Erections gone, PDE5i's stopped working, E2 related?

[Farmer Bryan]

Quick update; last couple days erections are starting to respond again to cialis, and libido has definitely jumped. Had a great time with the wife last night and orgasm intensity was excellent. As expected, my mood immediately improved.

Changes to my protocol have been no AI for exactly two weeks now, and skipped my last dose of HCG which puts me at about 5 days since last injection of that.

E2 is most likely climbing back up as my skin is noticeably more oily and a little bit of acne showing up but I’m taking that as a good sign and I have no complaints about that.

 

[Simbarn]

While I’m not looking to have kids (vasectomy) when I tried going without HCG for a time I had pretty significant testicular shrinkage that made me quite self conscious. I also had a constant dull ache in my testicles that was really bothersome. This resolved once I resumed the HCG. Also of note is that when I had blood labs drawn for the period of time that I was off HCG, my e2 levels didn’t change much. So it seems HCG doesn’t spike my e2 like it does in other guys. For now, I’d rather keep it going and avoid the testicular pain. Does HCG effect anything else other than T and E2 that could potentially cause ED and loss of libido?

Also, I checked back at my notes from the previous year when viagra was still working for me, everything was the same with my protocol with the exception of cytomel. I was taking a smaller dose back then. 100mcg of T4 and 37.5 mcg T3 as compared to my current 125mcg T4, and 50mcg T3. I’ve never heard of thyroid medication causing loss of erections, in fact it’s usually the opposite, so I doubt it is related.

As for lowering Test back down to 100mg, I’m not one of those guys who thinks more is always better, but at 100mg per week my free T went pretty low and I had a lot of trouble keeping up with my daily chores on the farm. I spent an afternoon building a fence and I could hardly move for over a week afterwards due to muscle pain. I felt 10 years older than my age. At 140mg I can work hard physical labour all day and my muscles are only a bit sore the next day. So while sexual function is unchanged at the higher dose, overall function and my ability to meet my daily demands is significantly better at 140mg a week. I’m not chasing higher numbers, I’m chasing symptom resolution and the ability to keep up with my responsibilities.

Edit to add: I haven’t taken a dose of Arimidex in 10 days, and I will refrain from taking any for the next few weeks to see if that has any positive effect. Although I’m sure it’s already well out of my system now and I don’t feel any change thus far. I will report back if I notice any changes in that regard.

"As for lowering Test back down to 100mg, I’m not one of those guys who thinks more is always better, but at 100mg per week my free T went pretty low and I had a lot of trouble keeping up with my daily chores on the farm. I spent an afternoon building a fence and I could hardly move for over a week afterwards due to muscle pain. I felt 10 years older than my age. At 140mg I can work hard physical labour all day and my muscles are only a bit sore the next day. So while sexual function is unchanged at the higher dose, overall function and my ability to meet my daily demands is significantly better at 140mg a week. I’m not chasing higher numbers, I’m chasing symptom resolution and the ability to keep up with my responsibilities."

I understand you are not necessarily wanting to take a high dose of testosterone (in my opinion 140 mgs per week is a high dose) for physical gains. However, I will give you my thoughts on what could be too much testosterone in your case:

I also understand your symptoms, I had similar sexual issues when I was taking too much testosterone.
If you feel the need to increase your T dose in order to cope with the physical demands you are putting on your body it is not dissimilar to increasing it for better performance in a sport. Yours however, being for more essential reasons of course.

It may be that the high dose you are currently on is acting as a "band-aid" for something else causing your issues which is making you less physically able than what you think a 40 yo should be. One needs to be careful here in knowing the difference between a 40 yo and a 25 yo.
This does not come without consequences. I dislike AI's greatly. In my opinion, if you need to use them it is a sign that too much T is circulating in your body. They are very difficult to control and can cause dramatic sexual issues. I feel it is much better to lower your dose to a point where you do not need them at all.
If you have been using 140 mg per week for a reasonable time you would need to go through a withdrawal period, when you do significantly lower your dose as it can take time for your body to adjust to a new lower level. During this time you may or may not notice any improvement in sexual function and you may feel physically weaker until you become more sensitive and adjusted to a more normal level of T.

I mention all of this in regard to your sexual difficulties. This is one of the trade offs for using too much testosterone: sexual function suffers especially erectile function for some men. As you are injecting 140 mg a week of T , plus 1500 iu of hCG on top of this adding in even more testosterone, I can see why your recent numbers are so high. Excessive testosterone can elevate sympathetic nervous system activity in the body, especially in your penis, which has the effect of lessening the power of the pro-erectile pathways in the erectile tissues. Essentially the pathways that maintain the penis in a flaccid state become more dominant; thereby making the parasympathetic and NO pathways less able to overcome its constant tonic force. This can also manifest as anxiety and other psychological problems due to neurotransmitter imbalances. Sexual sensitivity in the genitals themselves can also decrease because of this, further exacerbating ED.

This can be a side effect for some guys even on a moderate dose of T. The way in which exogenous testosterone is administered is very different to how we produce it naturally in a circadian rhythm, this I feel can upset the autonomic nervous system causing issues with erectile function and sexual sensitivity and the ability to orgasm. I feel some men are far more sensitive to this change in delivery to testosterone in this regard. I am one of those individuals.
I am curious to know how long you were on 100 mg per week? I agree with System Lord; that the AI may be causing much of your issues, possibly driving your estrogen far too low. However, the need to take them is most likely due to too much T in the first place.

You mention that sometimes “the stars align” and you suddenly experience almost normal sexual function. I am very familiar with these transient episodes when I was on higher amounts of testosterone (120 mg per week) than I am currently. They are, in my opinion, moments when the chemistry in your body is able to find a more normal balance (homeostasis) of hormones and neurotransmitters, a particular balance whereby sexual function can work well, something which it finds very difficult to do when an excess of one hormone is being artificially implanted into what is a very finely tuned system. It does not help when some vital hormones are almost missing as well, which are also part of sexual function. These high levels of testosterone can work for some men for a period of time, seemingly improving sexual function, somehow our body manages to cope with it and then it just doesn't. Dysfunctions occur.
If you are taking too much testosterone in order to compensate for other issues in your body, such as aging combined with other comorbidities (I am suspicious of your thyroid issues) then there will be problems. Testosterone is a very powerful chemical messenger. It can appear to ameliorate many issues in our bodies, especially when they start aging, however, we start walking into unnatural territory here and this in when more problems arise.

There has been some interesting research done in the recent past on excessive sympathetic activity in the penis which has been speculated to occur in middle age and beyond. This may mean as we age the mechanisms that keep the penis flaccid most of our waking hours gradually become more powerful or dominant as we age. This has been clearly shown in the animal model. Certain disease states such as diabetes can apparently accelerate this process. The mechanisms in the penis that cause flaccidity (predominantly the NE and the the Rho-kinase pathways) are actually working constantly to keep smooth muscle in all of the expansive tissues in a contracted state, so in effect its in a constant state of "tension" not "relaxation". However, such is the design of this system, that it is the strongest and most resistant mechanism, when compared to the opposing pro-erectile mechanism, known as the parasympathetic and NO pathways. When we are very young the balance between these two forces is much more equal. Not so at middle age, and much less in old age.
I feel TRT can cause further issues here and excessive testosterone may exacerbate this process sooner.
I think some men are more susceptible to this. They are more sensitive to the contractile mechanism in the penis than others, these guys are more prone to performance anxiety or stress causing erectile issues. Even more so as they age.
These men are also sensitive to erectile difficulties from drugs that cause adrenaline to rise in the body, such as cocaine and amphetamines, even coffee.
It would follow that any increase in sympathetic activity caused by TRT in these men may cause significant ED issues.

I wrote a post recently that covers much of what I have discussed here on the topic for another guy who has sexual issues from what I suspect is also too much testosterone. I go into other aspects of TRT there which you may find relevant.

More Penis Sensitivity questions

So I had been commenting earlier about having a difficult time orgasming. Someone had mentioned maybe my dose is too high. I had a thought, and wanted some feedback. So this morning, which is my low as I inject Monday AM and Thursday PM, I had more morning wood than I would normally. So that...

www.excelmale.com

I have just seen your last post about the significant improvement since stopping the AI and reducing hCG (which may also be lowering testosterone). Most likely your estrogen did crash far too low. I note your need for PDE5i for reliable erections, this need may be due to the elevated activity of sympathetic function in the penis. PDE5i boost the power of the NO pathway, thus helping overcome the dominance of the other inhibitory pathway. If you can lessen the power of the sympathetic pathway by reducing that which is stimulating it, will make PDE5i work even better, or you may not need them at all. You may find that after stopping the AI, your estrogen (given your T dose) may swing the other way, which may cause more sexual issues again. Be wary of sudden improvements whenever you make a protocol change as these are often not the true longstanding effects. These can often be just the result of hormone levels surging or dropping.
Good to hear your issues have improved.

I hope the above helps in some regard.

 

[equel]

Maybe:

U used cialis for too long and that along with the AI made ur e2 too low which fucked ur libido.

Lay off AI (or cialis, but pref AI) and libido will come back.

 

[Ribeye]

Greetings,

I've been trying to sort this out on my own for a while, but I'm at my wits end. Really hoping someone can help me solve this dilemma.

Over the past few months erectile function has gone from being able to get really hard with the help of 12.5-25mg viagra to completely dead dick, zero morning wood, and loss of sensation, significant loss of libido. 50mg of viagra doesn't do anything. Cialis at 10mg every day for a week hasn't worked either. Too afraid to try higher doses of viagra since it elevates my heart rate too much.

I'm married and in a very good relationship. I am very attracted to my wife but my body just won't cooperate with me at all and it is becoming very distressing.

I am 40 years old, been on TRT for about 5 years or so. Protocol is currently 140mg T Enanthate weekly in divided doses (E3D) with HCG 500iu E3D. Pin T on day 1, HCG on day 2, nothing day 3, repeat. Been taking 0.25mg Arimidex once per week.

I am also hypothyroid, and am being treated with 125mcg T4, and 50mcg T3 daily (divided doses with cytomel 25, 12.5, 12.5).

Recent blood work:
Free T4: 11.5 (11.5-22.7)
Free T3: 6.3 (3.5-6.5)
TSH: (0)
Reverse T3: (awaiting results, although it hasn't been elevated in recent years)
Estradiol 29 pg/ml (measured 6 days after my 0.25mg dose of ADEX)
Total Testosterone 30.9 mol/L (8.4-28.8)
Free Testosterone 450 pmol/l (115-577)
Bioavailable Testosterone 10.5 nmol/l (2.7-13.5)
SHBG 65.6 nmol/L (10-70)
Prolactin: 5.2 ug/l (2.1-17.7)
A1C: 4.7 (4.5-5.9)
Hematocrit 0.508 (0.410-0.510)
Hemoglobin 170 (135-170)
Ferritin 205 (40-300)

Mood is low and depressed, but I attribute this directly to my lack of sex drive and ED. When I can get hard and have good sex drive, life is great. This has been ongoing since this past summer, getting progressively worse and it's causing me significant anxiety.

The one thing that stands out to me is my SHBG being at the top of the reference range. Historically it has been right smack dab in the middle of the reference range, but has climbed up over the last year. This is most likely due to my T3 (cytomel) dose having gone from about 37.5mcg to 50mcg over the past year as I was beginning to get hypothyroid symptoms again. At 50mcg many of my hypo symptoms have resolved (cold all the time, dragging ass, diminished cognitive function, not digesting) so that seems to be dialled in now.

My E2 level is the big question mark for me. It looks like it is at a good level, but since I don't have access to the sensitive lab test here in western Canada, I really don't know for sure. I'm also wondering if my SHBG being so high could be gobbling up all my E2? From what I understand SHBG has a lower binding affinity for E2 than it does T, but I'm not well versed in SHBG issues.

Any suggestions would be welcome.

Thank you.

I am also hypo thyroid and have been taking T replacement for over a year. I have no issues with libido, and have had nothing but great libido since I started the T replacement therapy. You will have a very difficult time finding any good data suggesting high E2 is the cause of low libido, particularly since your T levels are pretty good. I suppose, if you E2 is unusually high or low, it could explain something, but not likely related to libido and or function. Your thyroid levels are high with TSH at 0. if you have any, thyroid replacement related side effects, nervousness, jittery, sleep issues, increased heart rate, increased BP, I'd look at cutting it back some. You need it, but if you have side effects it means you are getting more than you really need with TSH so low. In my own case, my T3 is actually a little high, my TSH is just under the low end of the therapeutic window, and I have no side effects related to T3 replacement. I also noticed your Prolactin is 5 which is on the low side. This can be estrogen related, that may be something to check into, but that should help, not hurt performance. it can explain post orgasm recovery time or inability to get orgasm regularly if it is HIGH. Yours does not appear to be. Everything I have seen watching the posts here over the last year, stay away from manipulating E2 as much as you possibly can. AI's are not easy to use properly and cause more problems than they help. if your T gets high, and E2 goes up with it, thats not unreasonable, and some like to see E2 high because it brings value, that is, skin quality improvements, cardiac protection, bone loss protective, etc.

 

[Farmer Bryan]

I mention all of this in regard to your sexual difficulties. This is one of the trade offs for using too much testosterone: sexual function suffers especially erectile function for some men. As you are injecting 140 mg a week of T , plus 1500 iu of hCG on top of this adding in even more testosterone, I can see why your recent numbers are so high.

HCG doesn’t seem to raise my T or my E2 much at this current dose (300iu eod) in the past I went one month without it and did labs at the end of that month and there was little change in my lab values. That’s not saying it doesn’t effect some other hormone in the cascade that was not tested. I’ll continue to remain off for a period of time and then reintroduce and see what effect it has on me.

I am curious to know how long you were on 100 mg per week? I agree with System Lord; that the AI may be causing much of your issues, possibly driving your estrogen far too low. However, the need to take them is most likely due to too much T in the first place.

I began at 100mg for the first 6 months of T replacement, didn’t get much improvement. I had originally started with HCG mono therapy and while I felt tremendous benefit from that at 1000iu 3x week, my e2 side effects of water retention and weight gain were too difficult to control which is why my doc suggested going on T with only modest doses of HCG to preserve testicular size and function to some extent. However strength, mood, libido, and overall quality of life were great. Wanted sex all the time. Never needed PDE5i’s everything felt great except I looked like a water balloon. I did this for over a year before switching to T + smaller doses of HCG.

At my current dose of 140mg/week plus HCG my free T levels are lower than they were on HCG mono, and my E2 levels are easily half.

I will admit that my TT is above range, but my current Free and Bioavailable T seem pretty good, no?

I hope the above helps in some regard.

It does. Thank you for the thoughtful and detailed response.

 

[Farmer Bryan]

Maybe:

U used cialis for too long and that along with the AI made ur e2 too low which fucked ur libido.

Lay off AI (or cialis, but pref AI) and libido will come back.

I’ve actually only been taking cialis for the past 6 weeks and my problems began before that. Viagra had stoped working so I thought giving cialis a try to see if that might help.

Two weeks off AI and libido is now showing signs of improving.

 

[Farmer Bryan]

I am also hypo thyroid and have been taking T replacement for over a year. I have no issues with libido, and have had nothing but great libido since I started the T replacement therapy. You will have a very difficult time finding any good data suggesting high E2 is the cause of low libido, particularly since your T levels are pretty good. I suppose, if you E2 is unusually high or low, it could explain something, but not likely related to libido and or function. Your thyroid levels are high with TSH at 0. if you have any, thyroid replacement related side effects, nervousness, jittery, sleep issues, increased heart rate, increased BP, I'd look at cutting it back some. You need it, but if you have side effects it means you are getting more than you really need with TSH so low. In my own case, my T3 is actually a little high, my TSH is just under the low end of the therapeutic window, and I have no side effects related to T3 replacement. I also noticed your Prolactin is 5 which is on the low side. This can be estrogen related, that may be something to check into, but that should help, not hurt performance. it can explain post orgasm recovery time or inability to get orgasm regularly if it is HIGH. Yours does not appear to be. Everything I have seen watching the posts here over the last year, stay away from manipulating E2 as much as you possibly can. AI's are not easy to use properly and cause more problems than they help. if your T gets high, and E2 goes up with it, thats not unreasonable, and some like to see E2 high because it brings value, that is, skin quality improvements, cardiac protection, bone loss protective, etc.

My thyroid dose is actually very dialed in, and for the first time in many years I actually have resolved a lot of the issues I was having with poor digestion, joint and muscle pain, shallow breathing, etc.

Yes, my TSH is 0 as I am on a full replacement dose of thyroid, but I have no side effects and I record my vitals every day. My free T3 is just under the top of the reference range. Pulse rate, BP, body temp all good. No jitters, sleep better than before. I do struggle with anxiety but I have my entire life, and that has actually improved a lot with getting my T levels up as well as my Thyroid. Still room for improvement but I’m definitely on the right track with that.

I think you’re right in that this may be E2 related. Perhaps I’m one of those people who thrives on higher e2? I know some guys suggest there is an optimal ratio (14-20:1 if I’m not mistaken) and if that is the case, then my ratio is definitely out of whack at around 30:1.

With my SHBG being so high I don’t want to drop my T levels right now, so allowing my e2 levels to come up may be what I need to do in order to balance that ratio out.

So far it seems to be helping but it is still early days and I know I need to be patient and let things reach homeostasis.

Thanks for the response.

 

[jobshopper]

Greetings,

I've been trying to sort this out on my own for a while, but I'm at my wits end. Really hoping someone can help me solve this dilemma.

Over the past few months erectile function has gone from being able to get really hard with the help of 12.5-25mg viagra to completely dead dick, zero morning wood, and loss of sensation, significant loss of libido. 50mg of viagra doesn't do anything. Cialis at 10mg every day for a week hasn't worked either. Too afraid to try higher doses of viagra since it elevates my heart rate too much.

I'm married and in a very good relationship. I am very attracted to my wife but my body just won't cooperate with me at all and it is becoming very distressing.

I am 40 years old, been on TRT for about 5 years or so. Protocol is currently 140mg T Enanthate weekly in divided doses (E3D) with HCG 500iu E3D. Pin T on day 1, HCG on day 2, nothing day 3, repeat. Been taking 0.25mg Arimidex once per week.

I am also hypothyroid, and am being treated with 125mcg T4, and 50mcg T3 daily (divided doses with cytomel 25, 12.5, 12.5).

Recent blood work:
Free T4: 11.5 (11.5-22.7)
Free T3: 6.3 (3.5-6.5)
TSH: (0)
Reverse T3: (awaiting results, although it hasn't been elevated in recent years)
Estradiol 29 pg/ml (measured 6 days after my 0.25mg dose of ADEX)
Total Testosterone 30.9 mol/L (8.4-28.8)
Free Testosterone 450 pmol/l (115-577)
Bioavailable Testosterone 10.5 nmol/l (2.7-13.5)
SHBG 65.6 nmol/L (10-70)
Prolactin: 5.2 ug/l (2.1-17.7)
A1C: 4.7 (4.5-5.9)
Hematocrit 0.508 (0.410-0.510)
Hemoglobin 170 (135-170)
Ferritin 205 (40-300)

Mood is low and depressed, but I attribute this directly to my lack of sex drive and ED. When I can get hard and have good sex drive, life is great. This has been ongoing since this past summer, getting progressively worse and it's causing me significant anxiety.

The one thing that stands out to me is my SHBG being at the top of the reference range. Historically it has been right smack dab in the middle of the reference range, but has climbed up over the last year. This is most likely due to my T3 (cytomel) dose having gone from about 37.5mcg to 50mcg over the past year as I was beginning to get hypothyroid symptoms again. At 50mcg many of my hypo symptoms have resolved (cold all the time, dragging ass, diminished cognitive function, not digesting) so that seems to be dialled in now.

My E2 level is the big question mark for me. It looks like it is at a good level, but since I don't have access to the sensitive lab test here in western Canada, I really don't know for sure. I'm also wondering if my SHBG being so high could be gobbling up all my E2? From what I understand SHBG has a lower binding affinity for E2 than it does T, but I'm not well versed in SHBG issues.

Any suggestions would be welcome.

Thank you.

Did you check your DHT?

 

[SpyrosB]

Your issue is low E2 and nothing else! No need to take any antidepressants no need to change anything else whatsoever, drop the Ai and everything will go away. All your symptoms are related to Low E2. Mood, sensation in penis, libido, skin - everything you mention is directy caused by your low estradiol levels.

There is NO maybe.

I can prove it to you via 100 different sources if you don't believe me but please save yourself from that trashy AI.
I'm happy to see you already realised that to an extent and are already much better without the AI.
The hcg however was probably helping, I would suggest you reinstate it.
You attribute your mood to the low libido not because the second causes the first, but because E2 controls mood and libido. When one goes away the other does as well by the same mechanism.
Yes, your high SHBG is further creating problems with your already low E2 indeed.

Also keep in mind cialis has some weak but not at all insignficant AI properties. it does inhibit aromatase. It won't help with your erections when your issues arise from low E2. PDE-5 inhibitors work best on people whose erectile issues are from low T.
Allow your E to rise naturally, do not inhibit it at all for a while, you will feel better than ever, more libido than ever, more sensation and orgasm pleasure than ever, better blood flow and erections and you will ditch the Cialis as well.

Only begin considering AI when you experience
1) Beginnings of Gyno, do not confuse this with nipple sensitivity. E2 increases may make your nipples more sensitive because E2 is connected to sensitivity especially in sexual areas all across the body (hence your numb weewee) - this does not necessarily mean you're getting gyno.
2) Venous leakage. if you have good libido, good sensitivity, get erections but can't keep them, it's time to consider some sort of AI. Although I would go to cialis before I touched any AI at all. Cialis will help with transiently reducing E2 levels and increasing blood flow to maintain erections.

That's it. Hot flashes and being more emotional do not warrant AI use. They are not only transient but better related to fluctuations in E2 levels than steadily increased levels. if you do experience them, allow your levels to stabilise for a few weeks and see if they've gone away. If they have not, it probably means your dosing protocol is causing too much fluctuation, in which case you should inject more often, or less likely, you're actually getting in the high e2 zone.

 

[Farmer Bryan]

Did you check your DHT?

Sorry I thought I responded to this, guess it didn’t post for some reason. Yes, I had my DHT checked in the last year and it was upper quadrant of normal reference range, so all good there.

 

[Farmer Bryan]

Your issue is low E2 and nothing else! No need to take any antidepressants no need to change anything else whatsoever, drop the Ai and everything will go away. All your symptoms are related to Low E2. Mood, sensation in penis, libido, skin - everything you mention is directy caused by your low estradiol levels.

There is NO maybe.

I can prove it to you via 100 different sources if you don't believe me but please save yourself from that trashy AI.
I'm happy to see you already realised that to an extent and are already much better without the AI.
The hcg however was probably helping, I would suggest you reinstate it.
You attribute your mood to the low libido not because the second causes the first, but because E2 controls mood and libido. When one goes away the other does as well by the same mechanism.
Yes, your high SHBG is further creating problems with your already low E2 indeed.

Also keep in mind cialis has some weak but not at all insignficant AI properties. it does inhibit aromatase. It won't help with your erections when your issues arise from low E2. PDE-5 inhibitors work best on people whose erectile issues are from low T.
Allow your E to rise naturally, do not inhibit it at all for a while, you will feel better than ever, more libido than ever, more sensation and orgasm pleasure than ever, better blood flow and erections and you will ditch the Cialis as well.

Only begin considering AI when you experience
1) Beginnings of Gyno, do not confuse this with nipple sensitivity. E2 increases may make your nipples more sensitive because E2 is connected to sensitivity especially in sexual areas all across the body (hence your numb weewee) - this does not necessarily mean you're getting gyno.
2) Venous leakage. if you have good libido, good sensitivity, get erections but can't keep them, it's time to consider some sort of AI. Although I would go to cialis before I touched any AI at all. Cialis will help with transiently reducing E2 levels and increasing blood flow to maintain erections.

That's it. Hot flashes and being more emotional do not warrant AI use. They are not only transient but better related to fluctuations in E2 levels than steadily increased levels. if you do experience them, allow your levels to stabilise for a few weeks and see if they've gone away. If they have not, it probably means your dosing protocol is causing too much fluctuation, in which case you should inject more often, or less likely, you're actually getting in the high e2 zone.

Thank you for your detailed response, I appreciate it. I’m not concerned about nipple sensitivity, in fact I welcome it. Just as you mentioned, it indeed correlates to penile sensitivity and libido for me. It’s not uncomfortable, and I haven’t had any signs of gyno over the many years I’ve been on TRT.

Emotionality is also not a concern for me. In fact lately I’ve felt rather emotionless the past few months which is a very concerning feeling for me as it is not in my nature to feel to flat and dull about life.

Thankfully things are still improving. Haven’t touched AI yet (and don’t plan to) and today I woke up with solid morning wood that I haven’t had in months. I am also feeling far more cheerful again. I’ve also noticed music is far more pleasurable to listen to lately, and even my daily chores on the farm have become enjoyable again.

Surprisingly I feel like my strength is improving as well and after a long days work yesterday I woke up this morning feeling only a slight bit of muscle soreness and ready to tackle the day.

Definitely making solid progress. Thanks to everyone who has chimed in. What a great community Nelson has created here.

 

[SpyrosB]

Thank you for your detailed response, I appreciate it. I’m not concerned about nipple sensitivity, in fact I welcome it. Just as you mentioned, it indeed correlates to penile sensitivity and libido for me. It’s not uncomfortable, and I haven’t had any signs of gyno over the many years I’ve been on TRT.

Emotionality is also not a concern for me. In fact lately I’ve felt rather emotionless the past few months which is a very concerning feeling for me as it is not in my nature to feel to flat and dull about life.

Thankfully things are still improving. Haven’t touched AI yet (and don’t plan to) and today I woke up with solid morning wood that I haven’t had in months. I am also feeling far more cheerful again. I’ve also noticed music is far more pleasurable to listen to lately, and even my daily chores on the farm have become enjoyable again.

Surprisingly I feel like my strength is improving as well and after a long days work yesterday I woke up this morning feeling only a slight bit of muscle soreness and ready to tackle the day.

Definitely making solid progress. Thanks to everyone who has chimed in. What a great community Nelson has created here.

Yes sir! Smell will become more sensitive and food will taste better too. You may find your hair are staying on your head longer. Your skin will not be as dry. Emotions and excitement will return, along with lust. Scary movies will be scary again. You will be less irritable, you will not feel as cold, your eyes may see a tiny bit better , joints will feel fresher and younger. Muscles will recover more easily and remain a lot more on you.Any Pelvic floor issues may improve, blood flow everywhere will be better and you may notice more vascularity. cardiovascular ability will improve, lipids will be better on blood work. Life will be more enjoyable and cognition, memory and concentration will improve. Remember this comment as you go along !

 

[jobshopper]

Sorry I thought I responded to this, guess it didn’t post for some reason. Yes, I had my DHT checked in the last year and it was upper quadrant of normal reference range, so all good there.

How did you feel when your DHT was in the upper quadrant?

 

[equel]

Yes sir! Smell will become more sensitive and food will taste better too. You may find your hair are staying on your head longer. Your skin will not be as dry. Emotions and excitement will return, along with lust. Scary movies will be scary again. You will be less irritable, you will not feel as cold, your eyes may see a tiny bit better , joints will feel fresher and younger. Muscles will recover more easily and remain a lot more on you.Any Pelvic floor issues may improve, blood flow everywhere will be better and you may notice more vascularity. cardiovascular ability will improve, lipids will be better on blood work. Life will be more enjoyable and cognition, memory and concentration will improve. Remember this comment as you go along !

Ye well if they get too high you will feel like shit, flat, life is shit and ur memory will be shit, aswell.

 

[SpyrosB]

Ye well if they get too high you will feel like shit, flat, life is shit and ur memory will be shit, aswell.

Unlikely. Those are not high E2 effects. Low E2 effects they may be.

 

[equel]

Unlikely. Those are not high E2 effects. Low E2 effects they may be.

No, Ive been doing this since 2017, dude. Im a roid monkey. Ive had low e2, high e2, high dht, low dht, high T low T low fucking brain-cells and low penis energy.

Ive tried everything under the sun, I know how this shit works.

When e2 is too high it fucks up ur serotonin and TSH, this makes ur cock weak and creates serotonin dominance, it also shoots prolactin thru the roof which in turn reduces your dopamine. U get lazy, u feel very little hunger, u get "brain fog" and u dont care about sex nor achievement.

 

[SpyrosB]

No, Ive been doing this since 2017, dude. Im a roid monkey. Ive had low e2, high e2, high dht, low dht, high T low T low fucking brain-cells and low penis energy.

Ive tried everything under the sun, I know how this shit works.

When e2 is too high it fucks up ur serotonin and TSH, this makes ur cock weak and creates serotonin dominance, it also shoots prolactin thru the roof which in turn reduces your dopamine. U get lazy, u feel very little hunger, u get "brain fog" and u dont care about sex nor achievement.

What do you suppose overshot your E2 when you experienced this? What were you using?

I am commenting here in the context of TRT. Supraphysiological doses and cocktails of AAS are out of my scope.

 

[equel]

What do you suppose overshot your E2 when you experienced this? What were you using?

I am commenting here in the context of TRT. Supraphysiological doses and cocktails of AAS are out of my scope.

Test injections. Doses over 120mg usually gets my e2 too high. Under 120mg I dont "feel right" (as in high testosterone, obviously).

Over 120mg my prolactin goes up almost 50%, which requires me using caber to hold it down - which in turn give other side effects.

TSH go from ~ 1.0-1.5 to 3-4.

Libido goes down.
Erections get soft.
Face gets fatter.

Yes, ive tried ED injections even, that spikes my e2 even more.

E7d gives me less average e2 than EOD and ED.

Tried it all.

 

[Simbarn]

HCG doesn’t seem to raise my T or my E2 much at this current dose (300iu eod) in the past I went one month without it and did labs at the end of that month and there was little change in my lab values. That’s not saying it doesn’t effect some other hormone in the cascade that was not tested. I’ll continue to remain off for a period of time and then reintroduce and see what effect it has on me.

I began at 100mg for the first 6 months of T replacement, didn’t get much improvement. I had originally started with HCG mono therapy and while I felt tremendous benefit from that at 1000iu 3x week, my e2 side effects of water retention and weight gain were too difficult to control which is why my doc suggested going on T with only modest doses of HCG to preserve testicular size and function to some extent. However strength, mood, libido, and overall quality of life were great. Wanted sex all the time. Never needed PDE5i’s everything felt great except I looked like a water balloon. I did this for over a year before switching to T + smaller doses of HCG.

At my current dose of 140mg/week plus HCG my free T levels are lower than they were on HCG mono, and my E2 levels are easily half.

I will admit that my TT is above range, but my current Free and Bioavailable T seem pretty good, no?


It does. Thank you for the thoughtful and detailed response.

You have lowered the amount of hCG you were taking, so you are now on 300iu 3 times a week instead of 500iu. This may help lower your T levels and estrogen effects of hCG.
It is very interesting that you had no negative effect on erectile function during that year on just hCG, when it was quite apparent that estrogen was causing significant side effects. I also find it as interesting that you now need PDE5i when on exogenous testosterone.

Do you know what level of testosterone the mono hCG was generating?

Yes, your free and bioavailable levels are just under the upper limit, but is this excessive for you? That is, could this much free T be considerably above your natural genetic levels?
Your recent labs show a relatively high level of SHBG. Is this causing the need for a higher dose of T in order to feel the effects of T?
Has your SHBG always been this elevated or has this occurred since TRT?

Some of the other members here who understand SHBG better than I, may comment on this too for you.

Sorry, I just saw in another post of yours that your SHBG went from middle of the range to where it is now on this last test.

 

[SpyrosB]

Test injections. Doses over 120mg usually gets my e2 too high. Under 120mg I dont "feel right" (as in high testosterone, obviously).

Over 120mg my prolactin goes up almost 50%, which requires me using caber to hold it down - which in turn give other side effects.

TSH go from ~ 1.0-1.5 to 3-4.

Libido goes down.
Erections get soft.
Face gets fatter.

Yes, ive tried ED injections even, that spikes my e2 even more.

E7d gives me less average e2 than EOD and ED.

Tried it all.

High e2 is not the cause of those symptoms.. besides, e7d will cannot possibly give you lower e2 than every day injections. There are no mechanisms to account for that.