Missing: One Libido, 35 Years Old

Age: 35
Height: 73 in (185 cm)
Waist: 38 in (97 cm)
Weight: 222 lbs. (100 kg)
Body hair: Thin hair, but substantial coverage, especially on chest and legs. Hair on head thinning noticeably over last year.
Facial hair: Covers entire beard area of face with no gaps and grows enough to require shaving every day. Average thickness.
Where I carry fat and how it has changed: I carry fat mostly around my midsection and somewhat in my chest. The belly fat has remained stubborn for several years, regardless of my exercise or diet regimens.
Health conditions, symptoms: Asthma and allergies since pre-teen childhood. Asthma can be exercise-induced or triggered by sneezing or coughing. Allergies are primarily seasonal and worst in the spring. Significant increase in GI issues (diarrhea, loose stools, gas) over past several years.
Rx and OTC drugs: Asmanex and albuterol for asthma, fluticasone for allergies, never taken any hair loss drugs or prostate drugs.
Diet: 70% organic with at least 1/2 lb. of protein (red meat, salmon, chicken) per day. Most carbs from veggies, fruits, and occasionally whole wheat bread or brown rice. I’m not perfect, so some junk food makes it’s way in now and then.
Training: Compound weightlifting routine three times per week.
Testes ache, ever, with a fever?: No.
How have morning wood and nocturnal erections changed: Much less frequent in the past few years, almost nonexistent recently for days or even weeks at a time.

Apologies in advance for the lack of some specific test result numbers here. I’m primarily trying to figure out my next steps, so hopefully what I have provided so far will be enough. I will update with my latest test results when I get them.

My primary concern for getting my T tested was low libido. First Total T test was done in June 2013 with a result of 398 ng/dL. Reference range for the lab was 348-1197. Met with a urologist in October 2013 and he took a new Total T test that came back at 309. Started me on Clomid, 50 mg EOD. One month later, Total T came back around 800. Fantastic number, but my libido hadn’t gotten stronger and I had the occasional bout of ED now to boot. Went back in January 2014 and Total T was still in the 700 range, but now libido was pretty much nonexistent and ED was happening more frequently. So, my numbers were up, but the symptoms I wanted to treat had gotten worse.

Went to see an endocrinologist in March 2014 for a second opinion. Did two T tests one week apart. First came back at 518, second at 401, essentially right back to my first test result almost a year ago. Doc said it wasn’t low enough to treat with HRT, and Free T was in the normal range for my age. (I don’t know the reference range, but Free T was 105 for the first test and 86 for the second.) He told me to exercise more, eat better, etc. to fix it naturally and come back in three months. I said no, I want a wider panel taken to figure out low libido, ED, and fatigue issues, so he ordered a fatigue screen. I am waiting for the results in a week, but I believe it tests cortisol, vitamin D, zinc, and iron levels among other things.

Has anyone else experienced lower libido and/or ED problems during and/or after Clomid? What other things should I be asking about if my end goal is to boost my libido?

If anyone can recommend DC/VA/MD doctors who are proactive in helping to resolve these issues rather than going strictly by the numbers, please let me know privately.

Thanks in advance for any help you can offer.

I don’t see an E2 lab value. Clomiphene blocks estrogen from binding to certain receptors and therefore has less inhibition of LH and FSH at the pituitary. It likely causes E2 to be metabolized less frequently and the elevation in T aromatizes at a greater rate. Libido appears to be related more with the correct E2:Test ratio than either hormone level alone. Because your T is still relatively low an elevation in E2 will cause ED and/or libido issues. This is why my Endo flat out refused to let me try Clomiphene before goin down the testosterone route. Studies showed Clomid was great at increasing T but didn’t fully indicate the rates of ED experienced. Clomiphene, in my opinion, is better suited to diagnostic and restart purposes.

Thanks for the reply. My most recent labs were for Total T and Free T. Would those likely have included E2 values as well that just were not shared with me, or do they tend to be a separate test altogether? Regardless, I will request the full results from both this and the fatigue screen to post here for further investigation.

Your explanation makes sense. When I mentioned the Clomid use to my endo, he said it is great for getting T levels up, but not great for treating symptoms. Wish I had known that beforehand. I really don’t care what the T number is as long as the symptoms are resolved. Sounds like the E2:T ratio is they key to getting this figured out.

Well it’s good for the diagnostic piece at least. The resulting rise in T at least proves your gonads are functioning fine, it’s just low output of LH/FSH from the pituitary.

E2 is a separate test and may be something to deal with after switching to T injections.

I am currently tapering off Clomid…
I started taking 25mg EOD in early December… and it didn’t take long and my LIBIDO was down…
Just got blood work… and they fucked up my total and free T so I have to get more bloods.

LH 12 scale of 2-6
FSH 7 scale of 2-8
E2 256 scale of <150 … PROBLEM…

Also clomid can mess with libido while still having E2 numbers in the range… IMO…

I am now tapering and down to 25mg twice a week…

Supposedly if you just stop taking it… It can shut you down…

[quote]Macmathews wrote:
I am currently tapering off Clomid…
I started taking 25mg EOD in early December… and it didn’t take long and my LIBIDO was down…
Just got blood work… and they fucked up my total and free T so I have to get more bloods.

LH 12 scale of 2-6
FSH 7 scale of 2-8
E2 256 scale of <150 … PROBLEM…

Also clomid can mess with libido while still having E2 numbers in the range… IMO…

I am now tapering and down to 25mg twice a week…

Supposedly if you just stop taking it… It can shut you down…
[/quote]

If you have to pay for your bloodwork I wouldn’t bother getting another one just for T (there is no free T test just [test+albumin+SHBG]). YOu have the info you need, TT would only prove that the LH is able to produce test in your leydig cells. The information that you got is more important though because E2 is the issue and clomid should be D/C’d

[quote]C27 H40 O3 wrote:

[quote]Macmathews wrote:
I am currently tapering off Clomid…
I started taking 25mg EOD in early December… and it didn’t take long and my LIBIDO was down…
Just got blood work… and they fucked up my total and free T so I have to get more bloods.

LH 12 scale of 2-6
FSH 7 scale of 2-8
E2 256 scale of <150 … PROBLEM…

Also clomid can mess with libido while still having E2 numbers in the range… IMO…

I am now tapering and down to 25mg twice a week…

Supposedly if you just stop taking it… It can shut you down…
[/quote]

If you have to pay for your bloodwork I wouldn’t bother getting another one just for T (there is no free T test just [test+albumin+SHBG]). YOu have the info you need, TT would only prove that the LH is able to produce test in your leydig cells. The information that you got is more important though because E2 is the issue and clomid should be D/C’d[/quote]

C27,

Could you chime in on this topic.
I would love to discuss more …
I am trying to get my Total T and Free T up…