Help! Insomnia, Irritability, and Libido Issues on TRT

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AhmetAtay

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Here's my most recent bloodwork with an SHBG of 38

I was on 250 mg test C split into daily injections as well as 150 IU HCG ED. I was also taking 100 mg pregnenolone before bed because my pre-TRT progesterone was 0.1

I have been waking up too early (after 6 hours in bed) and unable to go back to sleep + feeling mildly irritable and having problems with libido. My sexual interest is okay but my erections are absolutely laughable. It also seems to take me forever with stimulation to actually achieve orgasm.

I'd appreciate any help!

Based on these results I'm likely going to lower my test dose to 140 mg/week (still every day) and keep the HCG dose while dropping the pregnenolone.

Lab Results September 01.png
 
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Here's my most recent bloodwork with an SHBG of 38

I was on 250 mg test C split into daily injections as well as 150 IU HCG ED. I was also taking 100 mg pregnenolone before bed because my pre-TRT progesterone was 0.1

I have been waking up too early (after 6 hours in bed) and unable to go back to sleep + feeling mildly irritable and having problems with libido. My sexual interest is okay but my erections are absolutely laughable. It also seems to take me forever with stimulation to actually achieve orgasm.

I'd appreciate any help!

Based on these results I'm likely going to lower my test dose to 140 mg/week (still every day) and keep the HCG dose while dropping the pregnenolone.

View attachment 25287
100 mg/week split however you want. You got some room to go lower (lol).
 
I think I’ll try the 140 mg/week split into daily and have my bloods drawn again. I’m switching to propionate instead of Cypionate so I can adjust my dosage and have blood serum levels stabilize more quickly to facilitate dialing in.
 
TRT often is of little help with libido for many men. I know TRT is marketed as helping libido. Still, then, you see on forums like this where a great many guys find it of no help whatsoever in the libido department - and it's not always due to flawed protocols - often a guy's numbers will look perfect on paper and still, low to no libido.
 
I’m just trying to understand though why my libido would be poor with these numbers
There are some men on cycles reporting diminished sexual parameters and returning to normal levels brings it all back. You're well above normal and perhaps your body in an attempt to protect itself is down regulating the response to androgens.

High T can be just as bad as low-T for certain individuals.


Things that affect libido:
  • Obesity
  • High blood pressure
  • Diabetes
  • Poor sleep
  • Medications
  • Stress/depression
  • Low testosterone
  • Infections
  • High prolactin
  • Low thyroid hormones
  • Alcohol & drugs
  • Surgery
  • Heart disease
  • High cholesterol
 
I’ll do that. I’m just trying to understand though why my libido would be poor with these numbers

Your dosages are killing your erections. Thats the bottom line. Erections are a result of many physiological and neural signals (parasympathetic vs sympathetic nervous system signals, neurotransmitters, etc). You have effectively created an onslaught of a hormonal signal that is shutting down your other physiological, neurological signals.

As an aside, there are a host of dangerous outcomes from supra-exogenous dosages of testosterone. 150 mg q 10 days is more than sufficient for libido, overall wellbeing, muscle growth, etc. Let a trained, licensed physician guide you.

Also, consider getting some blood work labs done on your hemoglobin, RBC count and hematocrit to check for polycythemia. You might need to adopt therapeutic phlebotomy if your HCT is sky high, which likely is given your dosages and numbers.

See a physician ASAP and address these issues honestly.

see:

Melis MR, Sanna F, Argiolas A. Dopamine, Erectile Function and Male Sexual Behavior from the Past to the Present: A Review. Brain Sci. 2022 Jun 24;12(7):826. doi: 10.3390/brainsci12070826. PMID: 35884633; PMCID: PMC9312911.

Giuliano F, Rampin O. Neural control of erection. Physiol Behav. 2004 Nov 15;83(2):189-201. doi: 10.1016/j.physbeh.2004.08.014. PMID: 15488539.
 
My hemoglobin was 13.1 and hematocrit was 42.4.

That was a massive improvement for me once starting therapy. I have Beta Thalassemia Trait and my pre-TRT hemoglobin was 10.9
 
Yep. I dropped down to 120 mg. Feeling a bit better. I also took a little bit of an AI to get that E2 down faster.

BTW this was all being done through a clinic which I now realize didn’t know anything at all. Looking to change clinics now.
 
My starting prog was 0.1 and I was taking 100 mg Pregnenolone and 50 mg DHEA.

That brought my prog up to 1.9.

I’m now doing 20 mg Pregnenolone. That ought to bring my progesterone down into range.
 
Basically all of your labs are crazy high. In some guys their E2 level needs to be close to their SBGH level to feel good (this is the case for me). I also cannot stand pregnenolone. Dial it back and see how you feel.
 
Basically all of your labs are crazy high.

^^^^^^^^
What he said.

What did your Doctor say when he saw your Test and E2 labs? Is that E2 test a sensitive E2 test?

It sounds like you more than halved your Test dosage (which is good), and were taking "a little bit of AI." Please define "a little bit of AI."
 
Basically all of your labs are crazy high. In some guys their E2 level needs to be close to their SBGH level to feel good (this is the case for me). I also cannot stand pregnenolone. Dial it back and see how you feel.

This is pretty interesting... I've always noticed the same but never put it together.
 
Does anyone have any idea on why my libido/erectile quality might be poor with these numbers? High E2? High progesterone?
I have the same issue on higher doses. My theory is it has something to do with overstimulation of some neurotransmitters. Way too amped up. I get the same way if I drink too much caffeine also. Lower your dose. A LOT! And I wouldn’t change to test prop either. Stick with cyp or enanthate.
 
Beyond Testosterone Book by Nelson Vergel
^^^^^^^^
What he said.

What did your Doctor say when he saw your Test and E2 labs? Is that E2 test a sensitive E2 test?

It sounds like you more than halved your Test dosage (which is good), and were taking "a little bit of AI." Please define "a little bit of AI."
I wasn’t taking any AI when I had the test. After seeing the test values, I took 0.25 mg arimidex ONCE while I waited for my T levels to drop. It is an ultra sensitive E2 test.
 
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