Tired of these weak erections on TRT. Can't seem to find a solutions after 4 years.

[Keepfit1]

Never forget to try to enhance nitric oxide production.

How do you do that?

 

[Keepfit1]

My lowest Total Testosterone reading before TRT was in the 170ng/dl range. At that time, I had no erection issues. 10mg of tadalafil or 20mg of sildenafil would light me up all night. I would have sex every day at times when the wife was willing. Once I started TRT, that quickly moved to 4x a day on some days. I had great sex on TRT for the most part for the first 18 months to two years. The last couple years have been miserable. I would rate my erections at mostly a 6 out of 10. Sometimes less than that.

I can't remember the last time I had a spontaneous erection. I no longer wake up with them. I don't get strong erections through the night. I don't get erections when seeing my wife in sexy lingerie. It takes a good bit of physical stimulation to become aroused. Once I have an erection, it's gone almost immediately without physical stimulation. My libido is good. I want sex every day.

Early on, when I was figuring out my protocol, I would inject large amounts spread out 2x a week. I found that when I did that, taking anastrozole would bring erection quality back. I moved to daily injections to keep levels more stable and not spiking too high. That trick doesn't seem to work anymore and I don't want to be on anastrozole. I've also found that tamoxifen increases both libido and erection quality.

Before my erection issues, I would take 20mg of sildenafil and get flush, warm ears and extremities, stuffy nose and raging erections. Now, I can take 120mg of sildenafil + 20mg of tadalfil and I don't even get those negative side effects (I do get the acid reflux from tadalafil). Not even the side effects??? It's like whatever is happening in my body is completely blocking the effects of PDE5i's. All of my blood work is find. I've tried various levels from 700 Total to 1000 Total. I do better at 700 than 1000. Maybe I need to go back to 600 next to try that for a while.

This is an acute problem since TRT. I'm healthy otherwise. I'm going to say I don't watch porn, but I am starting to think social media feeds like ******** and Instagram are borderline porn always showing me fitness girls and similar things. I've removed Instagram from my phone.

One idea I'm still toying with is that for the first 2 years on TRT, I was banging my wife 10x a week. I was lifting weights hard for the first time in years, I was looking better, I had energy, people were noticing me physically changing for the better. Did I fry my dopamine system? I have restless leg syndrome and one of the medications for that is a dopamine agonist, ropinirole. That medication helps my legs. Meaning, my body is looking for more dopamine. Caffeine doesn't work too well on me anymore either.

I've read other similar situations online from guys that say their erections and/or libidos went south after a couple years of TRT.

Anyone have any other ideas for me to try? I've tried every protocol from 2x a week to daily injections, 100mg to 175mg per week of Test C. I still have sex, but this is now starting to get to the mental part for me where I'm never sure if it's going to be enough.

Thanks!

have you looked at prolactin?

 

[Dr.V.P.C.]

How do you do that?

Beside the things everyone knows ( exercise, nutrition , supplements , no smoking, avoid mouthwash ,etc) IMO the main thing most men neglect is emphasis is exclusive nasal breathing . And most of all , correct any degree of OSA . ( Almost every patient that starts CPAP using after some time feel great difference in erectile quality ) .

 

[Keepfit1]

Beside the things everyone knows ( exercise, nutrition , supplements , no smoking, avoid mouthwash ,etc) IMO the main thing most men neglect is emphasis is exclusive nasal breathing . And most of all , correct any degree of OSA . ( Almost every patient that starts CPAP using after some time feel great difference in erectile quality ) .

thats very interesting, why avoid mouth wash?. I have mild OSA but never connected that to sex, what is the connection?. I have considered CPAP but seems the drop out rate is quite high, I dont know if I could sleep with a mask on my face

 

[literally.me]

I were using test prop daily to see if it improves. As soon I inject my libido turnes off and my penis go soft. I stoped injecting for almost two weeks and those last days my libido were back to the point I had to masturbated some times a day. I tested it and injected again, 20min ago, my libido again is off and my penis dont respond anymore (it wad good all day long before I pinned the testosterone). So you guys don't believe in our situation but IT IS real. It is the testosterone shooting something that switch off the libido. Me and other guys here are suffering with this and it is not psychological, it is not anxiety and it is not diet or how many calories with eat or not in the day or whatever. IT IS THE TESTOSTERONE causing this for some reason we don't know yet because guys are starting to post this kinda of topics (just google "TRT and ED reddit" and you will see lots of topics like those) now as I see here and in other forums lately.

We need to discuss this issue seriously and we also need members who do not suffer, or have not yet suffered from this collateral, to be understanding. This is not a joke, lots of guys are now starting to suffer it. We need to be taken seriously.

 

[bixt]

I were using test prop daily to see if it improves. As soon I inject my libido turnes off and my penis go soft. I stoped injecting for almost two weeks and those last days my libido were back to the point I had to masturbated some times a day. I tested it and injected again, 20min ago, my libido again is off and my penis dont respond anymore (it wad good all day long before I pinned the testosterone). So you guys don't believe in our situation but IT IS real. It is the testosterone shooting something that switch off the libido. Me and other guys here are suffering with this and it is not psychological, it is not anxiety and it is not diet or how many calories with eat or not in the day or whatever. IT IS THE TESTOSTERONE causing this for some reason we don't know yet because guys are starting to post this kinda of topics (just google "TRT and ED reddit" and you will see lots of topics like those) now as I see here and in other forums lately.

We need to discuss this issue seriously and we also need members who do not suffer, or have not yet suffered from this collateral, to be understanding. This is not a joke, lots of guys are now starting to suffer it. We need to be taken seriously.

Great post, the bottom half about awareness on ED after TRT. I'm seeing this pattern EVERYWHERE. But people will deny deny deny.

As far as your question goes, I see you were using 10mg prop daily. Every tried lowering that to 5mg? Let me give you a recent personal example, I was using roughly 20-30mg prop daily for a couple months and recently erections got softer along with a loss of night wood. It crept in so gradually I didn't realise it. 2 weeks ago I dropped dose to 10mg daily, wham!, rock hard EQ, night erections are back. Change was immediate.

But if I pop an arimidex

Yeah, first time I tried arimidex things got extra rock hard again (before all the crap arimidex sides crept in like joint pain). Best kept for occasional use.

Most reliable thing for me is to keep changing things up every now and then.

The thing I hate most is that EQ is 11/10 on tiny does like 10mg cyp or prop / day. But gym performance SUCKS at that dose, recovery is crap, assertiveness and confidence down the drain after a while.


Heres the best part - it's always too many orgasms in a row that breaks things no matter what the dose. Then I have to either wait a week OR do a DRASTIC temporary protocol change to get things back. The drastic change can be anything like trippling the dose, making the dose 1/3, popping an arimidex (once off, it causes a drop and then a rebound), popping a few winstrols and/or dbols. Any other compound really. All that matters is some massive change.

All of this points back to the brain, the reward circuitry, satiation and resultant dopamine response \ desensitization of pleasure pathways from being greedy with sex and especially orgasm.

"greedy with sex and especially orgasm. "

There, I said it. There's a reason lot of great people are\were celibate. They figured the nofap thing on their own.

p.s. a solution can be had by having sex with no orgasm.

 

[bixt]

Beside the things everyone knows ( exercise, nutrition , supplements , no smoking, avoid mouthwash ,etc) IMO the main thing most men neglect is emphasis is exclusive nasal breathing . And most of all , correct any degree of OSA . ( Almost every patient that starts CPAP using after some time feel great difference in erectile quality ) .

Also citrulline (thanks @Nelson Vergel !) and arginine

 

[literally.me]

@bixt I can try to lower to 5mg per day. Didn't try yet because everytime I inject my libido switchs off and I was not injecting for two weeks. My libido the last days were good till today night when I tried to inject again to see.

I did created a post hours ago explaining this again. I injected around 30mg of Testosterone Cypionate and my libido tapered off but it was good the last days without anything for almost two weeks. I took 0.5mg of arimidex and my mood calmed down (I get kinda of anxious/angry on testosterone too) and my erection came back (I was able to masturbated 3 times already since my last post hours ago). So it is definitelly low shbg shooting my estrogen thru the roof (probably why arimidex helps)?.

 

[FunkOdyssey]

Great post, the bottom half about awareness on ED after TRT. I'm seeing this pattern EVERYWHERE. But people will deny deny deny..

The Cialis that almost everyone on long term TRT takes is for the minor blood pressure effects, and uh, vascular health. Definitely not to fix erections.

 

[DixieWrecked]

thats very interesting, why avoid mouth wash?. I have mild OSA but never connected that to sex, what is the connection?. I have considered CPAP but seems the drop out rate is quite high, I dont know if I could sleep with a mask on my face

Mouthwash has nothing to do with OSA. Two seperate things. Mouthwash kills the bacteria in your mouth that helps your body to produce NO.

OSA stresses you out and you get no real rest. It has a huge cascade of effects that can basically ruin your life,

 

[Guided_by_Voices]

thats very interesting, why avoid mouth wash?. I have mild OSA but never connected that to sex, what is the connection?. I have considered CPAP but seems the drop out rate is quite high, I dont know if I could sleep with a mask on my face

Mouthwash (and flouride) apparently kill the bacteria in your mouth that produce Nitric Oxide. For OSA/Snoring, you can start by taping your mouth shut when you sleep using micro-pore tape. The Mute brand nasal openers may also help. OSA is very damaging to the cardiovascular system which is one connection to sex. Anything which disrupts sleep quality and elevates sympathetic nervous system activation (stress response) is going to be counter-sexual.

 

[jchems]

I appreciate the sleep apnea talk and agree that if you have sleep apnea, I doubt you can figure out any health problems you're having without first fixing your sleep. However, what literally.me and I are talking about is a different phenomenon. This is related to the TRT in some way. I can almost immediately correct the issue with anastrozole, or just stop injecting testosterone and let my levels plummet. I just fear the long term implications of using AI routinely. I had zero erection issues with low T. They were great, I would wake up with them and PDE5i's were amazing to use at low doses. A couple weekends ago, I had a weekend away with the wife. I took PT-141, anastrozole and some tadalafil and I didn't stop all weekend. Rumor has it, the hazmat crew is still cleaning up that hotel room. All that to say, I clearly have the physical capacity for my body to produce strong erections. I'm with my wife of nearly 20 years, so anxiety isn't much an issue. My blood work is the best it's looked in years as far as lipids, triglycerides, A1c, etc. My blood pressure is perfect with low dose Telmisartan. Every experiment I have run leads me to conclude that it's something about the TRT. And anastrozole is the only thing that works every time. My Rouzier trained endo doctors office assures me it's nothing to do with estrogen. The ******** groups assure me it's nothing to do with estrogen. Everyone says the studies that I posted that show elevated estradiol levels associated with ED were not done correctly or they used unhealthy individuals. The thing that clued me in was listening to bodybuilders talk about why thy would suppress estrogen on cycle and what high levels did to their erections. Derek from the More Plates More Dates Youtube channel made a video, a light bulb went off in my head (because he explained exactly what I was exeriencing), I took anastrozole, and I had my erections back. Like other's I've heard this story dozens of times from guys. There still seems to be something we're missing.

 

[FunkOdyssey]

My Rouzier trained endo doctors office assures me it's nothing to do with estrogen. The ******** groups assure me it's nothing to do with estrogen. Everyone says the studies that I posted that show elevated estradiol levels associated with ED were not done correctly or they used unhealthy individuals. The thing that clued me in was listening to bodybuilders talk about why thy would suppress estrogen on cycle and what high levels did to their erections. Derek from the More Plates More Dates Youtube channel made a video, a light bulb went off in my head (because he explained exactly what I was exeriencing), I took anastrozole, and I had my erections back. Like other's I've heard this story dozens of times from guys.

I'd trust Derek's analysis and understanding of hormonal issues over Rouzier's any day of the week.

 

[zancek0]

I would say that if viagra or cialis don't help then the issue is not high E2 in itself. Dropping E2 has a downstream effect on various processes but we would have to find out what exactly does it affect that might be relevant for erections.

The dopamine agonist you're using might be playing a part in this. Where are your prolactin levels at? Prolactin is needed in small quantities to retain calcium which ensures proper functioning of NOS enzyme (nitric oxide synthase), and also dual oxidase enzyme, opiods etc.

And people on TRT getting limp dicks and zero libido... I mean, why would you necessarily have high libido and good erections? There's nothing magical in testosterone in itself. You override many regulatory mechanisms by pinning test, and this comes at a cost especially for people that dont actually need TRT.
Usually, the issue is nutrient deficiencies and mineral/electrolyte imbalances. Test influences iron metabolism (via test and dht) and copper metabolism (via e2); sodium and potasssium ratio gets dysregulated - potassium is being wasted if you dont use hcg (or low dose prog) to ensure some progesterone to retain potassium...


If your dick dies on TRT drop the dose so that it equals natural production. Tiny doses are better in these cases. @literally.me

 

[Guided_by_Voices]

And anastrozole is the only thing that works every time. My Rouzier trained endo doctors office assures me it's nothing to do with estrogen. The ******** groups assure me it's nothing to do with estrogen. Everyone says the studies that I posted that show elevated estradiol levels associated with ED were not done correctly or they used unhealthy individuals. The thing that clued me in was listening to bodybuilders talk about why thy would suppress estrogen on cycle and what high levels did to their erections. Derek from the More Plates More Dates Youtube channel made a video, a light bulb went off in my head (because he explained exactly what I was exeriencing), I took anastrozole, and I had my erections back. Like other's I've heard this story dozens of times from guys. There still seems to be something we're missing.

I seem to have the opposite problem in that my estrogen tends to be low for no reason I can identify, so I have to be aware of things that block aromatization, however in your case they might be helpful and less likely to produce overshoot that an AI. Zinc, melatonin and possibly aspirin are three things that immediately come to mind. Primobolan seems to have this affect for some people also.

 

[jchems]

I would say that if viagra or cialis don't help then the issue is not high E2 in itself. Dropping E2 has a downstream effect on various processes but we would have to find out what exactly does it affect that might be relevant for erections.

The dopamine agonist you're using might be playing a part in this. Where are your prolactin levels at? Prolactin is needed in small quantities to retain calcium which ensures proper functioning of NOS enzyme (nitric oxide synthase), and also dual oxidase enzyme, opiods etc.

And people on TRT getting limp dicks and zero libido... I mean, why would you necessarily have high libido and good erections? There's nothing magical in testosterone in itself. You override many regulatory mechanisms by pinning test, and this comes at a cost especially for people that dont actually need TRT.
Usually, the issue is nutrient deficiencies and mineral/electrolyte imbalances. Test influences iron metabolism (via test and dht) and copper metabolism (via e2); sodium and potasssium ratio gets dysregulated - potassium is being wasted if you dont use hcg (or low dose prog) to ensure some progesterone to retain potassium...


If your dick dies on TRT drop the dose so that it equals natural production. Tiny doses are better in these cases. @literally.me

I've tried to take into account that an AI will reduce T being converted to E2 so may raise Free T. So, I've taken my dose higher to get Free T higher. It only gets worse as I get Free T higher. I've taken proviron, thinking it may be a DHT issue. That has no effect on this issue.

I don't take the dopamine agonist enough to have an effect. I don't want the long term consequences of using that routinely. My prolactin was at 7 the last time I've had it checked. I've seen it as high as 13 when I was on nandrolone.

I suspect you're correct. There is some downstream thing happening. Is circulating E2 in my blood causing the problem? Probably not. But, like you mentioned, there are dozens of other issues it could be. I've tried iron. I've tried GHK-cu injections. I've tried progesterone.

So far, the only thing that works every time: anastrozole.

 

[zancek0]

I've tried to take into account that an AI will reduce T being converted to E2 so may raise Free T. So, I've taken my dose higher to get Free T higher. It only gets worse as I get Free T higher. I've taken proviron, thinking it may be a DHT issue. That has no effect on this issue.

I don't take the dopamine agonist enough to have an effect. I don't want the long term consequences of using that routinely. My prolactin was at 7 the last time I've had it checked. I've seen it as high as 13 when I was on nandrolone.

I suspect you're correct. There is some downstream thing happening. Is circulating E2 in my blood causing the problem? Probably not. But, like you mentioned, there are dozens of other issues it could be. I've tried iron. I've tried GHK-cu injections. I've tried progesterone.

So far, the only thing that works every time: anastrozole.

Okay, that's interesting. Do you use any supplements?

 

[Systemlord]

There is some downstream thing happening. Is circulating E2 in my blood causing the problem? Probably not. But, like you mentioned, there are dozens of other issues it could be.

Don’t forget about endocrine, disrupting chemicals, that can block hormones action on target tissue/receptors. Also long AR gene CAG repeats, men with long CAG repeats will get diminished action from testosterone on target tissues.

Variations in CAG Repeats of Men’s Androgen Receptor Gene

 

[Guided_by_Voices]

The thing I hate most is that EQ is 11/10 on tiny does like 10mg cyp or prop / day. But gym performance SUCKS at that dose, recovery is crap, assertiveness and confidence down the drain after a while.

Two things to consider...The more I have used Ipamorelin/ModGRF even intermittently, the more impressed I am with it, to the point where I think a lot of people hopping on tradition anabolics should be starting with that, especially given its close-to-zero side effect profile, but that's a topic for another day. Also, don't underestimate the benefits of microdosing something like oxandrolone or T-cream pre-workout once or twice a week. Whether that will help confidence I don't know, but it might resolve the gym performance issues without provoking other issues, especially if you're avoiding max-effort sets (which will tend to provoke overtraining) and focusing instead on increasing strength via increasing work capacity.

 

[bixt]

@bixt I can try to lower to 5mg per day. Didn't try yet because everytime I inject my libido switchs off and I was not injecting for two weeks. My libido the last days were good till today night when I tried to inject again to see.

I did created a post hours ago explaining this again. I injected around 30mg of Testosterone Cypionate and my libido tapered off but it was good the last days without anything for almost two weeks. I took 0.5mg of arimidex and my mood calmed down (I get kinda of anxious/angry on testosterone too) and my erection came back (I was able to masturbated 3 times already since my last post hours ago). So it is definitelly low shbg shooting my estrogen thru the roof (probably why arimidex helps)?.

Just try 5mg prop. What do you have to lose? The stuff works quick IMO, none of that waiting 12 weeks to "stabilise".

and my erection came back (I was able to masturbated 3 times already since my last post hours ago)

And then u felt like shit after cumming 3 times so now u back for more answers.