T for a long time and did get a blood test done a few months ago, altho not conclusive enough. Only measurement is total T which came in at 449. He is 23 yr old, (19 when symptoms became apparent). I've read enough on forums to know we're probably wasting our time with general practitioners, and plan to proceed with Defy Medical for treatment options. Now my question here is: we'd like to conceive in 6 months or so, more or less depending how soon we're ready. I know TRT seriously affects sperm count. Would it be better to just forget about treatment until after conception? If he suffers from low T is his sperm count already low and our chances slim? (Though our odds are certainly slim now, abstinence is 100% effective.) Or get a sperm analysis first to see what we're dealing with now? Waiting does seem like the easiest option almost, but some days I'm not sure I can take it waiting that long for him to finally have an interest in sex. His lack of arousal does have a serious affect on my self esteem, hard as I try not to. I would love if he would be the one trying to find answers, but it doesn't seem to bother him much, although he is willing to pursue treatment.

Hey Mrs. Robinson,

449 isn't a horrible T level it is not the high end of the spectrum but it sure isn't the lowest end either. Before you start looking at TRT for answers try examining some external influences such as stress level, diet, etc... I would exhaust all avenues before going this direction, just my humble opinion. Anyway if you would like to conceive in 6 months it might be wise to hold off. If he is having trouble obtaining or maintaining an erection maybe he should try cialis, viagra, etc...Adding exogenous testosterone will greatly reduce his sperm production. You might want to get that sperm analysis done just to see if there might be a fertility issue. If there are fertility issues a urologist might prescribe something to help him with his fertility.
Regarding the sex part and self esteem. I can definitely understand how it might impact you. It is tough when it appears the one you love isn't responding sexually but keep in mind if some of his attempts have failed there may be some psychogenic issues he is having and that is inhibiting the desired response. Again I would look at his daily stressors in life stress can kill both men and women's sex drive and act as a potential endocrine disruptor.

In any case good luck!

 

[Mrs. Robinson]

No trouble with erections, or becoming aroused when we try, it’s just the mood is rarely present.

I don’t really feel it’s stress related, because it’s been over 4 years. Sure we’ve gone through some high stress times, but overall life is pretty good.

 

[user_joe]

Not sure what the real science is, but isn't saw palmetto claimed to be a dht blocker? Why take that?

He he needs to get with an endo to see what's possible. That total test just tells you he's got mediocre testosterone levels. Kinda low for his age. Without all of the other values mentioned it means almost nothing. I wouldn't jump to conclusions. Get with a GOOD doc. He could test again and see 700. You need a knowledable doctor.

 

[FeelingLost]

I second Logan45's comments.
I am no expert by any stretch of the imagination but in my short time reading about TRT it for guys who like to practice making babies. Not for one who actually want to make one. When a person takes only T his testicles atrophy (turn to rasins and pull back up into the body) sperm production is greatly reduced.

I would suggest he try Clomid mono 1st with a Doctor who knows what they are doing. Best of luck.

 

[Vince]

Clomid with TRT, or by itself? I'm curious, I've read a lot of older guys say they take HCG along with TRT, but what it the purpose if they have no plans to conceive? Does it make TRT more effective?

You're asking about my levels right? I haven't done any tests, but have no reason to think anything is unbalanced. My cycle is like clockwork, and I do chart with BBT and OPKs, so ovulation is spot on.

You would use Clomid by itself, for a restart, if all options fails he may want to look at TRT as a last resort.

 

[Mrs. Robinson]

Not sure what the real science is, but isn’t saw palmetto claimed to be a dht blocker? Why take that?

Apparently I need to do some more research. The company had sent me a promotional bottle, and the article claimed it helps balance hormones. I thought it specifically mentioned testosterone, but I'm not seeing that now. Thinking I have it confused with something else. So is dht blocking a bad thing? How is hair loss related? (Not that he had that problem even.)

 

[FeelingLost]

Apparently I need to do some more research. The company had sent me a promotional bottle, and the article claimed it helps balance hormones. I thought it specifically mentioned testosterone, but I'm not seeing that now. Thinking I have it confused with something else. So is dht blocking a bad thing? How is hair loss related? (Not that he had that problem even.)

saw palmetto is taken for benign prostatic hyperplasia (BPH) if your husband has not be told by a doctor he has BPH I would stop taking it. There is a lot of snake oil salesmen out there in supplements land. Be careful only take something if you know you need it.

 

[user_joe]

DHT is a downstream hormone of testosterone. It's responsible for most male traits. People block it to preserve their hair but many regret it and end up on TRT.