Hi im looking for advice on getting libido back. So I’ve been on trt for about 7 years. Up until about 4 months I’d been doing it myself and then I decided to go to a clinic hoping for better results. So they wanted me to stay off the shot for about 2-3 weeks so that my level would come back low. It came back at 46. So they started me on 100 mg per week. Test came back at 425. They bumped me up to 150 with 0.25 AI once week and test came back 485. Bumped me up to 170 with 0.5 AI once week. Test came back 885 and E2 54. My libido has been zero for last few weeks. They think it’s the high estrogen but everything I read says don’t worry bout estrogen and DO NOT take AI. I have tried taking AI and not taking Ai with no real difference. Over the last few months there have been phases for a few days that my libido has been good. There was a time when I was on 100/150 per week when my libido was great. My question is, should I go back down to the lower dose even though my clinic would consider my levels low at that time? Or is there another approach I should try. Just this week I asked them to do twice week injection to see if that helps. Any thoughts?
If these are your T levels injecting once weekly and blood work was done at the true trough (7 days post-injection) then there is no way you only went from TT 425---485 ng/dL going from 100---150 mg T/week.
A dose increase of 50mg T/week is a big jump yet your TT only bumped up 60 ng/dL.
Something not jiving here.
Gets even nuttier as your TT 485 ng/dl on 150mg T/week jumped up to 885 ng/dL on your current dose of 170 mg T/week.
A sensible dose increase of 20 mg T/week yet your TT jumped up a whopping 400 ng/dL.
Regardless if your bloodwork was done at the true trough (7 days post-injection) and you are hitting a very high trough TT 885 ng/dL then your trough FT will be healthy or high depending on where your SHBG sits.
More importantly, your peak TT, FT, and estradiol will be much higher.
For all we know your FT is sky-high earlier in the week!
How many days after your last injection was blood work done?
Blood work should always be done at the true trough (lowest point) before your next injection.
Need to post labs TT, FT, estradiol, SHBG let alone CBC which includes RBCs, hemoglobin, and hematocrit.
Include assays/reference ranges.
Give us something to chew on here.
Keep in mind that although TT is important to know FT is what truly matters as it is the active unbound fraction of testosterone responsible for the positive effects.
Also keep in mind running too high a trough FT level can be just as bad in many ways as having too low an FT level especially when it comes to libido/erectile function and mood.
Libido/erectile function is multifactorial and it is not as simple as blaming estradiol or hormones.
Much more going on.