2 Years on TRT, I Can't Orgasm. Help!

Pharma / TRT Testosterone Replacement
1

I’m a 54 year old, 2 years on TRT I want to give some general observations and experiences in bullet form and see if you have any advice or comments.

  1. Issues: Wife did not like my sleeping problems (woke up at 2:a.m), fatness and lack of libido. With the fat and libido loss my penis actually looked smaller! I was 230 lbs. 5’11". She suggested I go to a TRT doctor. I went to a clinic and got setup. I have not other health issues.

First Six Months:

  • Took 40 ml of Testosterone cypionate 200mg/ml twice weekly, hcg 50 ml. Injected in buttocks, thigh and shoulder. Hcg injected into belly button area.
  • Instant weight gain, first month- bloating of 10 lbs
  • Nipples started protruding, E2 went up to 60
  • Morning erections were hard and libido went up 100%. Horny all the time.
  • Took some anastrosole .25mg every other day to get E2 down. When I first took this I had dizziness, heart palpitations and flushing. Very scary.

Second Six Months:

  • My joints started feeling fantastic (I previosly had arthritis in back, shoulders, knees)
  • Started lifting weights again and my arms and chest started looking great.
  • Lost the initial 10 pounds but still overweight (I should weight 200lbs., not 230)
  • Stopped taking anastrole since my E2 was stable.
  • Still great libido, still great erections, tons of energy, I was disappointed that I was still did not magically lose weight with TRT.

Second Year

  • Decided to focus on weight lifting and diet. Tracked my calories at 1600/day using calorie counting phone app. Lost 25 lbs mainly from calorie restriction.
  • Strength increase almost double on all lifts. People are amazed at my fitness level. I have not told my family of my TRT use due to stigma of “Steroids”. Society is still to judgemental.
  • I feel strong, back, knees, shoulders all like new.
  • My dick and balls actually look bigger all the time! LOL. They hang better and it really is noticeable to me.
  • A weird problem appeared which was that I could not orgasm during sex and barely could during masturbation. Doctor said it was common with TRT and offered some very heavy drugs to fix this??? WTF? I declined.
  • Right now I’m playing with my E2 level even though doctor says it is normal but my libido and ability to orgasm seems to fluctuate a lot. Not the worst thing but I would like to understand it.

So in summary, I took TRT and gained weight, then lost weight by watching my calories (who woulda thought?), TRT increased my libido, made my penis look and feel better but after two years now it is hit or miss if I can orgasm or not. I still wake up at 4:00 a.m. everyday! TRT WITH focus on exercise and diet have made my body look 30 years younger. I’m going to stay on TRT forever because of the effect is has on my muscles and overall fitness level but the E2 balance, libido and sleep effects are really all over the place. It would be nice to orgasm more than once every 10 times I have sex with my wife.

Thanks guys, John

2

Is there alcohol involved on the times you can’t cum?

1 Like
3

What are your testosterone and estrogen levels?

4

I would look into diet first. 1600 calories is a SEVERE caloric restriction, and sustaining that for too long will screw up adrenals.

3 Likes
5

You doctor was right about TRT causing erectile and orgasm issues, a lot of the time it’s the doctors poor protocol decisions and not paying attention to SHBG and pre-TRT estrogen levels. If your SHBG is on the lower end I can see why this protocol eventually failed.

Another problem is you were started on TRT, HCG and anastrozole and you wonder why there are problems. Anastrozole is a very bad drug, it murders my libido the instant I take it and throws off fluid balance. I actually gained weight on it. HCG is another one of those compounds not everyone responds well or can eventually cause problems.

I see few men find success on TRT, HCG and anastrozole.

I have low SHBG and when I was injecting my doses twice weekly, after awhile I could feel the swings in hormone levels and libido and erectile strength varied all the time. TRT decreases SHBG is just about everyone and when this occurs it means your protocol needs to change with it. When SHBG decreases, TT decreases, FT increases and usually E2 increases.

Your estrogen balance or lack thereof will dictate libido and erectile strength as well as orgasm quality. It sounds like your doctor is just unskilled at managing men on TRT and instead of learning how manage men on TRT, he would rather throw heavy drugs at the problem. If you go through members threads, you’ll see labs. I/we need to see pre-TRT and current lab testing otherwise we can guess all day as to your issues.

It is usually very difficult to balance all hormones when taking a bunch of other compounds, you inject HCG and now need a drug to counter the side effects which causes side effects of its own, TRT in isolation is so much easier to balance out all levels. Your doctor is just looking to make as much money as he can by selling a bunch of compounds and when they fails to delivery he offers more drugs.

I find it super easy to balance testosterone and estrogen injecting daily.

6

Need blood tests to have any chance of figuring it out. Anorgasmia isn’t a common issue of TRT as far as I know… I have a similar issue but it’s been that way well before TRT and has improved some since starting

What are your prolactin levels?

A lot of people have sexual issues on HCG and do better on T only.

1 Like
7

I would look at your E2 levels.

E2 GREATLY affects serotonin. Serotonin WILL absolutely put the brakes on orgasming.

Any SSRI usage?

Serotonin/dopamine balance is your issue. I’d bet money on it.

Q: WHAT drug did your dr. prescribe to help you orgasm? Dopamine agonist? Or maybe wellbutrin?

8

Does E2 increase or decrease serotonin?

9

I believe it increases serotonin somehow.

Testosterone helps facilitate dopamine… and estrogen does with serotonin.

This is why people have hard time orgasming on SSRIs.

1 Like
10

I knew that part and the testosterone increasing dopamine part but haven’t heard the e2 to serotonin part before. I’ll have to read on that a bit.

11

I wish that was the easy cause! I do wonder if my previous alcohol abuse cause some of my soft dick issues though. I stopped drinking a couple of years ago due “having too much fun”. i.e. booze is fun until it isn’t. I was on my way to becoming a total drunk. Thank God above I stopped in time before it killed me. I quit cold turkey and have not had a desire to get drunk since 2017’.

12

Thanks for thinking about my issues! I don’t take any antidepressants since I never suffered with that even when I was a borderline alchoholic and had ED issues. Right now with the great things that TRT has done for me I’m super chipper (Even though I don’t orgasm that often!) lol

13

Actually I don’t see a doctor but his physician assistant. You make a good point. Maybe I need to change clinics and get a second opinion. I was offered HCG to keep my testicles large but at my age and with a vasectomy maybe its time to just use Testosterone Only and leave the HCG behing. I don’t take any antidepressants

14

I tossed my labs last time but I think testosterone was aroun 1100 and E2 was 26. I’m also taking a once or twice weekly 2.5 mg of tadafil or cialis.

15

Thanks! That is a good suggestion. I needed to cut back calories to get my weight down. I’m at about 15% body fat now after 8 months only losing 1.5 lbs per week. I appreciate your suggestion.

16

I forgot to mention HCG supports adrenal function and if it’s not needed this can throw other hormones out of balance. For someone with stressed adrenals, HCG can work wonders.

In fact owner and founder of Excelmale who has been on TRT for a very long time found TRT quit working and his libido crashed, HCG restored all lost benefits quickly.

It’s strange because he tried HCG many years earlier and met with very negitive results. Something in his body changed and I think LH suppression over many decades played a part in it.

LH is a precursor to many hormones.

17

I would bet that 1600 calories a day is your problem. Especially if you weigh 200lbs. Use a calorie calculator and aim for 1-2lbs of fat loss per week, and make sure to Eat enough dietary fat. Also make sure to refeed.

18

That’s a low E2 for 1100 Total T. I would be curious what your free T is. Likely low

2 Likes