I started taking testosterone with medical supervision cause suddenly I couldn't get hard enough I'm 56 years at the same I wanted to gain muscle cause I work out a lot, I started with 125 mg once a week and every week I goes higher I haven't been noticing any improvement I'm now on 180 mg a week but still not much happening I only managed to have sex twice a week plus I'm using daily 5 mg Cialis, my doctor doesn't want to go higher but he suggested to take the dosage twice or 3 times a week I'm still not noticing any improvement in the gym so this I'll start taking twice a week and I'll convince my doctor to take 200 mg a week cause I'm not getting any muscle gain yet
You need to take a step back and rethink this one!
This is mess.
You and your doctor clearly lack the understanding of the PKs let alone how exogenous T works.
Most men on TRT are injecting 100-200 mg T (high-end)/week strictly IM or subcutaneously whether once weekly, twice weekly (every 3.5 days), M/W/F, EOD or even daily.
Even than most men would never need the high-end dose 200 mg T/week to achieve a healthy let alone high trough FT level.
Such dose is overkill for the majority.
Most can easily achieve a healthy/high trough FT level injecting 100-150 mg T/week especially when split into more frequent injections.
Sure there are some outliers who may need the higher-end dose but it is far from common.
Too many are overmedicated from the get go and end up running into issues down the road due to running too high trough FT levels.
Key when first starting TRT is to go low and slow as in 100 mg T/week no AI or hCG.
T only protocol as we want to see how your body reacts to testosterone without mucking up the waters along the way.
Blood work will be done 6 weeks in once blood levels have stabilized (steady-state) so we can see where said protocol (dose T/injection frequency) has your trough TT, FT, estradiol, DHT, prolactin, SHBG let alone other important blood markers such as RBCs, hemoglobin and hematocrit.
The only time the dose of T should be increased at the 6 week mark is if you truly feel unwell due to achieving low trough FT levels (highly unlikely) in most cases.
Otherwise every protocol needs to be given 12 weeks to truly gauge the outcome/effectiveness.....THIS IS CRITICAL!
The protocol chosen (dose T/injection frequency) needs to be followed week in and week out.
When first starting therapy or tweaking a protocol (increasing/decreasing dose T) hormones will be in FLUX during the weeks leading up until blood levels have stabilized (4-6 weeks using TC/TE) and it is common for many to experience ups/downs during the transition as T levels are increasing or decreasing (when lowering T dose) and the body is trying to adjust.
Even than once blood levels have stabilized (4-6 weeks) it will still take the body a few months to adapt to the new set-point and this is the critical time period when one needs to gauge how they truly feel overall regarding relief/improvement of low-T symptoms.
Every protocol needs to be given a fighting chance to claim whether it was a success or failure.
Many make the mistake of tweaking their protocol every 6 weeks because they do
not feel good.
The first 6 weeks means nothing when looking at the bigger picture.
Patience is key otherwise you will end up chasing your tail indefinitely.
It is a common theme when starting TRT or tweaking a protocol (increasing dose T) to experience what we call the honeymoon period (euphoric like state, increased libido/erections, overall well-being) due to increasing T levels, dopamine, lighting up ARs (androgen receptors).
Unfortunately this is short-lived and temporary as the body will eventually adapt and things will level out and this will become the new norm.
Many lack the understanding of how this works and end up on that never ending merry go round chasing the honeymoon period.
You were started on a reasonable dose of T 125 mg but it means nothing because you kept increasing your dose every week which is not how this works.
In the hopes of chasing the body composition benefits you went from 125--->a high-end 180 mg/week and are now aiming for 200 mg/week in your hopes of enhancing muscle/strength.
Never even gave the 125 mg T/week protocol a fighting chance let alone no labs at what would have been the 6 week mark if you stuck with it so we could see where said protocol has your trough TT, FT and estradiol let alone RBCs, hemoglobin and hematocrit.
For all we know your blood markers may have been high on such dose.
Now you ramped up your dose big time off the hop and it is pretty much a given that your trough TT, FT and estradiol are going to be absurdly high unless you are one of those rare outliers and you can be rest assured that you are driving up your RBCs. hemoglobin and hematocrit.
I understand you are eager to make some gains so you are aiming for the higher end dose which makes sense as you will notice better gains in muscle/strength on 200 vs 100 mg T/week but even than the higher end TRT dose is in no way comparable to the gains in muscle/strength one would obtain when abusing steroid doses 400-600 mg T/week so do not set your expectations too high.
Even than dose of T is only one piece of the pie as following a proper diet/training protocol is key let alone your GENETICS will have the final say.
Does not matter how much T you take if you are following a piss poor diet/training protocol let alone you need to put the time in.
It takes 4-6 weeks to reach steady state (TC/TE) and you would need to give it 12 weeks at said dose to see the full benefits.
Keep in mind that when using aromatizable androgens that a big portion of the gains in weight seen early on is water weight as in intra-cellular (inside the muscle cells) which results in fullness/hardness of the muscles and extra-cellular (between the muscle/skin) which is results in a bloated puffy look to the muscles.
Michelin man/moon face can be an issue for some even when using a high-end dose of TRT.
Top it all off that even if you attain some of the gains you are looking for on the high-end TRT dose of 200 mg T/week it may backfire in the long-run especially when it comes to libido/erections which many can struggle with when trough FT levels get too high.
It is pretty much a given that your trough TT, FT and estradiol will be through the roof on such dose and you will most likely be struggling with elevated RBCs, hemoglobin and hematocrit.
Once you reach steady-state (4-6 weeks) on your current dose (post #3) you need to get lab work done to see where your blood markers sit.
This is CRITICAL!