4 Month TRT Update

Pharma
1

4 months since I started on TRT. My initial prescription was

Enanthate: 0.20mls twice weekly - 100mg per week
HCG: 0.20mls twice weekly - 1000iu per week

I didn’t get on with the Enanthate, it was causing painful red lumps at the injection site. So I was moved to Cypionate 0.25mls twice weekly.

After 4 weeks my bloodwork came back
17-Beta Oestradiol 166.0 pmol/L
Testosterone 25.10 nmol/L (this was at 10.70 nmol/L on my 1st ever blood work)
Free Testosterone 0.761 nmol/L

As a result of the 17-Beta Oestradiol levels I was prescribed Anastrozole at 1/4 a tab once a week

Latest blood work results are
17-Beta Oestradiol 80.1 pmol/L
Testosterone 20.40 nmol/L
Free Testosterone 0.570 nmol/L

After consulting with the doc and trying to understand why my test results had decreased. He thinks it might have been that I had my bloods taken when my levels were on the decline and since it was on the same day as I was due my next dose. I also said that my libido is non existent and any kind of erection is very poor quality and can disappear pretty quickly

What he’s now suggested is to take my test dose 1 day and hcg dose the next, with that being increased to 0.22ml + 1/4 a Anastrozole, taking my dose to 1/2 a tab a week split over 2 doses
This is resulting in me injecting 4 times a week, mon (test), tues (hcg + 1/4 anastrozole), thurs (test), fri (hcg + 1/4 anastrozole)

My thoughts so far, is the TRT journey has been ok. It hasn’t been a game changer, like many of my friends said it has been for them. Not that I was expecting miracles, as the dosages aren’t that much. Whilst I’ve seen benefits in the gym, I’ve seen ZERO benefit in the bedroom. My libido and erection quality has gotten worse to the point of almost being non existent. And for this alone, since its such a big thing, I’m not totally convinced that TRT has been worth it. I mean as a result of lack of libido and shit erection quality, its having a big impact on my mental health, creating anxiety, which is likely making the situation worse. Since TRT is suppose to have benefits in improving mood, and I’m not experiencing that as a result of libido and erection quality, I’m not sure what I should do, as talking to the dr resulted in increasing HCG and anastrozole, but that hasn’t helped

Anyone on here also experiencing poor to non existent libido and poor erectio quality from TRT? What did you do?

I’m pretty frustrated with where things are in that department, it’s not only effecting my mind. But it’s now having an impact on my relationship, which isn’t good

Any thoughts, guidance would be welcome

2

HCG can really impact the sexual function negatively in some men. I’ll bet your estrogen was lower closer to taking your AI, and had recovered to where it is on the lab report at the end of your injection cycle.

If this is true, that would mean your estrogen was low most of the week, estrogen is needed for erectile strength and libido.

Why are you taking an AI?

3

Hey Buddy

On my initial blood work my estrogen was 166.0 pmol/L range according to their report is 36 - 146.8 pmol/L, so high. They started me on anastrozole. Latest report since taking anastrozole was 80.1 pmol/L. It was after this set of bloods, I raised my libido and erectile strength be total garbage and he increased my HCG by 0.02ml to 0.22ml and my anastrozole from 1/4 tab once a week, to 1/4 tab twice a week

Be honestly, it feels like things have gotten worse not better

Frustrated as hell

4

If a guy comes in to the doctors office and says doctor, my testosterone is low, but I have no symptoms, I feel great, the doctor isn’t going to recommend TRT.

It’s the same with whatever your estrogen value is, no symptoms, no treatment. Your doctor is treating a lab value and doesn’t understand that serum E2 doesn’t provide a complete picture.

There’s 50 times more estrogen in your tissues, which is where it does it’s thing, the serum levels are leftovers, as in not doing anything in the body.

Men typically run higher on the estrogen values on TRT and it’s normal and to be expected. Your body is doing what it’s supposed to do, maintain the proper T:E2 ratios.

If you have side effects, lower your TRT dosage and or change your injection frequency.

Don’t overcomplicate it with drugs.

5

Hey man
I hear you. But since I’m no expert in any of this and VERY new to it. I’m just following the doctors advice, much like I would do for anything that requires expert input, even general medical needs via GP. I wouldn’t not take their advice or administer what they tell me

So not sure what I do other than look to challenge the dr or simply just stop

6

I did have symptoms buddy. No libido (worse than when not on TRT) poor erection quality, low mood some developing acne

Dr attributed it to estrogen hence the Anastrozole. But also suggeting i separate my test and hcg injections to different days to give me a more steady flow of test production i assume. Whilst increaing my HCG dose from 0.20ml to 0.22ml twise weekly

2 weeks in and theres zero benefit that im seeing / feeling

So im a bit lost by it if im honest

7

So you had symptoms, that are most likely not estrogen related. Most symptoms on TRT are from the body unable to handle optimized testosterone due to whatever underlining disease is causing the low-T values.

By going on TRT, you’re trying to circumvent the disease process, sometimes it works, sometimes for a little while and sometimes it doesn’t.

A lot of providers are guilty of mismanagement of estrogen and over prescribing anastrozole.

Too much testosterone can hurt sexual function.

8

I personally haven’t experienced any sexual side effects from TRT but initially held a lot of water and experienced erythrocytosis pretty aggressively.

My doc and I were shooting for specific test and estrogen numbers as a ratio and dialed it in.

Water retention and blood cell creation continued for a couple more months and I eventually adapted.

I still have to donate blood but it’s manageable and stays in range on the donation centers schedule where I was needing therapeutic phlebotomies in between.

I no longer hold water either. Labs vary a touch of course but hover around chosen target values.

I personally don’t use HCG but have heard it can be difficult to manage.

I did take some gym advice and dose my test for daily injections vs 2x weekly, so the relative stability may play a role in managing symptoms, but I don’t mention it to the doc as it’s outside approved prescription protocols so who knows.

I’m not a doctor at all, but maybe give your body time to adjust to a new routine. I feel like making too many changes every few weeks will never allow you to find a new balance, but this of course is not medical advice.

1 Like
9

I’m just following the docs guidance my friend. I’m not qualified enough to challenge him on his proposal of any kind of dosage / protocol off the back off feedback I give him and my bloods

So I’m somewhat at a stalemate and really not enjoying it

10

I hear you buddy, and for sure this feels like the best thing to do. But 4 months of things like my libido getting worse, erections no existent and very poor quality, is really starting to get to me mentally and having a pretty poor impact overall

Today I’ve emailed the dr again outlining that things have in fact got worse and to the point of now having a negative impact on my mood. And that it’s either the protocol or dosing that’s the issue or that TRT just isn’t for me in any capacity. Since my libido and erection quality was better pre TRT, not great, but certainly better

11

I’ve been giving this some further thought and spoken to a couple of friends who are also on TRT, but they’re not taking HCG etc. And I’m thinking I should speak to my doc and ask / suggest to him about stripping my protocol back, even if it sets me back a little and just doing the Cypionate twice weekly, see how I go with that

Interested in others views on this?

Seems from the many chats I’ve had on here. That the feeling is that my dr has kicked things off with me with far too many moving parts and I’m clearly not responding positively