M27 Low Libido, ED since 3 years -> Urologist suggests Tamoxifen

Pharma / TRT
1

Hello, i am 27, 185cm, 83kg and have sexual problems since around 3 years. The thing is i can not get my head around the reason for it. I do not have morning errections even longer than that but i have never really thought about it because everything else was working fine.

What I already checked:

Thyroid .. normal

MRT of head/pituary .. normal

Sleep Lab … normal (started to wake up at least one time every night since around the same time but lab found nothing)

Last Bloods:

FSH … 3.2 mU/ml 1.5 - 12.4

LH … 3.9 mU/ml 1.7 - 8.6

Estradiol … 11 pg/ml * 11 - 43

Prolactin … 183 µU/ml 86 - 324

Testosterone … 4.9 ng/ml 3.5 - 8.4

TSH … 1.75 µU/ml 0.50 - 4.20

free T3 … 5.3 pmol/l 3.1 - 6.8

free T4 … 1.27 ng/dl 0.92 - 1.68

The lab before that (for SHBG):

Prolactin 292 æU/ml 86 - 324 Estradiol 14 pg/ml 11 - 43 PROG Progesterone 0.17 + ng/ml 0.05 - 0.15 SHBG 37.80 nmol/l 18.30 - 54.10 Testosterone 5.3 ng/ml

The only reason for my lacking libido i can think of is my strangely low estradiol. My urologist wants me to try 20mg/day of tamoxifen for 2 months now to try to jumpstart my hpta axis. I mean it would probably work but wouldnt it block my estrogen even more?

I would be happy for some insights!

2

This would help you possibly get things moving again. Tammox blocks estrogen receptors at the breast so it should not lower estrogen across the board. In fact if estrogen does not bind to breast receptors there may be more availability in the rest of the body for conversion.
That being said i think clomid would be a better choice here or both.

3

I personally think its a waste of time. With that SHBG and your lowish TT you prob have low FT. You also have borderline low E2. TRT is prob in your near future.

4

Thanks for the replies! I also talked about clomiphen with him but he said tamoxifen works better. What would be the advantage of taking both?

Yes trt may be necessary in my future but i would like to try other options first to preserve fertility.

5

You can still be fertile on TRT but for some it lowers sperm count enough to cause issue. However, you can use fertility protocols when you’re ready for kids that basically give you the same shot at having kids as you did naturally all while still continuing TRT.

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