When trt does not bring libido back or it worsens on trt.

[tmckenzie]

Updating here. I got off of all arimidex, ten days or so in, morning wood soft. Eq bad, breasts hurting, bloating. . 25 arimidex went down the hatch, started peeing a ton, over the next few days, everything libido wise is coming back. Now, this happened about a month ago, but I was on arimidex. I got to really thinking what the hell was different. I had not had a shot of hcg in close to two weeks. This week, I cut out hcg, will see where it goes. I read some rare times in men where hcg will tank libido. Maybe I am one. Been tanked all year really until I ran out of it. Was good before. They have me on 500 mg twice a week. Am I crazy?

 

[Clint Lovelace]

Curious to see how it changes now without the HCG. I finally see a great urologist so I am very hopeful for a solution for myself.

 

[tmckenzie]

Libido has been good today. Had great sex this am. Hcg may hold me back.

 

[Clint Lovelace]

how has it been past 3 days? Was that your first time able to have sex in a while? Erections good and strong? I see a urologist (who is supposed to be a specialist in ED and low T) tomorrow in Birmingham so I am hopeful.

 

[tmckenzie]

I had sex twice in last two days. Only dry orgasms, weak erections, like loosing them while in a vagina. With low t, I had no sex trouble like this. I have no idea what to do.

 

[Clint Lovelace]

So you can get hard enough to penetrate but you can't stay hard? Sounds like you need Trimix

 

[Vince Carter]

As testosterone blood levels go up, so does estradiol. Adolescent boys have a lot of testosterone AND estradiol. Some studies say that testosterone to estradiol ratios of 14-20 are best for fertility.

So, assuming someone's total testosterone is 1000 ng/dL, then a estradiol of 50-71 pg/mL (divide 1000 by 14 and 20) is to be expected. What causes gynecomastia is not having a high estradiol, but having a low testosterone-to-estradiol ratio.

That is why I am not in agreement with the use of anastrozole unless your T to E2 ratio is below 14.

I know this post will generate some discussion. I have read every single paper of E2 in men and I think this hype is nuts of treating E2 purely based on its value and not on how much testosterone we also have. Testosterone is the prohormone nature made to create estradiol and balancing the two is what matters.

Nelson

Old thread just curious if the ever evolving TRT regimen if this is still viable? I'm considering my ratios and evaluating if an AI is really necessary; high T and high E2. Still looking at things to fine tune...libido/drive/ED symptoms are lagging.

I have 24hr peaks of 1450, 72hr trough of 814, SHBG @ 12-15, I inject Cyp @ 50mg EOD, HCG 100iu EOD, and Anastrozole @ .15mg (compounded) EOD.

I would like to further reduce my AI use or eliminate it entirely. I've never had nipple issue, when I've been E2 elevated my first symptom seems to be nite sweats. If I could get to using an AI jsut once or even twice a week...I'm chasing some libido and ED issues even with Tadalifil/Sildenafil/NO stack. I've been overdosed on Anastrozole >6 months ago, I know what being crashed out is like.

 

[tmckenzie]

So, if I divide my total test, 1300 last check. Estradiol was 75 on the sensitive test. What numbers do I use to determine if I am to high on E2. Sure seems like it.

 

[CoastWatcher]

So, if I divide my total test, 1300 last check. Estradiol was 75 on the sensitive test. What numbers do I use to determine if I am to high on E2. Sure seems like it.

Thise are significantly high values. What is your protocol, and how are you feeling?

 

[ERO]

I have read that the ideal testosterone to estrogen ratio is between 14 and 20, so using that calculation, you are OK.

Calculation would be 1300 total T, divided by your E2 of 75, so 1300/75 = 17.33, which is between 14 and 20.

I am hoping Nelson can comment on this, but I think this is correct.

 

[Nelson Vergel]

ERO

That is correct. At that T blood level, it would be amazing if your E2 was not over 40 pg/mL. I would not take anastrozole unless you think you have nipple breast tissue swelling.

 

[Vince Carter]

INteresting...will give this ratio a try. Assuming like other tests we're basing it on trough total T...right?

 

[chaps]

50mg cyp e3d with the addition of 10mg suspension has helped a lot, my erections are still not where they need to be. I tried hcg but could not tolerate it, all different doses it bloated the hell out of me and my buddy is finding the same thing. Pregnenolone cream maybe 3 times a week has helped, as Nelson mentioned cortisol can help. I am going to look at nutrient deficiencies next then amino acid therapy for neurotransmitters which isn't cheap :s. I do feel that a lot of guys would benefit from a compounded testosterone where the cyp or enthanate was cut back a tad and a little propionate was added, the shorter esters or esterless (suspension) really do help

 

[ERO]

50mg cyp e3d with the addition of 10mg suspension has helped a lot, my erections are still not where they need to be. I tried hcg but could not tolerate it, all different doses it bloated the hell out of me and my buddy is finding the same thing. Pregnenolone cream maybe 3 times a week has helped, as Nelson mentioned cortisol can help. I am going to look at nutrient deficiencies next then amino acid therapy for neurotransmitters which isn't cheap :s. I do feel that a lot of guys would benefit from a compounded testosterone where the cyp or enthanate was cut back a tad and a little propionate was added, the shorter esters or esterless (suspension) really do help

Agreed. I had a prior TRT doc prescribe Test Propionate a couple years back and I liked smaller, more frequent injection of that vs. twice a week with Test Cyp. Many if not most docs don't do Test Prop, though it seems.

 

[Juan Valdez]

Is there a safe place to buy/try this?

 

[ERO]

Is there a safe place to buy/try this?

I am with Defy Medical and I asked them about Test Propionate. They said that they sometimes prescribe it, so it is at least possible with them. I have a phone consult with Dr Saya in a week and I will ask him directly.

 

[EDHSJAL]

Medications are usually to blame for not being able to cum

Fatigue is a sex drive killer. Sleep apnea is one of the main issues in fatigue that does not get better with 8 hours of sleep.

A bit of TMI here, but watching a few minutes of porn a day helps me keep my sex drive muscle going. This works even when I am stressed out with work. Visual/sound stimulation is well known to help. Sex drive is like a muscle that needs to be worked a few minutes a day.

HCG + TRT + Cialis works for most. I think if this protocol does not help, there must be other issues like medication side effects, fatigue, etc

Sex drive and erectile function are complex.

View attachment 305

My doctor had me try try oxytocin, but it didn't seem to do anything for me. I will ask him about dopamine & Seratonin.

 

[Hank123]

Any updates from people on what has worked for them?

I am having the same issue. Currently taking HCG 25 three times a week, 50 clomid three times a week, and arimadex .5 twice a week.

Test results showed 1300, with estradoil at 29.

Seems like some people are saying it could be any of the three. According to that result maybe I should take less arimadex?

 

[ERO]

I have tried oxytocin and various neurotransmitter support supplements that are supposed to affect serotonin and dopamine - none have helped in the slightest.

In your case, Hank 123, I would try skipping the Arimidex or cutting way down. Your T to E ratio is 44 (which means your E2 is VERY low when compared to your T level of 1300 - not as compared to the lab range) and the ideal T:E: range is between 14 and 20. Now the T to E ratio doesn't work for everybody, but its sure worth a try when nothing else has helped.

 

[Casey Cappleman]

This is good info Nelson. I just joined excel male, and have been on trt for a year now, without having as dramatic of an effect on my libido as i had hoped. I started trt at low t center for first two months with no hcg or anastrozole, and my libido sky rocketed. Have been with e.hormones ever since then, self injecting 180 mg test cyp once per week, along with 500 iu hcg twice per week, and o.5 mg anastrozole twice per week. My last bloodwork showed my t levels at 907, and my e2 levels at around 27. Could my ai use be whats caused my libido to not be what i had experienced at low t center?