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Madman - would you advocate for daily Tadalafil as a preventative measure even in the absence of any current ED issues?

I have gone through the same thing. Went to a sleep doctor. He recommended 5 mg of melatonin about an hour before bed. He also recommended some light thing that you are supposed to stare at when you wake up for period of time each day, but I never did it. The melatonin seems to work well.

A bit over my head - what's our takeaway from this?

I dropped the nasal gel after giving it another week. I think my T levels were fine on it, but the buildup in my nose was getting too much, and my throat was constantly sore. I would have liked to get some labs on it to see where it put me and realize the benefits, but the mode of application...

I have labs for both every day and every other day. My free T was about the same level for both, E2 was in a better range for every other day. I need to get some labs for every third day next and see where that leaves me.

I have done pretty well on Enclomiphene for the past year and a half. I don't have a raging libido, but I think it's normal. No eye floaters or anxiety. I don't feel like Superman on it like some talk about being on TRT, but I am definitely better on it than off it. I'm always playing with...

I had to bail on the nasal gel again. Did it for another weeklong stretch, and I had even dropped the Enclomiphene for a few days. The testosterone levels felt fine, but it's just too much with the nasal application. My throat was constantly bothering me after a few days, and my nose felt...

I had difficulty getting dialed in with cypionate and always felt too hopped up. My natural total testosterone is in the low 300's, so I really just need a boost to get me up into a decent range. Enclomiphene gets me into the mid to low 500's and generally pretty good on the other numbers as...

I’ve had pretty good overall results on Enclomiphene, much better than I did on cypionate. In talking with Defy, a lot of patients have had good results with Enclomiphene as well.

Certainly a valid concern and one that is on my mind. One thought I have is to actually get the more concentrated gel from Empower that is 10 mg, or double the Natesto dosage. That would at least cut down on the amount of some of the gel. It’s currently 8 clicks with the 5 mg, so I should be...

Well, I actually took my last dose of Enclomiphene 5 days ago and have been going just with the nasal gel (3 applications per day, 10 mg total each application). I just wanted to see what the nasal gel would do alone. So far, seems ok. I feel a little lower than when on the Enclomiphene as...

What's your thought process on waiting until getting tested? If it's short-lived and doesn't build up in your system, it would seem like you could get tested after one dose and get an accurate read of what level you can expect to hit going forward.

I would give Natesto or the Empower nasal gel (if going through Defy) a try. I am using it now, and although it’s only been a few days, feeling good on it. Enclomiphene is another option. There are lots of posts on both.

Yes, not a problem at all. A year’s prescription. And use GoodRx.

The FDA didn't approve Enclomiphene in the form of Androxal, but you can get it from the compounding pharmacies. i get it from Empower through Defy. Although it wasn't approved, there are studies that support its ability to improve numbers. I think some of those studies also address an...

Agreed on not combining enclomiphene and Natesto/nasal gel at the same time. I am currently taking both, but I've been on enclomiphene for a year and half and have plenty of labs and subjective history on it to be able to tell any differences that are caused by the recent addition of the nasal...

I see on the Natesto directions not to blow or sniff your nose for an hour. So would that suggest that after an hour any medication/gel still in your nose doesn't have any impact on T levels? In other words, after you hit the peak after about an hour, you could completely remove everything...

I do wonder what the impact would be if I dropped Enclomiphene. Maybe I’d do better with the higher dosage in that case since I wouldn’t have the Enclomiphene already propping my levels up. I probably need to sit down and figure out a plan on how to approach this and figure out which...

Yeah, Defy offered to prescribe a stronger concentration of T per application, but I went with the same concentration as in Natesto. But even with that, the ability to control the dosage with Empower for me is pretty key. Allows for a lot of trial and error.

And while I don’t have labs, my skin has also been oily while using the gel. To me, that’s a sign that my DHT level has shot up.

Other benefit is that less gel has resulted in less issues for me with the gel running down my throat. Also, I haven’t had the headaches I had originally with the higher dose.

Very informative, thanks for sharing Fortunate. I have been using enclomiphene and Empower nasal gel for the past 5 days (I’ve been using enclomiphene for a year and a half). I have been playing with either twice or three times per day on the gel. With Empower’s delivery method, I can adjust...

Do you think there's a benefit to taking enclomiphene and the nasal gel? My thought is that the enclomiphene would better ensure that you don't shut down and keep your baseline T level higher than without while also taking the nasal gel. It's what I'm experimenting with at the moment.

This is great, thanks @madman! So my takeaway would be that the lower dose is still going to give me a boost (just not as high as the larger dose) and it will take about the same amount of time for it to return to baseline (6-8 hours)? In which case, it may just be a matter of finding the...

Were you cream only for a period? At one point, Defy had me taking shots and supplementing with cream. Pushed my numbers shortly after the cream off the charts in total and free testosterone and DHT. It was just too much for me as I am low SHBG.

Yeah, problem there is getting the prescription and the cost. The lowest total testosterone I've tested at prior to starting TRT and then changing over to Enclomiphene was 330, and I don't think I can get insurance coverage for TRT for anything above 300. I went with 1/4 of the usual dose...

Or even maybe just doing one nostril instead of both, or decreasing the nasal dosage by not going the full 8 "clicks" for a rotation. Might be enough to top things off without side effects.

I did notice a lot more random erections, libido probably increased a bit. So there was some good, and maybe that's a sign to me that in general my T is too low. The feeling in my nose and headache was just too annoying, although I'm not ready to give up on it completely, particularly since I...

I tried the Empower version for 5 days. Just didn't like it. It does seem to build up in your nose, and occasionally you can feel it running down your throat, which isn't pleasant. I also felt like I was high (and actually tired) for a few hours after taking each dose, obviously due to the...

@Cataceous @madman I understand taking doses of Natesto 6-8 hours apart from each other, but what is your view on the ideal time to take the doses, particularly in the evening? Trying to get my head around how the evening dose would work with the peak of my natural production in the early...

What about one of their other solutions that doesn't have Finasteride? A combo of Minoxidil and Latanoprost looks promising.