Good Libido, Poor to Absent Erections on TRT

Pharma / TRT Testosterone Replacement
1

I’m 38. Started TRT 4 months ago. My baseline TT was 276 with a normal range of 240-700.
My initial dose was .5ml (100mg) test cyp twice a week. Few weeks later I had great energy, sleeping better, clear mind, stable mood.
Couple weeks later ED hit without warning. It would come and go over the days. I thought maybe high E2 so I took arimidex and nolvadex. Made it worse. I felt shitty, sweating, full blown ED. About a week later I went and had my labs done which are as follows:

TRIG <=499 109mg/dL
HDL. >=40 mg/dL. 29 (L)
LDL. <=159. 110mg/dL
DIHYDROTESTOSTERON 106.0-719 774.1 (H)
ESTRADIOL, ULTRA < OR = 29. 36 (H)pg/mL
FSH. 1.4 - 18.1 <1.0 (L)
LH 1.5 - 9.3 <1.0 (L)
PROLACTIN 2 - 18 ng/mL 24 (H)
SHBG. 10.0 - 60.0 11.7
TESTOSTERONE, FREE, 59.0 - 166.0 379.6 (H)
TESTOSTERONE, LC MS. 240 - 700 1,088 (H)
HGB 13.0 - 17.0 15.2
HCT. 39.0 - 51.0 44.0

I decided to take a few weeks off everything. Ed seemed to have subsided but had some premature ejaculation issues that were short lived.
Started back a little over a month ago in TRT. Now it’s .25ml(50mg) every 3 days. No AI’s at all.
Energy is down a bit from the original dose but manageable. My libido is great but erections are terrible. I can get one but it’s 70% at best and will disappear. I cannot keep it up. Cialis 10mg was prescribed and does absolutely nothing for me.
At a loss here. I’m sure there is a way to get this figured out and I know I’m making mistakes along the way. Trying to minimize those.
The Dr did order a MRI of the pituitary with was unremarkable.
Thanks for any input.

2

I reduced the dose a week ago, libido returned, so did sensitivity. erection maybe a little better. I have been on the treatment for 5 months and have had no erection problems except for two weeks when I took a couple of small pieces of anastrozole. this is low shbg so free t is always really high. current protocol 100mg Sustanon 250 eod. I have changed protocols from time to time, but now I am at my best and my wife looks great. give the protocol time and I will too. I think I’m close to a full pot. I feel like less is better, which is weird, it works… with high doses, I lost sleep at night, etc. I know it will work as long as I find a dose that works for me because I already experienced it. I don’t want to eat anastrozole because it messes up HDL cholesterol.

3

Stopping treatment isn’t necessary, your protocol isn’t optimized. Your SHBG is, was 11, and unless you have type 2 diabetes, SHBG will decline into the single digits.

I would try twice weekly or daily injections may be necessary.

4

All you really likely needed to do is to taper down your dose until boners come back and libido is still there.

But you can’t try a lower dose for a week and decide it’s not working. Sounds like you were 200mg per week, which is a high dose. Try 180mg per week and see what results. But stay with it for at least a month or more.

1 Like