I’ve been on TRT for a number of years specifically due to poor libido and it has not helped yet. New to this forum and I see a lot of support (and contention) on the E2 topic.
I’ve never let my E2 rise for any length of time because it always makes me feel like garbage, but I’m giving it a shot now.
I don’t have relevant labs yet as I’ve done a reset on my protocol and started again 3 weeks ago. I do aromatize quickly, and have a relatively low SHBG (~25 off trt, ~20 on trt).
I’m also currently experimenting with HCG because I wasn’t getting symptom resolution on Testosterone alone before I got off TRT for a while. I avoided HCG prior due to increased e2.
Current Protocol:
- Test E: 100mg weekly split into daily doses
- HCG: 750iu weekly split into 3 doses
- No A.I.
Current Symptoms (typically occur on with higher e2):
- Fatigue
- Brain Fog
- Dead Dick (no erections, no sensation, no desire)
- Irritability and slightly depressive mood
These symptoms also occur when I’m on only testosterone at doses higher than 165mg weekly.
4/19/2019 - 165mg Test Cyp, No A.I., No HCG
Total T: 1144 ng/dl (264 - 916)
Free T: 28.4 pg/ml (8.7 - 25.1)
Estradiol, Sensitive: 44.8 pg/ml (8.0 - 35.0)
SHBG: 17.8 nmol/L (16.6 - 55.9)
Pre TRT SHBG: 29.2 nmol/L (16.6 - 55.9)
Prolactin: 16.8 ng/mL (4-15.2)
Considering it’s been just a hair over three weeks, should these symptoms level out by weeks 8-10?
If not, what might explain these symptoms outside of the E2 argument?
(I know HCG doesn’t sit right with some folks but currently experimenting with it due to doctor recommendation that some folks don’t get symptom resolution without it).
Similar symptoms and more.
On TRT for nearly 3 years. Lab’s every 3 months at lst to dial things in.
Test: 150/wk, 2x/wk SubQ
HCG: 40 EOD Sub Q
No AI
Thyroid low dose time release 2x/wk.
Docs: Endo + Dr. Saya at Defy + Naturopath
For myself, it took a long long time to dial things in. And, even with minor adjustments, at least 2-3 months after each adjustment for things to settle out.
IMHO: It’s all synergistic, and takes time to get each part of things working together in your med protocols, etc. And, with time, things still need tweaking as my body changes and ages, etc.
IMHO: The “E2 Argument” you mention, again, depends on each person’s response to their own unique TRT, etc, protocols and thier own body. IE: Age 30 vs Age 70, etc.
Suggest, talk to your doc, (have a good one that understands TRT), labs and monitoring and adjusting to find what works “for you” specifically.
I am not a professional. This is just my experience so far. I learned to be patient with things to get the dialed in and the results have been great.
Good luck.
Aloha
In the absence of labs it will be difficult to assist you. You say these symptoms occur at weekly dosages greater than 165mg but don’t even provide labs.
Was poor libido the only symptom why you sought out TRT?
What is your CBC results on 165mg weekly?
Need more info.
What’s your prolactin look like? Do you have labs yet?
I don’t have labs for this round yet. Waiting a few more weeks for my protocol to stabilize.
I updated my original post with 165mg labs *(from 2019). My prolactin is over range. I took a look at some other blood labs in 2018 / 17 and my prolactin is consistently ~10 ng/mL (4-15.2) +/- 1 on 150mg and less. When using DHT cream 2x daily it was as high as 20.01 ng/mL.
That’s where I’d be looking to make improvements. High PRL can make it hard to get off the couch and get going
As mentioned, prolactin is a probability. 100mg is low and since you’re also low SHBG, the benefits of TRT are going to be minimal. HCG should bring your numbers up, but theyre practically virtual, and only look good on paper. HCG has its merits though. I lowered my dose for a month, added HCG, and Ive been having some so-so days here and there. Finally decided to get back on 220mg/wk and the difference is where I feel proper. I dont think the problem is High E, but more like a “not enough T” situation. I know that you aromatase fast, but give the idea of more T and let E fall where it may, a chance. You can only aromatase so much and still be in a good place. Either way, I know that more T is the answer but you will most likely disagree due to fear of a higher dose and the fear of high E. When you do try a higher amount, let me know. I bet it will trigger some good things. But first get labs for us to look at, then make a better decision. Oh, more frequent injections will help with high E. I have labs to prove it. No AI, daily shots and 220mg/wk. Labs were taken the day before I decided to take HCG and lower my dose.
High prolactin will inhibit your libido. If you can lower your prolactin to a more optimal number, your libido should hypothetically increase.
I disagree with those saying to increase your T further. Look to modify one variable at a time. Work on prolactin first. If that fails, look elsewhere.
I would search to fix prolactin before adding in hcg also, unless immediate testicular atrophy and fertility are concerns. If you begin having difficulty sleeping, experience water retention and increase blood pressure, hcg may not sit well with you.
“Prolactin increases following orgasm are involved in a feedback loop that serves to decrease arousal through inhibitory central dopaminergic and probably peripheral processes. The magnitude of post-orgasmic prolactin increase is thus a neurohormonal index of sexual satiety.”
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As stated check prolactin. But your dose is still too low. Others will disagree because they are not low SHBG.