Penis sensitivity issue

[jonezee2014]

I've been on TRT for about 6 years now and still struggle with getting sex right back to where it was prior to a vasectomy I had. I discovered immediately after it that my testosterone tanked (at the time the doctors had no clue so I went on a series of SSRIs for over a year until a blood test was done). Since then I've had times were it was great but mostly it hasn't been dialed in. I've done tons of research on the forums here and still seem to struggle. I'm a low SHBG guy and have attached my latest panels here that might be relevant. For the most part I feel pretty good nowadays but my biggest struggle is penis sensitivity, erection quality and anorgasmia. These were pretty normal prior to TRT and not much of an issue. I have a good libido and usually I have no problem obtaining an erection but keeping it sometimes is a challenge and the biggest problem seems to be because the sensitivity is diminished and it sometimes takes way too long to have an orgasm, and sometimes just give up. I've worked with Defy Medical, Dr Rob Kominiarek and most recently Dr Meehan and I just can't seem to get things right. I did get quite a bit of improvement once starting daily tadalifil (lead to almost every day having morning wood vs before it was hit or miss) but the sensitivity has remained a challenge. Attached is my latest labs and below supplements I was talking at the time of the labs.

Here's my protocol as of my latest blood test attached:
.13mL Test Cyp and prop blend daily
140iu HCG daily
AM DHEA, Vitamin D, 5mg Cialis daily
Noon Allopurinol
PM Magnesium, best rest / insomintol (melatonin), 25mg DHEA, 60mg Pregnenolone

Here's my current protocol, I've dropped some things down trying to troubleshoot this problem and taking some advice from Dr Meehan:
.1mL Test Cyp daily
1 click Test cream applied to inside of leg daily
AM Vitamin D, 5mg Cialis, Iron supplement
PM Best rest / insomintol, 60mg Pregnenolone

 

[Loki]

I would switch the application of the cream to your nuts. Makes a huge difference. Also your prolactin isn't out of range but on the high end of it. I swear by Cabergoline. I will check my dosing but it is the recommended amount from Gene on this site. You could even cut it down to half of what he recommends. Your DHT is on the low side as well, so that application change will boost it for sure.

I think those 2 adjustments and it would make a huge difference...

 

[Vvs1]

I would switch the application of the cream to your nuts. Makes a huge difference. Also your prolactin isn't out of range but on the high end of it. I swear by Cabergoline. I will check my dosing but it is the recommended amount from Gene on this site. You could even cut it down to half of what he recommends. Your DHT is on the low side as well, so that application change will boost it for sure.

I think those 2 adjustments and it would make a huge difference...

Do you take Cabergoline based on symptoms? Such as you have normal prolactin but improved sexual function while taking it.

 

[Vvs1]

I've been on TRT for about 6 years now and still struggle with getting sex right back to where it was prior to a vasectomy I had. I discovered immediately after it that my testosterone tanked (at the time the doctors had no clue so I went on a series of SSRIs for over a year until a blood test was done). Since then I've had times were it was great but mostly it hasn't been dialed in. I've done tons of research on the forums here and still seem to struggle. I'm a low SHBG guy and have attached my latest panels here that might be relevant. For the most part I feel pretty good nowadays but my biggest struggle is penis sensitivity, erection quality and anorgasmia. These were pretty normal prior to TRT and not much of an issue. I have a good libido and usually I have no problem obtaining an erection but keeping it sometimes is a challenge and the biggest problem seems to be because the sensitivity is diminished and it sometimes takes way too long to have an orgasm, and sometimes just give up. I've worked with Defy Medical, Dr Rob Kominiarek and most recently Dr Meehan and I just can't seem to get things right. I did get quite a bit of improvement once starting daily tadalifil (lead to almost every day having morning wood vs before it was hit or miss) but the sensitivity has remained a challenge. Attached is my latest labs and below supplements I was talking at the time of the labs.

Here's my protocol as of my latest blood test attached:
.13mL Test Cyp and prop blend daily
140iu HCG daily
AM DHEA, Vitamin D, 5mg Cialis daily
Noon Allopurinol
PM Magnesium, best rest / insomintol (melatonin), 25mg DHEA, 60mg Pregnenolone

Here's my current protocol, I've dropped some things down trying to troubleshoot this problem and taking some advice from Dr Meehan:
.1mL Test Cyp daily
1 click Test cream applied to inside of leg daily
AM Vitamin D, 5mg Cialis, Iron supplement
PM Best rest / insomintol, 60mg Pregnenolone

Your progesterone is high, and DHT is low. Too much prog. will antagonize the androgen receptor.

I feel like you should just do pelvic floor exercises and do the T cream on the scrotum. Make sure you do a lotion on the dick too. Maybe a dopamine promoter as well.

 

[Gman86]

It’s not hard to figure out why ur having issues, u have so many things out of whack. Which ones are causing u the most issues in regards to ur specific symptoms might be a little harder to pinpoint.

Ur E2 is most likely too high for someone with ur SHBG level

Ur thyroid is off. TSH is a bit too high and RT3 is too high

DHT way too low

DHEA probably too high. Any reason to keep it that high?

Progesterone is a bit high. Might want to back off the preg dose a bit. I think u mentioned that u might be eliminating it all together

Prolactin is a bit high

Insulin is way too high. Which is weird because ur A1C looks pretty good. Were u fasting for these labs?

How did u get ur IGF-1 so high? Is that ur natural level, or are u taking something to boost it?

 

[Loki]

Do you take Cabergoline based on symptoms? Such as you have normal prolactin but improved sexual function while taking it.

Prolactin just has a tendency for me to slightly creep up on TRT. It was driven off symptoms. When I take caber I do have higher libido and I also notice much better sexual function as well...

 

[Loki]

It’s not hard to figure out why ur having issues, u have so many things out of whack. Which ones are causing u the most issues in regards to ur specific symptoms might be a little harder to pinpoint.

Ur E2 is most likely too high for someone with ur SHBG level

Ur thyroid is off. TSH is a bit too high and RT3 is too high

DHT way too low

DHEA probably too high. Any reason to keep it that high?

Progesterone is a bit high. Might want to back off the preg dose a bit. I think u mentioned that u might be eliminating it all together

Prolactin is a bit high

Insulin is way too high. Which is weird because ur A1C looks pretty good. Were u fasting for these labs?

How did u get ur IGF-1 so high? Is that ur natural level, or are u taking something to boost it?

I am very curious on that IGF-1 as well...

 

[Cataceous]

I'll echo what the guys said about prolactin: mine crept up over the years and when it got over 10 ng/mL I had those symptoms, near anorgasmia, really low penile sensitivity, etc. The symptoms can be ameliorated with cabergoline, but in the long run it's better to get the other hormones to more normal levels too, which may make the caber unnecessary.

 

[jonezee2014]

It’s not hard to figure out why ur having issues, u have so many things out of whack. Which ones are causing u the most issues in regards to ur specific symptoms might be a little harder to pinpoint.

Ur E2 is most likely too high for someone with ur SHBG level

Ur thyroid is off. TSH is a bit too high and RT3 is too high

DHT way too low

DHEA probably too high. Any reason to keep it that high?

Progesterone is a bit high. Might want to back off the preg dose a bit. I think u mentioned that u might be eliminating it all together

Prolactin is a bit high

Insulin is way too high. Which is weird because ur A1C looks pretty good. Were u fasting for these labs?

How did u get ur IGF-1 so high? Is that ur natural level, or are u taking something to boost it?

Thanks for your reply. I know I can bring DHT up using the cream so I can try that. As for DHEA, it's been something Dr Kominiarek had me on (25mg AM / PM) but I'm backing off that to see if I can eliminate all the variables. As for Thyroid, any suggestions on lowering those items? I've lowered my pregnenolone to 30mg at bedtime, it was suggested because I do get some anxiety at times and my pregnenolone levels were low. I can eliminate that as well to add to the list of reducing variables. I was fasting for the labs, however it may have not been for a full 12 hours. My Dr also mentioned what you saw about my IGF-1 being so high, not taking anything that I know of that would do that, I guess it's natural?

 

[jonezee2014]

Prolactin just has a tendency for me to slightly creep up on TRT. It was driven off symptoms. When I take caber I do have higher libido and I also notice much better sexual function as well...

Where are some sources for caber and suggested dose to start with?

 

[jonezee2014]

I'll echo what the guys said about prolactin: mine crept up over the years and when it got over 10 ng/mL I had those symptoms, near anorgasmia, really low penile sensitivity, etc. The symptoms can be ameliorated with cabergoline, but in the long run it's better to get the other hormones to more normal levels too, which may make the caber unnecessary.

Thanks for the suggestion, yes I'm working on reducing everything down to just Test and then re-do labs after some time to see where things are at. Would you guess that to be the best first step?

 

[Vvs1]

Prolactin just has a tendency for me to slightly creep up on TRT. It was driven off symptoms. When I take caber I do have higher libido and I also notice much better sexual function as well...

I'll echo what the guys said about prolactin: mine crept up over the years and when it got over 10 ng/mL I had those symptoms, near anorgasmia, really low penile sensitivity, etc. The symptoms can be ameliorated with cabergoline, but in the long run it's better to get the other hormones to more normal levels too, which may make the caber unnecessary.

Before you took Cabergoline and had the symptoms, did you have temporary or intermittent times or days where everything was normal? Or was it 24/7 lasting symptoms. Any changes with morning wood?

 

[sammmy]

Pregnenolone is completely useless for a male, doesn't matter what your levels are. It converts mainly to progesterone in males, not into testosterone or estrogen.

Insomnitol contains melatonin which can be anti-sexual, and high doses of herbal concentrates that can mess up neurotransmitters. If possible drop it and get on a clean sleep drug like Ambien. Yes, it is not 'all natural' but it works and doesn't interact with the sexual system like melatonin or these herbs could.

 

[Cataceous]

Thanks for the suggestion, yes I'm working on reducing everything down to just Test and then re-do labs after some time to see where things are at. Would you guess that to be the best first step?

That's a pretty reasonable approach.

If you ever do try cabergoline then I think starting very low is the safest thing. By this I mean only 50-60 mcg once or twice a week.

Before you took Cabergoline and had the symptoms, did you have temporary or intermittent times or days where everything was normal? Or was it 24/7 lasting symptoms. Any changes with morning wood?

Symptoms varied quite a lot, even in the same day. The cabergoline made things more consistently ok. But since adopting a complicated protocol that better mimics natural hormone levels, I have the best overall results in the 5+ years I've been on TRT.

 

[Gman86]

That's a pretty reasonable approach.

If you ever do try cabergoline then I think starting very low is the safest thing. By this I mean only 50-60 mcg once or twice a week.


Symptoms varied quite a lot, even in the same day. The cabergoline made things more consistently ok. But since adopting a complicated protocol that better mimics natural hormone levels, I have the best overall results in the 5+ years I've been on TRT.

What’s ur complete current protocol, if u don’t mind me asking

 

[Cataceous]

What’s ur complete current protocol, if u don’t mind me asking

Daily: 3.7 mg enanthate, 2.8 mg propionate, 12.5 mg enclomiphene, 20 mcg gonadorelin 5.25x, 0.5 mg progesterone. Also experimenting with kisspeptin-10 now.

 

[sammmy]

According to ingredient list on Amazon, 'insomnitol' contains a hefty dose of 5-HTP which is a precursor of serotonin. Boosting serotonin like SSRI's do, easily leads to anorgasmia. Get on Ambien and drop that whole poly-pharmacy in insomnitol. The 'all natural' mixtures are the ones causing most problems, not the targeted drugs.

 

[Cataceous]

According to ingredient list on Amazon, 'insomnitol' contains a hefty dose of 5-HTP which is a precursor of serotonin. Boosting serotonin like SSRI's do, easily leads to anorgasmia. Get on Ambien and drop that whole poly-pharmacy in insomnitol. The 'all natural' mixtures are the ones causing most problems, not the targeted drugs.

Good catch since he didn't mention the 5-HTP. I've even had trouble with L-tryptophan, but 5-HTP bypasses an internal rate limit so is worse.

 

[Larry B]

Great post! I have no issue with ED but occasionally I have an issue reaching orgasm as well. I associated it with age. What is the cream mentioned above to rub on the nuts and dick? I'm on .30 ml of testosterone twice a week and .5 mg of anastorzole once per week. I also inject .50 cc of HCG twice a week. My testosterone level is in the 900's. I have the full list of test results but nothing is out of range.

 

[jonezee2014]

This is all great stuff everyone. I never knew that having all of these supplements could cause so many issues, I've taken them all on the advice of my TRT doctors so maybe the affect me more than others.. I'm hoping simplifying my protocol will lead to success, if anything it will at least help narrow down the variables. Stopping Insomnitol tonight, already stopped Pregnenolone and DHEA.