No Libido and orgasmic anhedonia on TRT , need you advice

[pelo911]

Hi Guys

i'm 40 years old.
around 2.5 years ago i lost around 20lb of muscle for no reason
so i went to do a blood test at Urologist clinic , found out i have low T
other then the muscle loss i didn't had any issues.
sometimes i feel like i wish i wouldn't did this blood test , because since then everything got worst.
maybe for me i was better not to know i have low T.

when i found out i started to read online non stop
the doctor couldn't find what cause the low T.
i did also a sleep study and found our i have Sleep Apnea (the Urologist said he don't think it's the cause of the low T) , i tried to sleep with Cpap for 2 month but i couldn't.

my HDL is low , even before i started with medication.

the doctor gave me Clomid and add HCG after few month
i was on Clomid for about a year.

then the doctor suggest to start TRT

my libido started to decline over time until it's just completely dead!
i just not interesting in sex anymore , not thinking about it , watch porn and not feel anything

when i have orgasm i don't feel any pleasure , sometimes i feel like it's about to happen
there is a "built up" but then no pleasure at all.

i red this article and i feel very similar to that:

What is orgasmic anhedonia/pleasure dissociative orgasmic dysfunction?

The word “anhedonia” refers to the inability to experience pleasure from an activity that is normally considered pleasurable. People with orgasmic...

www.issm.info

the Urologist (very well known doctor) couldn't find a solution for me
because "on paper" everything look ok.

because of the loss of my sexuality i think my mood also dropped down
i don't enjoy things i use to enjoyed all my life (for example i have an exotic car i use to love and now i didn't even started the engine over 6 month).

the doctor put me on a women medication trial (could be placebo, we don't know yet)
Addyi (flibanserin) for 2 month , nothing changed.

he gave me also Vyleesi (Bremelanotide) , didn't changed the libido at all
i had spontaneous erections the day after.

we tried not to take Anastrozole but the estradiol jumped to 67 after few weeks.
so i started to take it again.

no morning wood i think in the past 2-3 years.
maybe sometimes , very rare.

DHEA went down to 1900 (use to be 3700 before i start medications)

supplements: (didn't changed anything)
fenugreek
mucna pruriens
tongkat ali
Ashwagandha
maca
5HTP

seems like the doctor gave up
i'm tired from all of it , just want my life back

anything you could think off i should try or check
i'm open to do anything !

Thanks a lot !!

 

[Vince]

Hi Guys

i'm 40 years old.
around 2.5 years ago i lost around 20lb of muscle for no reason
so i went to do a blood test at Urologist clinic , found out i have low T
other then the muscle loss i didn't had any issues.
sometimes i feel like i wish i wouldn't did this blood test , because since then everything got worst.
maybe for me i was better not to know i have low T.

when i found out i started to read online non stop
the doctor couldn't find what cause the low T.
i did also a sleep study and found our i have Sleep Apnea (the Urologist said he don't think it's the cause of the low T) , i tried to sleep with Cpap for 2 month but i couldn't.

my HDL is low , even before i started with medication.

the doctor gave me Clomid and add HCG after few month
i was on Clomid for about a year.

then the doctor suggest to start TRT

my libido started to decline over time until it's just completely dead!
i just not interesting in sex anymore , not thinking about it , watch porn and not feel anything

when i have orgasm i don't feel any pleasure , sometimes i feel like it's about to happen
there is a "built up" but then no pleasure at all.

i red this article and i feel very similar to that:

What is orgasmic anhedonia/pleasure dissociative orgasmic dysfunction?

The word “anhedonia” refers to the inability to experience pleasure from an activity that is normally considered pleasurable. People with orgasmic...

www.issm.info

the Urologist (very well known doctor) couldn't find a solution for me
because "on paper" everything look ok.

because of the loss of my sexuality i think my mood also dropped down
i don't enjoy things i use to enjoyed all my life (for example i have an exotic car i use to love and now i didn't even started the engine over 6 month).

the doctor put me on a women medication trial (could be placebo, we don't know yet)
Addyi (flibanserin) for 2 month , nothing changed.

he gave me also Vyleesi (Bremelanotide) , didn't changed the libido at all
i had spontaneous erections the day after.

we tried not to take Anastrozole but the estradiol jumped to 67 after few weeks.
so i started to take it again.

no morning wood i think in the past 2-3 years.
maybe sometimes , very rare.

DHEA went down to 1900 (use to be 3700 before i start medications)

supplements: (didn't changed anything)
fenugreek
mucna pruriens
tongkat ali
Ashwagandha
maca
5HTP

seems like the doctor gave up
i'm tired from all of it , just want my life back

anything you could think off i should try or check
i'm open to do anything !

Thanks a lot !!

It would be nice to see your labs with ranges. My only thought is, your testosterone is too high.

 

[sammmy]

I would drop all the "natural" supplements. If 5HTP really increases serotonin like pharmaceutical antidepressants, that may have a negative impact on sexuality. Antidepressants are well known to cause either not being able to ejaculate/orgasm at all or getting there but feeling no pleasant sensation (ejaculation without orgasm).

 

[Systemlord]

around 2.5 years ago i lost around 20lb of muscle for no reason
so i went to do a blood test at Urologist clinic , found out i have low T

the Urologist (very well known doctor) couldn't find a solution for me
because "on paper" everything look ok.

A lot of doctors are going to interpret things differently, just because hormones are in the normal ranges doesn't mean levels are normal for you. An 85 year old man with Free T levels closer to the bottom of the ranges is normal because testosterone declines as we age, a younger man at the same levels isn't normal even though it's with in range.

You want advice, to be able to do that we need labs values and reference ranges.

 

[pelo911]

i forgot also Oxandralone , 12.5mg twice a day (also didn't help with Libido)

T cypionate 0.325ml twice a week (130 total)
HCG 0.375ml twice a week (750 total)
anastrozole 0.25mg twice a week

blood test from December:
HDL 32
Prolactin 6.8 ng/ml
SHBG 12 nmol/L
Free T 20.8 ng/dl
Total 677 ng/dl

you can see past results , number not stable (changing all the time)

Thanks again guys!!!

 

[Systemlord]

On 12/7/20 your E2 was 40, SHBG 12 and here is more than likely is the problem, your E2 is high in relation to SHBG, more than likely leaving a LOT of free estradiol floating round in the body which can be cause for low libido and sexual problems.

I have the same issue, SHBG is 18, estradiol is 62 and what libido I had 2 weeks ago (6 weeks, stable state achieved) is diminished somewhat as well as my erections now that I'm closer to 8 weeks. A few weeks ago my estradiol was lower and sexual function was better.

You need to get the estradiol closer to 30, losing weight can help decrease the estradiol. Another way to double down to lower the estradiol is either decreasing the T dosage or HCG should do the trick, or more anastrozole.

I would try decreasing the HCG first since this will lead to hormones stabilizing more quickly versus lowering the T dosage and wouldn't require an increase in anastrozole.

 

[pelo911]

Om 12/7/20 your E2 was 40, SHBG 12 and here more than likely is the problem, your E2 is high in relation to SHBG, more than likely leaving a LOT of free estradiol floating round in the body which can be cause for low libido and sexual problems.

I have the same issue, SHBG is 18, estradiol is 62 and what libido I had 2 weeks ago is diminished somewhat as well as my erections. A few weeks ago my estradiol was lower and sexual function was better.

You need to get the estradiol closer to 30, losing weight can help decrease the estradiol. To do that either decreasing the T dosage or HCG should do the trick, or more anastrozole.

right , SHBG dropped down compare to past results
any idea what can cause it?

 

[Systemlord]

right , SHBG dropped down compare to past results
any idea what can cause it?

TRT decreases SHBG in just about everyone, how much is going to be different for everyone. The only instance SHBG would increase on TRT is in those with type 2 diabetes which suppresses the SHBG, since testosterone helps manage glucose, some will see glucose levels return to normal and SHBG keep from getting suppressed again.

 

[pelo911]

TRT decreases SHBG in just about everyone, how much is going to be different for everyone. The only instance SHBG would increase on TRT is in those with type 2 diabetes which suppresses the SHBG, since testosterone helps manage glucose, some will see glucose levels return to normal and SHBG keep from getting suppressed again.

SHBG 6 month before was 18
then dropped to 12

my glucose level is high , 94
and i'm not eating a lot of carbs , eat clean

 

[pelo911]

any suggestion?

 

[jchems]

On 12/7/20 your E2 was 40, SHBG 12 and here is more than likely is the problem, your E2 is high in relation to SHBG, more than likely leaving a LOT of free estradiol floating round in the body which can be cause for low libido and sexual problems.

I have the same issue, SHBG is 18, estradiol is 62 and what libido I had 2 weeks ago (6 weeks, stable state achieved) is diminished somewhat as well as my erections now that I'm closer to 8 weeks. A few weeks ago my estradiol was lower and sexual function was better.

You need to get the estradiol closer to 30, losing weight can help decrease the estradiol. Another way to double down to lower the estradiol is either decreasing the T dosage or HCG should do the trick, or more anastrozole.

I would try decreasing the HCG first since this will lead to hormones stabilizing more quickly versus lowering the T dosage and wouldn't require an increase in anastrozole.

Thanks @Systemlord. I've not heard this before. i.e. Low SHBG = More available E2 = low libido. Is this your anecdotal experience or did you read/learn this from somewhere you could share? I'm off to Google to look now, but if you have something handy that'd be great. Thanks!

 

[Systemlord]

Low SHBG = More available E2 = low libido. Is this your anecdotal experience or did you read/learn this from somewhere you could share?

I have seen low SHBG guys test for free estradiol and commonly see a very high free estradiol level. This forum has a couple of threads discussing this topic in detail.

Try using the search function.

 

[pelo911]

I have seen low SHBG guys test for free estradiol and commonly see a very high free estradiol level. This forum has a couple of threads discussing this topic in detail.

Try using the search function.

SHBG 6 month before was 18
then dropped to 12

any idea what can cause the drop?

but anyway , even with 18
no libido
nothing changed

 

[pelo911]

new test
morning cortisol

 

[nippy]

new test
morning cortisol

hi , its been a few months since you have posted . Any news on the libido ? Im in the same boat .. very interested in your story

 

[DS3]

On 12/7/20 your E2 was 40, SHBG 12 and here is more than likely is the problem, your E2 is high in relation to SHBG, more than likely leaving a LOT of free estradiol floating round in the body which can be cause for low libido and sexual problems.

I have the same issue, SHBG is 18, estradiol is 62 and what libido I had 2 weeks ago (6 weeks, stable state achieved) is diminished somewhat as well as my erections now that I'm closer to 8 weeks. A few weeks ago my estradiol was lower and sexual function was better.

You need to get the estradiol closer to 30, losing weight can help decrease the estradiol. Another way to double down to lower the estradiol is either decreasing the T dosage or HCG should do the trick, or more anastrozole.

I would try decreasing the HCG first since this will lead to hormones stabilizing more quickly versus lowering the T dosage and wouldn't require an increase in anastrozole.

Sexual function being negatively impacted by estradiol is not an evidence-based claim. In fact, current research supports quite the opposite.

The posted recommendations are reckless.

Below is a study covering the role of estradiol in male reproductive system. Men on TRT were included.

The role of estradiol in male reproductive function - PMC

Traditionally, testosterone and estrogen have been considered to be male and female sex hormones, respectively. However, estradiol, the predominant form of estrogen, also plays a critical role in male sexual function. Estradiol in men is essential ...

www.ncbi.nlm.nih.gov

 

[ekiewln]

when I started trt I have one month of everything is great then my libido erections and orgasms all plummet. I get off trt and everything goes back to good. I have blood monitored and everything seems fine. I just started back up and same exact thing happened. If you stop trt your sex drive should come back. There’s actually a lot of people who report this erectile insensitivity on testosterone. Managing the hormone System is extraordinarily complex. I believe some people are just unlucky and the trt is just not an optio for some if you want a good sex drive.