Libido - 1 huge leap forward, 5 steps back.

[The slice]

I have always struggled with libido and generally feeling good on TRT.



I am a relatively low aromitiser and have single digit SHBG.



I have tried just about every protocol under the sun over the last 10 years. Over the last year I have been experimenting with lower doses (60-90 mg per week) I have better morning wood with this approach but ZERO libido and delayed ejaculation. I believe the issue with this approach is my E2 just gets too low, bottom 15% of the reference range.



I decided a few months ago to try higher dosages - (250mg / week) I got a minor improvement in energy, sense of wellbeing, a slight improvement in ejaculation but still zero actual libido.



A few weeks ago I stated to realise I was looking a little puffy, bloated and my morning wood was not consistent - I decided to try a small dose of an AI to see if there were any improvements. WOW!!! 12.5mg of Aromasin and the next day my libido was through the roof. I mean insane, for the first time in 10 years I felt sexual desire!!!!! I ordered a blood test as I wanted to get a reading of what my blood work looked like when I am feeling horny.



It was a week before my test arrived and over the course of the following days, the libido dropped. 2 days feeling amazing, 2 days feeling ok, and a few days of feeling just ok. My blood work (now a week after taking the AI) showed my E2 as right at the top of the reference range. I then took another 12.5mg of Aromasin and the effects were nowhere near as pronounced. I took another 12.5mg another week later and I felt like shit. Libido gone, morning wood gone - I did blood work and realised over the course of a few weeks I had managed to crush my E2. It was only just registering on the reference range. (11).







Couple of strategies I am considering:



Moving to test prop daily injections - I have heard of some people responding better libido wise to a more rapid fluctuation as opppsed to a steady release. Perhaps it was the fluctuation of using the AI that cause the improvement?



Lowing my test down to 40mg per week to bring my free test and androgen index within the normal range and adding E2 vaterate to make up for the low aromatisation. My body clearly likes having higher E2



Dropping test all together and running primobolan as my primary androgen alongside exogenous E2



Go back to doing the 210 test. Trying a lower dose of Aromasin and/or using HCG to minimise potential crashing of E2



As frustrating is this has been it does give me some hope that libido is possible - I am not joking, best part of 10 years I’ve had zero sex drive and for those few days it was like being a 15 year old kid again.



Any thoughts, insights or suggestions would be massively appreciated.

 

[M.J]

Thing that worked for me, stop using hcg after three weeks of use, and you get honeymoon period.
It won’t come immediately maybe the next day but give it 4 or a week max it will come.
I have been doing this for years now.
I discovered it because I travel often and. Noticed this keeps repeating and figured approximate cyclical time for it which is 3weeks.

Don’t stop using testosterone during this time, Only stop hcg. That the only thing worked for me.

 

[chriskchris]

I have had similiar experiences. It has been 10-years now that I have been on HRT. Started very early in life with secondary hypo, idiopathic.

To get to your point, it wasn't until the last year that I realized without HCG I do not get good libido. Like you, the positive impacts are very short-lived and cyclical. I believe it is attributable to high E2 as the HCG causes really high E2. I have no idea why cypionate does not work well on its own although like you, have times where it 'works well' if I boost the dose before subsiding and feeling terrible.

Like you I have very low SHBG. Often I have low testosterone but high bio testosterone. E2 is always on the high side of normal but with HCG it can go well above the high side of normal.

So like you, I find it hopeful that we can turn our situations around as I proved this year after 10-years of HRT that sex life can be normalized and all is not lost. The erections I have had in the past year with HCG were the best ever and I didn't need pills. The challenge is to maintain the positive feeling which includes energy levels and gym strength.

So I re-started it all with anastrozole, starting with 25 mg per week and will go by how I feel. Also breaking my Cypionate dose into 2 (50 + 50) as rec'd by many of the knowledgeable members on here for those who have SHBG in a way to mitigate estradiol conversion. Also reduced by HCG dose to 300 miu x 3 rather then 500 miu x 3, which after a couple blood tests have helped lower estradiol.

Can't comment on low E2 as I haven't had that since without low tesosterone but high E2 is the end of your sex life on HRT from my experience.

 

[M.J]

I have had similiar experiences. It has been 10-years now that I have been on HRT. Started very early in life with secondary hypo, idiopathic.

To get to your point, it wasn't until the last year that I realized without HCG I do not get good libido. Like you, the positive impacts are very short-lived and cyclical. I believe it is attributable to high E2 as the HCG causes really high E2. I have no idea why cypionate does not work well on its own although like you, have times where it 'works well' if I boost the dose before subsiding and feeling terrible.

Like you I have very low SHBG. Often I have low testosterone but high bio testosterone. E2 is always on the high side of normal but with HCG it can go well above the high side of normal.

So like you, I find it hopeful that we can turn our situations around as I proved this year after 10-years of HRT that sex life can be normalized and all is not lost. The erections I have had in the past year with HCG were the best ever and I didn't need pills. The challenge is to maintain the positive feeling which includes energy levels and gym strength.

So I re-started it all with anastrozole, starting with 25 mg per week and will go by how I feel. Also breaking my Cypionate dose into 2 (50 + 50) as rec'd by many of the knowledgeable members on here for those who have SHBG in a way to mitigate estradiol conversion. Also reduced by HCG dose to 300 miu x 3 rather then 500 miu x 3, which after a couple blood tests have helped lower estradiol.

Can't comment on low E2 as I haven't had that since without low tesosterone but high E2 is the end of your sex life on HRT from my experience.

Seems like fluctuation in estrogen is the reason behind libido or whatever hormones hcg plays with.
I still cycle hcg to get that boost. I wish there was another way.

 

[Systemlord]

Seems like fluctuation in estrogen is the reason behind libido or whatever hormones hcg plays with.

Steady hormones isn't always optimal for libido. Steady hormones can lead to overstimulation for some is enough to mess with erectile strength and or libido.

Oral testosterone, Kyzatrex or Jatenzo anyone?

 

[Sergel]

Steady hormones isn't always optimal for libido. Steady hormones can lead to overstimulation for some is enough to mess with erectile strength and or libido.

Oral testosterone, Kyzatrex or Jatenzo anyone?

I can't get Prop in Canada... thinking of trying Oral for a bit to see if libido would improve ....

Anyone here on oral?

 

[Nujace]

I can't get Prop in Canada... thinking of trying Oral for a bit to see if libido would improve ....

Anyone here on oral?

There’s several quality UG sources in Canada that carry Test Prop. Easy to source.

 

[Phil Goodman]

Seems like fluctuation in estrogen is the reason behind libido or whatever hormones hcg plays with.
I still cycle hcg to get that boost. I wish there was another way.

When you cycle HCG what does that timing look like? Been on a lowish dose(750 ius/week) for a few years and do well on it. Have considered taking a break, but then I always end up leaning towards “if it ain’t broke don’t fix it”.

Do you notice a benefit from a break that makes it preferable for you more than just staying on?

 

[Systemlord]

Anyone here on oral?

I used to be on oral T, way better than injections.

Thread 'My Experience On Jatenzo (Oral TRT) Log'

Jun 16, 2021

I wanted to start a thread detailing my personal experience with Jatenzo (oral TRT) which is remarkable in how quickly it has shown results when compared with injections. The first week on Jatenzo was very pleasant unlike my experience after dosing changes on injections, all with minimal swings and I felt things stabilize on day 7 which is where things felt consistent.

The first few days on Jatenzo my glucose levels were the lowest, then over the next two and a half weeks I would see glucose levels fluctuate wildly and at the end of week three a return to those same lower fasting and...

• Systemlord
• jatenzo oral testosterone
• Replies: 374
• Forum: Testosterone Basics & Questions

• 

 

[Phil Goodman]

I used to be on oral T, way better than injections.

Thread 'My Experience On Jatenzo (Oral TRT) Log'

Jun 16, 2021

I wanted to start a thread detailing my personal experience with Jatenzo (oral TRT) which is remarkable in how quickly it has shown results when compared with injections. The first week on Jatenzo was very pleasant unlike my experience after dosing changes on injections, all with minimal swings and I felt things stabilize on day 7 which is where things felt consistent.

The first few days on Jatenzo my glucose levels were the lowest, then over the next two and a half weeks I would see glucose levels fluctuate wildly and at the end of week three a return to those same lower fasting and...

• Systemlord
• jatenzo oral testosterone
• Replies: 374
• Forum: Testosterone Basics & Questions

• 

Perhaps for you, you also appear to be an outlier in a lot of ways. From what I’ve seen, most who’ve tried both greatly prefer injections.

 

[Jerajera]

I can't get Prop in Canada... thinking of trying Oral for a bit to see if libido would improve ....

Anyone here on oral?

I would try compounded cream applied to the scrotum if you can get it in Canada. Best protocol for me in 5 years of trying pretty much everything including combos of Test + Primo/Masteron, in terms of energy, libido and mental clarity.

Huge difference between once/day and twice/day application though; I don't feel nearly as good on twice/day application.

Test P was also great for libido but I aromatized too much on it and quickly got severe anxiety, water retention, higher BP, headaches, etc...cream is similarly quickly in and out of your system (also leading to less HPGA suppression), but the disproportionate conversion to DHT relative to any other exogenous Testosterone modality is great for those who aromatize more than ideal (I would guess the majority of men, especially as they get older) as DHT is strongly antagonistic of E2 (and in a way that is almost certainly healthier than AIs).

 

[madman]

I can't get Prop in Canada... thinking of trying Oral for a bit to see if libido would improve ....

Anyone here on oral?

TE or TC are your only options when it comes to injectable esterified T as they are the treating testosterone deficiency in Canada.

As I have stated in a previous thread if you wanted to give TP a go than you would need to seek out a UGL source!

When it comes to oral TU in Canada your only options are the generics as the grand daddy Andriol which was the only oral TU available on the market for decades.

Even then would not even waste my time with the older TU formulation Andriol/generics due to poor absorption/blood levels achieved as they need to be taken with meals high in fat mind.


* Clinical and biochemical variability

* An early oral TU formulation (ANDRIOL®) was approved for use in many countries but never in the United States. This formulation is heavily reliant on dietary fat intake as a means of increasing absorption and therefore leads to significant intra- and inter-patient variability in testosterone response [23, 24]. This results in the need to dose hypogonadal men with several capsules three or more times daily affecting compliance. Several studies have also demonstrated both gastrointestinal and liver adverse effects including severe cholestasis and jaundice [25, 26]. Consequently, these oral TU formulations have never been widely utilized to treat TD in the United States although they remain available in many countries




A new oral testosterone undecanoate therapy comes of age for the treatment of hypogonadal men (2020)

*Historically, efforts to administer oral T have taken two primary paths: alkylation of T at the C-17 position to create T analogs that are resistant to first-pass hepatic metabolism (exemplified by methyltestosterone);2 or fatty-acid esterification of T to create a T-ester (exemplified by TU) that is absorbed via the intestinal lymphatic system thus bypassing the portal circulation.3 Oral methyltestosterone, originally discovered and used clinically in the mid-1930s,1 is the only oral TRT ever approved for use in the US, but has been associated with serious hepatotoxicity such as cholestasis, peliosis hepatis, and hepatic adenocarcinoma4–6 and therefore is not recommended for clinical management of male hypogonadism. Conversely, while oral TU has not been associated with liver toxicity, an early oral TU formulation approved for use in many countries but never in the US (Andriol®) was highly influenced by dietary fat, thus leading to significant intra- and inter-patient variability in T response and questionable clinical utility.7,8 Reformulation of this product to reduce the effect of dietary fat did not address the low TU content of the capsules, thus resulting in the need to dose hypogonadal men with several capsules three or more times daily. Even then, reported serum T response would not result in average serum T levels in the normal range9 and therefore would not pass current-day regulatory scrutiny for efficacy. Consequently, these oral TU formulations have never been widely used to treat T deficiency although they remain available in many countries.








You would be far better off using one of the newer oral TU formulations (Jatenzo, Kyzatrex or Tlando).

Unfortunately none of them are available in Canada but the good news is both as Marius Pharmaceuticals and Verity Pharmaceuticals are currently seeking approval from Health Canada.

If they are approved they will most likely be available sometime this year.

Thread 'Testosterone Products in Canada - (oral TU, transdermal, injectables)'

Oct 12, 2024

Big pharma transdermal T patch Androderm manufactured by Allergan Inc. was discontinued back in 2018!

Big pharma brand name Andriol (oral TU) manufactured by Merck was also discontinued back in 2018 and more recently 2024 our beloved Delatestryl (testosterone enanthate) manufactured by Valeant has been discontinued.

The only oral TU available is the generic PMS-Testosterone and Taro-Testosterone capsules.

Come 2025 we may have the option to use the newer versions of oral TU Kyzatrex or Tlando which are available in the US as Marius Pharmaceuticals and Verity Pharmaceuticals are...

• madman
• canada; trt; testosterone/formulations
• Replies: 4
• Forum: Testosterone and Men's Health Articles

Thread 'Testosterone Therapy in Canada'

Mar 25, 2023

@Marcel

THE DEA And ACCESS TO TRT TELEMEDICINE

It only took 22000 comments and a few congresspeople to stop the DEA from scheduling kratom, and that was with 60 days to comment. We are up to -15k comments and at least 6 congresspeople and two senators with one week left to comment and a far stronger case than with kratom. If the DEA ignores...

www.excelmale.com

We have always been far worse off than the US when it comes to the treatment of men for testosterone deficiency.

Although there has been some improvement in certain areas we are still lacking in many others.

*In 2013, a comprehensive Canada-wide needs assessment revealed that over 25% of Canadian physicians were uncomfortable with the diagnosis and treatment of TD and identified significant knowledge gaps related to patient management.4 To address...

• madman
• canada; trt; teatment; blood test/assay
• Replies: 9
• Forum: Testosterone and Men's Health Articles

• 

Post in thread 'Would love some input on lab results'

May 25, 2018

I was chuckling a bit while reading this. Seems that 200mg twice a day can get men to average levels and 300mg twice a day for upper range. My current prescription of 40mg twice a day doesn't look like it will do much at all.

I think there are 60 capsules in each bottle so 300 mg twice a day would last 4 days taking 15 capsules a day to get to upper normal

Do not get to caught up on the doses used in that study.

I had thought that the starting dose was 80 mg/day (40mg morning/40mg evening).

It is actually 120-160mg (60-80mg morning/60-80 mg evening) for the first 2-3 weeks to...

• madman

Post in thread 'HELP - Doubts about TRT'

Apr 12, 2024

Andriol sounded a great option but what about the dosage thing, apparently it is severly underdosed like 40 mg a pill, and people saying to have a decent dose that changes something physiologically, you need too many capsules and end up having to buy multiple bottles per month.

Break it down here: Wondering if my TRT prescription schedule makes sense at all

Andriol has been discontinued in Canada and was replaced by the generic Taro-Testosterone.

Even then I would not recommend anyone use it let alone very few doctors would even prescribe it as many men will have a hard...

• madman

Post in thread 'Results: SubQ vs IM @ 70mg/week'

Dec 28, 2024

Is this hard on the liver?

No it would be from use of the 17α-alkylated orals such as stanozolol, oxandrolone, methyltestosterone, methandrostenolone, oxymetholone, and fluoxymesterone as they are notorious for driving down HDL, increasing LDL, stressing the liver and hammering down SHBG.

Even then the dose/duration of use will play a big role.

Androgel Not working

I heard oral t affects kidneys? And is very expensive? You would mean liver. When it comes to testosterone therapy methyltestosterone was the older original c-17 alpha alkylated oral formulation used which had been linked to such! It is no longer used and was replaced by Andriol (oral TU)...

www.excelmale.com

Oral TU (Jatenzo, Tlando, Kyzatrex) and throw in the first oral TU formulation Andriol which was released in 1970!

* [1]. Systemic...

• madman

• 

Post in thread 'My Experience On Jatenzo (Oral TRT) Log'

Feb 20, 2022

Madman, you are citing the manufacturer of Jatenzo, which has an obvious bias to trash the competition Andriol and convince us Jatenzo is much better.

I highly doubt one cannot achieve normal testosterone levels with 200mg Andriol twice per day, regardless of how many capsules that is and how much it will cost. I also highly doubt that Jatenzo has absorption much different from Andriol due to some imaginary "proprietary vehicle". There are claims that oral undecanoate is absorbed through the lymphatic system long before Jatenzo.

Look over some of the older oral TU (Andriol)...

• madman

• 

 

[madman]

Perhaps for you, you also appear to be an outlier in a lot of ways. From what I’ve seen, most who’ve tried both greatly prefer injections.

Again much more to the story here!

Post in thread 'Feedback on lab results'

Oct 12, 2024

Feel better on trt or not on trt?? Kind of confused because above you said you feel better now than you did on trt.


Either way, it’s your life and hope you find something that works and makes you feel good enough to enjoy your time on this planet. I do agree with madman though, that free t level seems chronically low and not what most would consider even close to a healthy level. If you feel better there then hopefully you’re an exception.


Also, if you are such an outlier that makes me reconsider your constant praise of oral testosterone. Not saying it didn’t work for you...

• madman

•