Solid Labs on TRT but Weak Sex Drive, Thoughts?

Hey everyone!

I am about to hit the 1 year mark on trt (maybe a little too much) but I went in for some basic labs to get an idea what my body was doing. The biggest gripe I have is my sex drive is very meh with minimal morning wood lately. I can still plow the ol lady no issue but my desire is not that high. In the last year it has been all over the place but I always appreciate hearing what you guys have to say. Here are some lab results:

(Also for reference my diet is spotless, I train cardio and weights for motocross. 215 lbs with abs)

ALT 0-41 (28)
AST 0-40 (19)
Total testosterone 264-916 (1162)
Free testosterone 5-21 (54.04)
% free testosterone 1.50-4.20 (4.69)
Estradiol 16-51 (34.2)

Thanks in advance for any info!

E2 is a little low in comparison. PRL/thyroid/cortisol?

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A subset group of men with have sexual problems when running abnormally high testosterone.

Testosterone also converts to other hormones, and also effecting the balance of those hormones.

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I cruise with 200-400mg/week and am sort of similar. There doesn’t seem to be any consistency in when it happens.

Your free T is quite high and E seems low relatively.

What dosage T are you taking?

What’s your SHBG?

Are you taking an anti-aromatase?

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As of late I am very open to being E2 friendly, I have softened my stance. I would like some clarification here though about his E2 being relatively low as you guys are saying.

Is this an argument for the supposed ratios? What are low converters supposed to do then? I personally don’t believe in ratios.

Am I doomed in where my individual E2 drops really low when I lower my dose, but isn’t “high enough” when I increase dose and my T goes above limit?
Is HCG the possible answer?

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So no aromatase inhibitors or any other random meds are in play. My joints are a little sore but not bad like low E bad.

Those are the labs I have on hand now but could potentially get more.

Dosage is 60mg every other day because for some reason my body does not like bigger amounts infrequently.

I may lower it a hair to get closer to the top of the healthy range and see if that does anything.

OP, your sex drive may not be related to your hormone levels at all. Perhaps, like myself, there are times or episodes when you or her or both just don’t feel like it. Chalk it down to stress, work, age, family or other commitments and responsibilities you have. Do you recall when your weak sex drive started to occur?

Are you taking any other medication that could effect your drive? Benzo’s? SSRI’s?

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No no other medications and it’s been maybe a month or a little longer. I’m 31 so I hope it’s not age lol just not chasing her as much as I did. Appreciate the feedback!

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I tend to see a ratio of around 40:1 ratio of TT to E2, except 2 exceptions when I was doing HCG regularly or was doing subq E5D in where it was less skewed.

You’re not on TRT. Did your doctor prescribe 180 to 240 mg per week?

How about trying TRT to see if you might not have problems actual TRT?

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Yes I am on TRT, and yes my doctor prescribes whatever he thinks we need to figure out my level and clearly they are high. The condescending attitude is not necessary as this is an open forum for discussion of issues. As you may know hormone balance is not a quick process to dial in.

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It’s true you’re treating hypogonadism, low-T using testosterone, but you have a little extra. It’s a fact, you’re not on TRT but are on performance enhancement therapy. What your doctor thinks you need may not actually be what you need.

For the fact you’re having sexual problems, only strengthens my augment.

There’s no condescending attitude here, you made a factually incorrect statement. The last thing we need is new members coming to T-Nation believing abnormally high levels, Free T 2x times the normal limit is “testosterone replacement therapy”.

There is a fine line between TRT and performance enhancement therapy/AAS.

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Correct, now that I have labs to see it is high it will be adjusted to the amount getting me to high optimal. I was aware it was high once I received the labs hence the range attached to the levels.They were much lower last time. We overcorrected it a bit. If that is in fact the issue directly correlating to the sexual function then obviously that will correct in the process. If it is not the reasoning then I will continue to figure out why my sexual function is not optimal.

I did not mean condescension. All I meant was that you’re not on a clinical dose.

What kind of doc you see? Urologist? Endocrinologist?

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It likely is, especially of this is the only change made and things were fine before.

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All good man, I appreciate the clarification. I haven’t done labs in a while but the last time I did they were not great and this has been the result of an over correction. This doctor is a GP but he tries his best to listen to the patient and work with us versus the ones that know everything. After seeing the results I’m going to lower the dosage down and get it in range to see if the sexual function balances out.

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HCG made a huge difference for me. on pure T, regardless of dose, its low-average. anything between 500-1000IU/3x week of HCG ramped it big time. things feel much more sensitive for me down there with libido significantly higher.

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Any significant changes in labs before and after HCG and what were they? E2?

This! Testosterone in isolation was so disappointing, flat. With HCG, its night and day difference.

Did you notice a big change in lab work?