low SHBG. Zero libido - help please

[The slice]

See if you can eliminate all of the potential causes for low libido.

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

Prolactin would be the only one I couldn’t eliminate from the list.

 

[GeauxBears]

Any possibility you are undiagnosed ADHD?

@The slice The single most contributing factor to my libido issues was ensuring my ADHD was properly treated, which I didn’t even know I had the condition until the pandemic hit and I was overwhelmed by work + family in same space.

I had erection issues literally because I was multitasking thinking about what kind of coffee brew I wanted in the AM vs. the great sex that was right in front of me. 15 mg Dexedrine ER in AM and then again at noon solved those particular issues While TRT handled the erection quality and other challenges I was experiencing.

 

[Systemlord]

I have considered prolactin may be the issue but I suspect it’s more likely my free test to E2 ratio.

You do not have a prolactin issue. You do have low E2 issue, as your ratio of testosterone to estrogen is too high.

You need a higher dosage of hCG, estrogen therapy, or DHEA which will convert to estrogen in men.

Anything <83 pmol/L or 20 pg/mL is considered low in adult males, children typically score at the bottom end of those ranges.

Estrogen, the main sex hormone in women, and plays a bigger role in male libido than previously thought, according to research that may guide development of sex-drive treatments.

The study found that reducing estrogen in men undergoing treatment for low testosterone resulted in a drop in libido and an increase in body fat, even as testosterone levels improved.

The research is published in the New England Journal of Medicine.

 

[Seagal]

You do not have a prolactin issue. You do have low E2 issue, as your ratio of testosterone to estrogen is too high.

You need a higher dosage of hCG, estrogen therapy, or DHEA which will convert to estrogen in men.

Anything <83 pmol/L or 20 pg/mL is considered low in adult males, children typically score at the bottom end of those ranges.

Estrogen, the main sex hormone in women, and plays a bigger role in male libido than previously thought, according to research that may guide development of sex-drive treatments.

The study found that reducing estrogen in men undergoing treatment for low testosterone resulted in a drop in libido and an increase in body fat, even as testosterone levels improved.

The research is published in the New England Journal of Medicine.

IMHO, before doing all above, I would lower the T dose and check what impact it has on your E2. Maybe you have already some E2 data points when you tried different T dosages.