No Sex Drive, Low Test and High Estrodiol. HELP!

Pharma / TRT Testosterone Replacement
1

Hi guys, I’m new to this site so hope I’m in the right place!!!

26 Male
6ft
14stone / 200lbs / 91kg
Body fat around 8%

I did a few pro hormone courses each lasting about 4-5 weeks and took tamoxifen and DAA during and as PCT for 4-6 weeks after each.

My sex drive always took a dive but seemed to be fully back after my 4-6 weeks PCT.

My last one was November 2013 (over 2 years ago) and I haven’t recovered yet. I’ve had a number of lab tests see below.

I’ll be great full for anyone’s input / knowledge on how to recover my sex drive!

Test Date: 6th Jan 2015 Time: 07:15am
TESTOSTERONE
Plasma testosterone level (XaltQ) - 14.5 nmol/L [6.0-27.0]

LH/FSH
Plasma LH level (XaElA) - 5.0 u/l [0.7-11]
Plasma FSH level (XaELZ) - 1.8 u/l [0.8-7.7]

SERUM SEX HORMONE BINDING GLOBULIN LEVEL (44CD.)
Serum sex hormone binding globulin level (44cd.) - 37 nmol/L [13.0-71.0]

PROLACTIN
Plasma prolactin level (XaELY) - 338mu/L [0.0-280.0]

Note: estradiol was not tested and took started taking pramipexole due to high prolactin.

Test Date: 4th Aug 2015 Time: 08:00am
TESTOSTERONE
Plasma testosterone level (XaltQ) - 15.5 nmol/L [6.0-27.0]

LH/FSH
Plasma LH level (XaElA) - 4.0 u/l [0.7-11]
Plasma FSH level (XaELZ) - 1.9 u/l [.08-7.7]

SERUM SEX HORMONE BINDING GLOBULIN LEVEL (44CD.)
Serum sex hormone binding globulin level (44cd.) - 32 nmol/L [13.0-71.0]

17 B ESTRADIOL
Plasma oestradiol level (XaEQo) - 235 pmol/L [male up to 73]

PROLACTIN
Plasma prolactin level (XaELY) - 125mu/L [0.0-280.0]

Note: Started arimidex at 0.5mg daily until next blood test (approx 10 weeks)

Test Date: 12th Oct 2015 Time: 07:40am
TESTOSTERONE
Plasma testosterone level (XaltQ) - 14.5 nmol/L [6.0-27.0]

LH/FSH
Plasma LH level (XaElA) – 3.6 u/l [0.7-11]
Plasma FSH level (XaELZ) – 2.3 u/l [.08-7.7]

SERUM SEX HORMONE BINDING GLOBULIN LEVEL (44CD.)
Serum sex hormone binding globulin level (44cd.) - 23 nmol/L [13.0-71.0]

17 B ESTRADIOL
Plasma oestradiol level (XaEQo) - 133 pmol/L [male up to 73]

PROLACTIN
Plasma prolactin level (XaELY) - 208 mu/L [0.0-280.0]

Note: bumped Arimidex up to 1mg a day until 3 days before next blood test which I then reduced back to 0.5mg

Test Date: 9th Nov 2015 Time: 07:00am
TESTOSTERONE
Plasma testosterone level (XaltQ) – 13.7 nmol/L [6.0-27.0]

LH/FSH
Plasma LH level (XaElA) – 8.5 u/l [0.7-11]
Plasma FSH level (XaELZ) – 2.9 u/l [.08-7.7]

SERUM SEX HORMONE BINDING GLOBULIN LEVEL (44CD.)
Serum sex hormone binding globulin level (44cd.) - 28 nmol/L [13.0-71.0]

17 B ESTRADIOL
Plasma oestradiol level (XaEQo) - 195 pmol/L [male up to 73]

PROLACTIN
Plasma prolactin level (XaELY) - 274 mu/L [0.0-280.0]

Note: tried arimidex at much lower dose of 0.25mg every other day to prevent possible rebound until next blood test.

Test Date: 24th Dec 2015 Time: 07:10am
TESTOSTERONE
Plasma testosterone level (XaltQ) – 12.8 nmol/L [6.0-27.0]

LH/FSH
Plasma LH level (XaElA) – 4.7 u/l [0.7-11]
Plasma FSH level (XaELZ) – 2.2 u/l [.08-7.7]

SERUM SEX HORMONE BINDING GLOBULIN LEVEL (44CD.)
Serum sex hormone binding globulin level (44cd.) - 28 nmol/L [13.0-71.0]

17 B ESTRADIOL
Plasma oestradiol level (XaEQo) - 125 pmol/L [male up to 73]

PROLACTIN
Plasma prolactin level (XaELY) - 173 mu/L [0.0-280.0

Note: I reduced arimidex over the next 10 days and came off completely. After a couple of weeks I started to get sore nipples. So I started and currently still on aromasin at 25mg daily and occasionally 50mg depending how I feel, along with 20mg tamoxifen daily. I think for the first time maybe my estradiol may possibly be low but I don’t have any symptoms that really stand out other than low sex drive and trouble to get / keep it up (which I had anyway). I don’t have ache joints or feel like death which people describe low E2 as.

I’m hoping by lowering my estradiol that my test should increase (negative feed back loop)

Is there such a thing that by reducing your estradiol too much it can slow down testosterone production?

Has anyone got any idea what’s going on here?

Am due to go for another blood test soon

Thanks

2

Prolactin probably from a pituitary adinoma. You need a MRI to confirm.

0.5mg/week Dostinex/cabergoline in divided doses might be better.

These drugs should shrink the adinoma, so the MRI diagnostic window may have been missed.

You should not need that much anastrozole. Is it real?

Anastrozole reduces T–>E2, but it is the liver that needs to clear it.

Have you had your testes examined?
Any changes or aches?

Please follow these links in the 2nd post of the 1st forum topic:

  • advice for new guys
  • things that damage your hormones
  • HPTA restart

Do you get cold easily now?
Are your outer eyebrows sparse?
General hair thinning?
Dry skin?

3

When I did these PH courses I was pretty much on tamoxifen continuously as I used to be on tamoxifen during the 4 week PH course which was 2weeks on 2 off and then 2 more on, I’d then stay on tamoxifen for a PCT 4-6 weeks and then I’d start another course the same as I just mentioned. Stupid and I’ve learnt the hard way!!! I was probably taking tamoxifen for 18months at 20mg daily. :confused:

I’m no longer taking prami, I only took that from the date of my first test result to my second test result.

Would you say my prolactin levels are high?

As far as I’m aware all the AI I get is real, I base this on the fact I never got morning wood until I started taking arimidex I also had it from two different sources so the chances of them both being fake is less likely. Also after I felt my nipples start to hurt and I started the aromasin I also started getting morning wood again, so on that basis I assume it’s working to some extent.

My morning wood is very few and far between, when I start an AI I seem to get morning wood after a couple of days, I continue the AI and the morning wood stops, so I stopped the AI but I didn’t get morning wood again until I started taking an AI again, it’s as if I get morning wood as my e2 drops past the ‘sweet spot’ but not as it starts to rise past the ‘sweet spot’

I am prone to a cold but I don’t think so any more than before this all started.

My skin isn’t particularly dry but I have noticed my forehead isn’t as greasy as it used to be.

I noticed more hair start to come out in the shower but that doesn’t happen anymore and hasn’t for a long while.

Eyebrows aren’t the thickest on the outer part but I wouldn’t say they are any different to what they used to be.

I did notice my loads were very thin / watery and not a lot of volume but that has now improved a lot and I would say they are pretty much back to normal.

My testes did ache on that last course I did towards the end and occasionally they ache now but not often or for long, they also don’t seem to hang so much now, more up tight. I’ve not had them examined no.

Is it possible for you to paste a link in here for the second post of the first topic as I’m not sure where I’m meant to be looking for

  • advice for new guys
  • things that damage your hormones
  • HPTA restart
    (although it’s pretty self explanatory I can’t seem to find it) :s

Thanks a lot, much appreciated for your time and knowledge.

Sorry I’m not familiar with T–>E2. What does this stand for…total estradiol?

4

I did also got a bunch of other things test on my first and second test, not sure if they are of any use, see below:

Test Date: 6th Jan 2015 Time: 07:15am

BONE & LIVER PROFILE
Bone and Liver calcium (XalRk) - 2.35mmol/L [2.12-2.55]
Corrected calcium - 2.33mmol/L [2.12-2.55]
Plasma alkaline phosphate level (XalRj) - 48 iu/L [32.0-91.0]
Plasma total protein level (XE2eC) - 70 g/L [60.0-80.0]
Plasma albumin level (XalRc) - 41 g/L [35.0-50.0]
Plasma globulin level (XaltX) - 29 g/L [23.0-35.0]
Plasma total bilirubin level (XaETf) - 10 umol/L [7.0-35.0]
Plasma alanine aminotransferase level (XalRi) - 19 iu/L [17.0-63.0]

TSH
Plasma TSH level (XaELW) - 1.90 mu/L [0.3-5.6]

RENAL PROFILE (44J5.)
Plasma sodium level (XalRf) - 141 mmol/L [133.0-146.0]
Plasma potassium level (XalRI) - 4.7 mmol/L [3.5-5.3]
Plasma creatinine level (XaETQ) - 112 umol/L [57.0-113]
Plasma urea level (XaDvl) - 5.6 mmol/L [2.5-7.8]

PREDICTED GFR MALE
AGE 25
GFR calculated abbreviated MDRD (XaK8y) - >60 mL/min

NON FASTING LIPDS
Serum cholesterol level (XE2eD) - 3.36 mmol/L
Plasma triglyceride level (44e…) - 0.95 mmol/L

LIPID FRACTIONATION (XaJmA)
Plasma HDL cholesterol level (XaEVr) - 0.99 mmol/L
Plasma LDL cholesterol level (XaEVs) - 1.94 mmol/L
Serum cholesterol/HDL level ratio (XaEUq) – 3.4

Test Date: 4th Aug 2015 Time: 08:00am

BONE & LIVER PROFILE
Bone and Liver calcium (XalRk) - 2.36mmol/L [2.12-2.55]
Corrected calcium - 2.30 mmol/L [2.12-2.55]
Plasma alkaline phosphate level (XalRj) - 57 iu/L [32.0-91.0]
Plasma total protein level (XE2eC) - 74 g/L [60.0-80.0]
Plasma albumin level (XalRc) - 43 g/L [35.0-50.0]
Plasma globulin level (XaltX) - 31 g/L [23.0-35.0]
Plasma total bilirubin level (XaETf) - 20 umol/L [7.0-35.0]
Plasma alanine aminotransferase level (XalRi) - 23 iu/L [17.0-63.0]

TSH
Plasma TSH level (XaELW) – 2.03 mu/L [0.3-5.6]

RENAL PROFILE (44J5.)
Plasma sodium level (XalRf) - 137 mmol/L [133.0-146.0]
Plasma potassium level (XalRI) - 4.1 mmol/L [3.5-5.3]
Plasma creatinine level (XaETQ) - 112 umol/L [57.0-113.0]
Plasma urea level (XaDvl) - 5.8 mmol/L [2.5-7.8]

FASTING GLUCOSE
Fasting blood glucose level (XE2mq) - 4.9mmol/L [3.6-6.1]

PROGESTERONE
Serum progesterone level (XE2dq) - < 2.0 nmol/L

B12 & FOLATE
Serum vitamin B12 level (XE2pf) - 449 pg/ml [180.0-914.0]
Plasma folate level (X76tC) - 7 ng/ml [4.0-20.0]

FULL BLOOD COUNT (424…)
Heamoglobin concentration (Xa96v) - 165.0 g/l [130.0-170.0]
Total white blood count (XaldY) - 6.3 109/L [4.0-10.0]
Platelet count – observation (42P…) - 211 109/L [150.0-450.0]
Heamatocrit (X76tb) - 0.484 l/l [0.4-0.5]
Mean cell volume (42A.) - 92.1 fL [83.0-101.0]
Mean cell haemoglobin level (XE2pb) - 31.3 pg [27.0-32.0]
Mean cell haemoglobin concentration (429…) - 340.0 g/L [315.0-345.0]
Red blood cell distribution width (XE2mO) - 14.3% [11.6-14.0]
Red blood cell count (426…) - 5.25 1012/L [4.5-5.5]
Neutrophil count (42J…) - 4.0 109/L [2.0-7.0]
Lymphocyte count (42M…) - 1.8 109/L [1.1-3.5]
Monocyte count – observation (42N…) - 0.4 109/L [0.2-1.0]
Eosinophil count – observation (24K…) - 0.1 109/L [0.0-0.5]
Basophil count (42L…) - 0.0 109/L [0.0-0.1]
Percentage neutrophil count (XE2mP) - 63%
Percentage lymphocyte count (XE2mQ) - 28%
Percentage monocyte count (XE2mR) - 7%
Percentage eosinophil count (XaCJj) - 1%
Percentage basophil count (XE2mS) - 0%

6

Look at the 2nd post of the first topic in the forum, its the one at the top.

TSH should be closer to 1.0 - ignore the range
Have you been using iodized salt?
You may be iodine deficient
Post oral body temperatures as per thyroid basics explained

Please follow these links in the 2nd post of the 1st forum topic:

  • advice for new guys
  • things that damage your hormones
  • thyroid basics explained <<< added
  • HPTA restart

Yes, prolactin is becoming a concern.
You could as to have a MRI scan to see if a adinoma is there.
That can repress LH/FSH and T as well as lowering dopamine and that takes the fun out of everything.

7

I’ve managed to find the links you recommended to read through. After reading through HPTA restart, in there you mention not using SERM and HCG at the same time, I did this @ 250iu HCG EOD and 20mg tamoxifen ED for a couple of weeks (approximately 7 months ago), could this have / still be causing me trouble?

As for the things that damage your hormones, I’m sure everyone can probably pick things that apply to them, as I have been able to, but there isn’t anything that jumps out at me.

As my PH cycles (superdrol) were so short, I’m hoping I haven’t permanently damaged part of my HPTA, would you say this is a fair assumption?

I haven’t been using iodised salt no.

Oral body temp is something I will aim to post asap.

What is the normal range of prolactin for someone my age (26)?

I’ve been more concerned about my E2 level and been focusing on getting that into range as I was under the impression high E2 can be quite suppressive of test?

I’ve been on aromasin at 25/50mg daily and tamoxifen 20mg daily for 2 weeks now, would you suggest a new set of blood tests Monday or should I wait a little longer?

Do you build a tolerance to aromasin? And can it cause nose bleeds as I’ve been getting them the last few days.

Something I had noticed is, since all this started I’m nowhere near as hot and feel cold a lot more.

Also since I stated the aromasin I feel more aggressive.

Thanks

8

Nose bleeds might be from low humidity, if that happens were you are.

Prolactin levels are not age related. Yours is simply too high. Mid range is good.
You should be screened for a prolactin secreting pituitary adinoma with a MRI.
Any loss of width of peripheral vision? Should be close to 180 degrees.
0.5mg/week dostinex/cabergoline will lower prolactin and shrink adinoma.
prolactin is LH/FSH repressive and lowers dopamine - gloomy or moody

So you are iodine deficient. Others in your household also deficient?

E2=80 pmol/L would be a good target for most guys [22pg/ml]

9

I miss read one of your questions previously, you asked if I get cold easily now…yes I do get cold easily now and I never used to. What could this mean?

How long should it take Dostinex to reduce my prolactin? And once adinoma (if I have one) has shrunk, is that a permanent fix or will I have to continue Dostinex to keep it under control?

Prolactin is released on orgasm, if I was to of had sex the night before my test, could this be a cause for high levels of prolactin on my test, or should they have come back down to normal level within the 10 hour gap?

I’m going for a new set of bloods on Monday so will post them once I have results, and if possible some advice from you what your next step would be?

Thanks

10

Do not know how fast prolactin would drop after orgasm.

Dostinex should act quite fast. Have no idea how long effect would be if stopping Dostinex. I had assumed lifetime requirement.

Getting cold is a symptom of low thyroid function, that often is a result of not using iodized salt leading to iodine deficiency.

Post oral body temperatures as per thyroid basics explained.

Body temps are regulated by effects of thyroid ft3 hormone on mitochondria that produce ATP, the universal currency of cellular energy.

11

So after 50mg aromasin ED and 20mg tamoxifen EOD for 6 weeks, I had some new bloods done. My results (below) are not what I was expecting, I thought and was hoping my E2 would be rock bottom as I haven’t yet been able to get my E2 in range. But my T has improved from 12.8 to 15.2 which I suppose is a plus.

Do I need to taper off aromasin or am I ok to just stop?

Has anyone got any ideas what could possibly be causing high E2 that an AI can’t lower. I’ve previously tried arimidex 0.5mg ED for 10 weeks and now aromasin as explained in paragraph above, and haven’t managed to get my E2 lower than 120 (test lab ref range up to 73).

Is intratesticular E2 a possibility? If so what are my options?

Someone must have an idea of what’s going on here and a way to resolve it!!!?

Test Date: 31st March 2016 Time: 07:15am
TESTOSTERONE
Plasma testosterone level (XaltQ) - 15.2 nmol/L [6.0-27.0]

LH/FSH
Plasma LH level (XaElA) - 8.3 u/l [0.7-11]
Plasma FSH level (XaELZ) - 2.7 u/l [0.8-7.7]

SERUM SEX HORMONE BINDING GLOBULIN LEVEL (44CD.)
Serum sex hormone binding globulin level (44cd.) - 27 nmol/L [13.0-71.0]

17 B ESTRADIOL
Plasma oestradiol level (XaEQo) - 156 pmol/L [male up to 73]

PROLACTIN
Plasma prolactin level (XaELY) - 211mu/L [0.0-280.0]

Do you think I would benefit at all from an attempt to restart HPTA with HCG and AI then SERM?

12

I’ve been off the Aromasin for 3 days and I can feel my e2 rising, nipple feels tender and my erections are noticeable softer. Why is my body creating so much e2 naturally!!?

Someone PLEASE HELP!

13

@KSman please could you give your input on my last 2 posts, anything is appreciated.

I have another appointment with a private endo this week.

I’m getting desperate to sort this.

14

i remember reading something about people with a zinc deficiency who started treatment for it and within a weak saw a dramtic reduction in e2 levels followed by an increase in testoerone of 50% or more.

so you may want to look into zinc deficiency alot of people dont get the recomonded amount of it anymore

15

I started a thyroid supliment about 2 weeks ago which has a daily value of 25mg zinc included, which is about 170% of you daily value. I don’t feel any different.

My biggest thing is why I can’t lower my e2, even with a high AI dose which should apparently crash you within days.

16

You can’t lower your e2 past a certain point due to the use of SERM. E2 on SERM is not always the real image or better to say SERM increase e2 production but hides that from the brain. Have you been on SERM non stop for some time? If you want to diagnose hypogonadism, the least you should do is cut out all the drugs you are taking for 4-8 weeks and test. Prolactin could also be a tad higher from elevated e2 but if the first prolactin no. was without any SERM, I would think a prolactinoma could be present.

You should probably taper off the SERM and run AI along with it and continue low dose ai after you taper off for about a week. Then you would get representative numbers of how your hpta is working.

17

The above set of test results were after 10 weeks 0.5 adex ED only, no SERM.

18

Seems like your problem is the estradiol, which some how is not budging even on this high dose adex. I am not much experienced with the drugs to be honest , I have just read a lot. Your T levels seem to be not “too bad”. It depends on the symptoms really. High E is a problem which is obviously not helping and your competitive AI seems not to be working. Maybe someone else could give information about how it is possible.

Is your liver okay? It is the livers function to clear estrogens from the body which it seems not to be doing.

19

I’ve had a liver profile done twice and all came back fine.

20

Please provide the liver panel results.

You are making a lot of E2 and/or you are not clearing E2 because of a liver issue. The issue can be from drugs that interfere with that.

Your E2 was better, but need to get nearer to E2=80 pmol/L

Try anastrozole+aromasin. We understand why anastrozole does not work inside the testes. But there is the possibility that aromasin does. So a combo can be tried.

Whats going on with iodine and body temperatures?
Feeling more alert?

Been busy, tax time and travel coming up…

21

These ^ are previous tests, haven’t had one recently.

I’ve started Lero at 2.5mg EOD hope this might do the trick. I’m all out of ideas for my e2, if I don’t take anything I start to get tender nipples within days.

Do you think a restart with HCG may help me…to bump up my T?

I don’t have a thermometer to take temps, it’s something I need to do and get results up here ASAP.

I definitely feel a little more enogetic and stronger in the gym and don’t feel the cold so much.

These are all pluses but I’m not back to my old self, no sex drive and soft erections.