Low Libido, Low SHBG Protocol HELP - LABS x3

Robotics · May 24, 2020

Has anyone dealt with something similar? Libido seems to be illusive and hard to find. I am a low SHBG and struggle with libido/erections. daily injector IM (9mg x 7 = 63 mg week)

The only time I have felt normal in that sense (libido) is usually when I am coming off TRT (for a week or two). Or randomly when off TRT for a select week or so.

I theorize that my E2 on TRT is too high even though my T is sufficient. I also feel anxiety and loss of Penis sensitivity and orgasm quality on TRT.

I am thinking of adding in 0.125mg 2x a week of arimidex, then 3x depending on how i feel/labs. To get my estradiol and free e2 down to match that set of labs where i felt some libido and decent erections(green column) to reach my Target (blue column).

Any Advice?

Estradiol is non-sensitive - sensitive is not available in my province.

	Some Libido/ Decent Erections (off TRT)	Bad libido/Erections (off TRT)	Bad libido/so so Erections (on TRT)	Target	Range
TT	297	320	536	536	(230-835) ng/dl
FT	301	276	592	592	(175-700) pmol/L
Estradiol	23.43	22.06	39	23.43	(0-44) pg/ml
SHBG	16	20	16	16	(10-55) nmol/L

Calculated Free E2	0.67	0.58	1.14	0.68
Calculated TT/E2 Ratio	12.7	14.5	13.7	22.9
Calculated FT/E2 Ratio	12.8	12.5	15.2	25.3

Free E2 Calculator came from:
Spreadsheet for Calculating Free T & E2

TLawyer · May 24, 2020

Robotics said:
Has anyone dealt with something similar? Libido seems to be illusive and hard to find. I am a low SHBG and struggle with libido/erections. daily injector IM (9mg x 7 = 63 mg week)

The only time I have felt normal in that sense (libido) is usually when I am coming off TRT (for a week or two). Or randomly when off TRT for a select week or so.

I theorize that my E2 on TRT is too high even though my T is sufficient. I also feel anxiety and loss of Penis sensitivity and orgasm quality on TRT.

I am thinking of adding in 0.125mg 2x a week of arimidex, then 3x depending on how i feel/labs. To get my estradiol and free e2 down to match that set of labs where i felt some libido and decent erections(green column) to reach my Target (blue column).

Any Advice?

Estradiol is non-sensitive - sensitive is not available in my province.

Some Libido/ Decent Erections (off TRT)

Bad libido/Erections (off TRT)

Bad libido/so so Erections (on TRT)

Target

Range

TT

297

320

536

536

(230-835) ng/dl

FT

301

276

592

592

(175-700) pmol/L

Estradiol

23.43

22.06

39

23.43

(0-44) pg/ml

SHBG

16

20

16

16

(10-55) nmol/L

Calculated Free E2

0.67

0.58

1.14

0.68

Calculated TT/E2 Ratio

12.7

14.5

13.7

22.9

Calculated FT/E2 Ratio

12.8

12.5

15.2

25.3

Free E2 Calculator came from:
Spreadsheet for Calculating Free T & E2

That's an incredibly narrow range on your E2. Doesn't really seem workable to to keep it within a 1 point range. What is your DHT level?

Robotics · May 24, 2020

TLawyer said:
That's an incredibly narrow range on your E2. Doesn't really seem workable to to keep it within a 1 point range. What is your DHT level?

DHT top of range due to my low shbg. The target E2, is just that, a target. I expect to get around it plus or minus a few points (low 20's).

Cataceous · May 24, 2020

It could be a useful experiment, but I'm sure you're aware of the multiple other variables that can differ between being on TRT and not, e.g. kisspeptin, GnRH, LH...

swoops36 · May 24, 2020

You’ve got a lot of room to work with your dose. You might find you feel better with TT/FT higher even with lower SHBG. Your e2 looks fine, I wouldn’t add an AI to an already lower T protocol

Robotics · May 24, 2020

swoops36 said:
You’ve got a lot of room to work with your dose. You might find you feel better with TT/FT higher even with lower SHBG. Your e2 looks fine, I wouldn’t add an AI to an already lower T protocol

I feel high E symptoms even at 39. Anxiety, dull orgasms, loss of sensitivity.

swoops36 · May 24, 2020

I see. I think your solution could be to see if your dose needs to be higher, or have you tried that before?

TLawyer · May 24, 2020

Robotics said:
DHT top of range due to my low shbg. The target E2, is just that, a target. I expect to get around it plus or minus a few points (low 20's).

What do you consider top of the range? I wouldn't think it would be that high given where your TT is right now. For what it's worth, I am low SHBG (11-13) and use cream and injections. With cream, I hit total testosterone about 1,500 with a DHT of 144, and Defy is good with that. I level out with a total testosterone about 700 and DHT at 49 when the cream wears off.

TLawyer · May 24, 2020

Robotics said:
I feel high E symptoms even at 39. Anxiety, dull orgasms, loss of sensitivity.

Have you ever had your prolactin levels tested?

Robotics · May 24, 2020

TLawyer said:
Have you ever had your prolactin levels tested?

Yes a while back. It was 11 (0-15 ug/L)

Systemlord · May 25, 2020

Robotics said:
I feel high E symptoms even at 39. Anxiety, dull orgasms, loss of sensitivity.

I find that some men struggle to get an ideal T/E2 ratio on TRT, lowering your dosage might take you further away from your ideal T/E2 ratio, but raising your dosage may or may not do the trick.

Robotics · May 25, 2020

Systemlord said:
I find that some men struggle to get an ideal T/E2 ratio on TRT, lowering your dosage might take you further away from your ideal T/E2 ratio, but raising your dosage may or may not do the trick.

isn't another option adding a low dose AI? I have already tried lowering my dosage gradually down by 1mg a day increments, E2 came down but T values did as well as expected. How would raising my dosage help, the excess dht might offset the e2?

AdamYoung · May 25, 2020

Does testosterone cream reduces aromatising to estrogen n dht? Or the solution here is to use ester which doesnt aromatise. Can any experts way in please?