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Author Topic: Sudden loss of libido and ED while on TRT  (Read 713 times)

golfboy307

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Sudden loss of libido and ED while on TRT
« on: November 06, 2017, 07:50:50 am »
Guys,

Need some advice.  Just by way of background, I have been on TRT for about 18 months.  After about a three month ramp up period, it delivered on all of the promises:  cleared the brain fog, big boost in mood and confidence, and most importantly to me:  improved libido and erections.  During this time on TRT, I have noticed however that every few months I seem to run into down periods that inexplicably kills my erections and along with it libido (they go hand in hand for me, no pun intended).  About 10 days ago I hit the wall again, after four months of amazing sex and erections (since about June).  With no change in my workouts, diet or stress level, here is what is happening:

*Complete disappearance of nocturnal and morning wood
*Waking up anxious, hard to get an erection (normally this is my BEST time)
*Sleep has gotten very choppy
*Stressed again, but maybe just because of items 1-3.  Panic starts to set in, which only makes 1-3 worse

I was at the doctor three weeks ago and ironic thing is I told him how great I was doing.  Oops.  I tried up the Cialis to about 5mg, but that had basically no impact.  So frustrating after four months of strong erections (both during the night and sponstaneous during the day).

What should I take a look at?  The urine based cortisol test from September was normal (but I was doing great then).  I am not opposed to some self testing since I don't see him again until March.  T levels normally run towards the high end of the range on dosage of 70mg e5d.  E2 is normally in the 35-40 range sensitive but I have not really been bothered by it (as far as I know).  Not on AI or HCG. 

Thanks for taking the time read this and letting me vent.  I really appreciate this site and all of the help I have found here. 
Age 50, 5'10, 155 lbs
Cholesterol 157 (HDL 51, LDL 94, Trigs 78, LDL-P 850)
Fasting Glucose 90 (down from 97 pre TRT)
A1C:  5.2 (down from 5.7 per TRT)
Homocysteine:  12.4 > 11.0 > 10.2 > 8.9 using B vitamin therapy.  MTHFR positive 

BP  120/78 (using plant based diet and 10 mg Lisinopril ACE Inhibitor)  145/90 prior to meds.

Current protocol:  70 mg Test Cyp IM every 5 days. 
2/15/17 labs:  Total T (peak day): 1169 (250 - 1100 ng/dl).  Free T 198 pg/ML (46-225).  Sensitive E2: 40 High.  Previously 32. PSA 0.2  Hemocrit 44.2. SHBG: 32


Supplements:  Multivitamin, plus additional B12, B6, D, K2, Fish Oil, Magnesium, and Coq10

Evening stack:  3g Cittruline, 100 mg Pycnogenol, 2.5G Kyolic garlic, 1 LEF Endothelial defense   2 mg Cialis EOD, or as needed

sh1209

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Re: Sudden loss of libido and ED while on TRT
« Reply #1 on: November 06, 2017, 08:12:15 am »
Iíve been fighting this for the last several years and have finally decided to come off permanently as of a couple weeks ago. No matter what my labs were, libido was non existent. I was on Trt well over 7 years and finally Iíve had enough, itís judt not worth it. I wish you luck figuring it out, unfortunately I was unable to.

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Re: Sudden loss of libido and ED while on TRT
« Reply #1 on: November 06, 2017, 08:12:15 am »

golfboy307

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Re: Sudden loss of libido and ED while on TRT
« Reply #2 on: November 06, 2017, 08:17:38 am »
Thanks SH1209.  I can appreciate your frustration.  However, at least 18 months into the process, the "good" times are like being 30 years old again, and seemed to last (and very worth it).  It is a bit maddening to try and understand how your body can change for the negative in such a short period, and then bounce back.
Age 50, 5'10, 155 lbs
Cholesterol 157 (HDL 51, LDL 94, Trigs 78, LDL-P 850)
Fasting Glucose 90 (down from 97 pre TRT)
A1C:  5.2 (down from 5.7 per TRT)
Homocysteine:  12.4 > 11.0 > 10.2 > 8.9 using B vitamin therapy.  MTHFR positive 

BP  120/78 (using plant based diet and 10 mg Lisinopril ACE Inhibitor)  145/90 prior to meds.

Current protocol:  70 mg Test Cyp IM every 5 days. 
2/15/17 labs:  Total T (peak day): 1169 (250 - 1100 ng/dl).  Free T 198 pg/ML (46-225).  Sensitive E2: 40 High.  Previously 32. PSA 0.2  Hemocrit 44.2. SHBG: 32


Supplements:  Multivitamin, plus additional B12, B6, D, K2, Fish Oil, Magnesium, and Coq10

Evening stack:  3g Cittruline, 100 mg Pycnogenol, 2.5G Kyolic garlic, 1 LEF Endothelial defense   2 mg Cialis EOD, or as needed

Mindscape

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Re: Sudden loss of libido and ED while on TRT
« Reply #3 on: November 06, 2017, 08:37:55 am »
That's the lowest dosage I've seen, what's near the top of the range? 916-1200? We are left guessing, labs? Your symptoms seem awfully familiar to withdraw from medications.
« Last Edit: November 06, 2017, 08:43:11 am by Mindscape »
Age: 45, Ht: 6'0, Wt: 230 lbs
First Protocol: 75mg weekly
Second Protocol: 50mg T Cyp 2x/week
Third protocol: .25ml 100mg EOD

Pre-TRT labs:
Total Test: 119 ng/dL  348-1197 ng/dL
Free Test: 5 ng/dL
SHBG 25 nmol
TSH: .58  0.35 - 4.00 mcIU/mL
-------------------------
4 weeks into TRT May 2017:
Total Test: 531 ng/dL trough 451 ng/dL 264-916 ng/dL
Free Test: 15.2 ng/dL
SHBG 18 nmol

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Re: Sudden loss of libido and ED while on TRT
« Reply #3 on: November 06, 2017, 08:37:55 am »


golfboy307

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Re: Sudden loss of libido and ED while on TRT
« Reply #4 on: November 06, 2017, 09:00:37 am »
Sorry, some of my recent blood work from March on 70 mg test cyp IM every five days:

Total T:              1169  (range 250-1100 ng/dl)
Free T:               198    (range 46- 224 pg/dl)
SHBG:                32
DHT:                  85      (range 16-79 ng/dl)
E2 (sensitive)      39      (< 29)  Was previously 32 six months earlier

I am curious to self test some of these labs when I hit the skids to see one of the above measures is out of whack.  All thyroid tests are fairly normal, with a TSH around 2.00.  T3 and T4 good.

Its a mystery!  My doctor thought I should maybe come down in dosage based on those labs, but that is already a pretty small amount.
Age 50, 5'10, 155 lbs
Cholesterol 157 (HDL 51, LDL 94, Trigs 78, LDL-P 850)
Fasting Glucose 90 (down from 97 pre TRT)
A1C:  5.2 (down from 5.7 per TRT)
Homocysteine:  12.4 > 11.0 > 10.2 > 8.9 using B vitamin therapy.  MTHFR positive 

BP  120/78 (using plant based diet and 10 mg Lisinopril ACE Inhibitor)  145/90 prior to meds.

Current protocol:  70 mg Test Cyp IM every 5 days. 
2/15/17 labs:  Total T (peak day): 1169 (250 - 1100 ng/dl).  Free T 198 pg/ML (46-225).  Sensitive E2: 40 High.  Previously 32. PSA 0.2  Hemocrit 44.2. SHBG: 32


Supplements:  Multivitamin, plus additional B12, B6, D, K2, Fish Oil, Magnesium, and Coq10

Evening stack:  3g Cittruline, 100 mg Pycnogenol, 2.5G Kyolic garlic, 1 LEF Endothelial defense   2 mg Cialis EOD, or as needed

Osprey

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Re: Sudden loss of libido and ED while on TRT
« Reply #5 on: November 06, 2017, 09:03:39 am »
You could try HCG, some report improved libido from it.

Have you tested DHEA-S and progesterone?

Supplementing DHEA and/or pregnenolone can reduce anxiety and improve sleep for some.

Mindscape

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Re: Sudden loss of libido and ED while on TRT
« Reply #6 on: November 06, 2017, 09:12:28 am »
Sorry, some of my recent blood work from March on 70 mg test cyp IM every five days:

Total T:              1169  (range 250-1100 ng/dl)
Free T:               198    (range 46- 224 pg/dl)
SHBG:                32
DHT:                  85      (range 16-79 ng/dl)
E2 (sensitive)      39      (< 29)  Was previously 32 six months earlier

I am curious to self test some of these labs when I hit the skids to see one of the above measures is out of whack.  All thyroid tests are fairly normal, with a TSH around 2.00.  T3 and T4 good.

Its a mystery!  My doctor thought I should maybe come down in dosage based on those labs, but that is already a pretty small amount.

I'm starting to wonder if an E2 of 39 is just plain high for you, one thing that never ceases to amaze me is how some can get high E2 symptoms with their E2 near the top when others don't have any problems. It all comes down to what's high for you, it could be that your TT could just be too high for you. Back when I was on 200mg E14D after my second shot I felt as you describe, anxious, heart rate and sleep problems. It wasn't until I backed down off the dose that I felt better.
Age: 45, Ht: 6'0, Wt: 230 lbs
First Protocol: 75mg weekly
Second Protocol: 50mg T Cyp 2x/week
Third protocol: .25ml 100mg EOD

Pre-TRT labs:
Total Test: 119 ng/dL  348-1197 ng/dL
Free Test: 5 ng/dL
SHBG 25 nmol
TSH: .58  0.35 - 4.00 mcIU/mL
-------------------------
4 weeks into TRT May 2017:
Total Test: 531 ng/dL trough 451 ng/dL 264-916 ng/dL
Free Test: 15.2 ng/dL
SHBG 18 nmol

golfboy307

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Re: Sudden loss of libido and ED while on TRT
« Reply #7 on: November 06, 2017, 09:22:03 am »
Mindscape,

I have played around backing my overall dosage down to 60-65 mg, and may try that again to see if it helps.  I had a shot last night and only did 60 mg.

Regarding the E2, I tried Anastrazole (0.25 mg. on day of shot) the month of May, and it was a pretty bad experience.  I think I crashed the E2, because I was miserable (similar symptoms to now ironically).  I stopped it cold turkey after a month, and by mid June things took off, and were great up until about 10 days ago. 

Thanks for taking the time to respond.
Age 50, 5'10, 155 lbs
Cholesterol 157 (HDL 51, LDL 94, Trigs 78, LDL-P 850)
Fasting Glucose 90 (down from 97 pre TRT)
A1C:  5.2 (down from 5.7 per TRT)
Homocysteine:  12.4 > 11.0 > 10.2 > 8.9 using B vitamin therapy.  MTHFR positive 

BP  120/78 (using plant based diet and 10 mg Lisinopril ACE Inhibitor)  145/90 prior to meds.

Current protocol:  70 mg Test Cyp IM every 5 days. 
2/15/17 labs:  Total T (peak day): 1169 (250 - 1100 ng/dl).  Free T 198 pg/ML (46-225).  Sensitive E2: 40 High.  Previously 32. PSA 0.2  Hemocrit 44.2. SHBG: 32


Supplements:  Multivitamin, plus additional B12, B6, D, K2, Fish Oil, Magnesium, and Coq10

Evening stack:  3g Cittruline, 100 mg Pycnogenol, 2.5G Kyolic garlic, 1 LEF Endothelial defense   2 mg Cialis EOD, or as needed

golfboy307

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Re: Sudden loss of libido and ED while on TRT
« Reply #8 on: November 06, 2017, 09:44:42 am »
Osprey,  DHEA-S and Preg. have tested normal for me. 
Age 50, 5'10, 155 lbs
Cholesterol 157 (HDL 51, LDL 94, Trigs 78, LDL-P 850)
Fasting Glucose 90 (down from 97 pre TRT)
A1C:  5.2 (down from 5.7 per TRT)
Homocysteine:  12.4 > 11.0 > 10.2 > 8.9 using B vitamin therapy.  MTHFR positive 

BP  120/78 (using plant based diet and 10 mg Lisinopril ACE Inhibitor)  145/90 prior to meds.

Current protocol:  70 mg Test Cyp IM every 5 days. 
2/15/17 labs:  Total T (peak day): 1169 (250 - 1100 ng/dl).  Free T 198 pg/ML (46-225).  Sensitive E2: 40 High.  Previously 32. PSA 0.2  Hemocrit 44.2. SHBG: 32


Supplements:  Multivitamin, plus additional B12, B6, D, K2, Fish Oil, Magnesium, and Coq10

Evening stack:  3g Cittruline, 100 mg Pycnogenol, 2.5G Kyolic garlic, 1 LEF Endothelial defense   2 mg Cialis EOD, or as needed

PeakT

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Re: Sudden loss of libido and ED while on TRT
« Reply #9 on: November 06, 2017, 09:45:03 am »
Guys,

Need some advice.  Just by way of background, I have been on TRT for about 18 months.  After about a three month ramp up period, it delivered on all of the promises:  cleared the brain fog, big boost in mood and confidence, and most importantly to me:  improved libido and erections.  During this time on TRT, I have noticed however that every few months I seem to run into down periods that inexplicably kills my erections and along with it libido (they go hand in hand for me, no pun intended).  About 10 days ago I hit the wall again, after four months of amazing sex and erections (since about June).  With no change in my workouts, diet or stress level, here is what is happening:

*Complete disappearance of nocturnal and morning wood
*Waking up anxious, hard to get an erection (normally this is my BEST time)
*Sleep has gotten very choppy
*Stressed again, but maybe just because of items 1-3.  Panic starts to set in, which only makes 1-3 worse

I was at the doctor three weeks ago and ironic thing is I told him how great I was doing.  Oops.  I tried up the Cialis to about 5mg, but that had basically no impact.  So frustrating after four months of strong erections (both during the night and sponstaneous during the day).

What should I take a look at?  The urine based cortisol test from September was normal (but I was doing great then).  I am not opposed to some self testing since I don't see him again until March.  T levels normally run towards the high end of the range on dosage of 70mg e5d.  E2 is normally in the 35-40 range sensitive but I have not really been bothered by it (as far as I know).  Not on AI or HCG. 

Thanks for taking the time read this and letting me vent.  I really appreciate this site and all of the help I have found here.

3 point cortisol, thyroid (free T3 and free T4 and rt3 and TSH), DHEA-S, progesterone and maybe prolactin.
THE MOST COMPREHENSIVE BOOK ON TRT/TESTOSTERONE:
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And check out my New Peak Testosterone Program: http://www.peaktestosterone.com/peak_testosterone_program.aspx
If you are on medications or have a medical condition, always check with your doctor first before making any lifestyle changes or taking new supplements.  And low testosterone is a medical condition.

Cataceous

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Re: Sudden loss of libido and ED while on TRT
« Reply #10 on: November 06, 2017, 10:13:45 am »
I'll echo the suggestions to try a lower testosterone dose and/or hCG. When I was taking 98 mg/week T cypionate my total T level was over 1,200 ng/dL but I didn't see libido improve until dropping to ~60 mg/week and adding hCG, ending with TT in the 700-800 ng/dL range.

I do have occasional reductions in libido, but I suspect mine are due to DHT at the bottom of the range, which isn't your problem.
I am not a medical doctor; any suggestions are meant to be discussed with your doctor.
Age: 56, Ht: 5'10", Wt: 154 lbs
Protocol: 18 mg T enanthate subQ qod, 250 IU hCG subQ qod, 6.25 mg DHEA orally bid
5/2017 test results: TT: 800 ng/dL (348-1197), FT: 16 pg/mL (7.2-24), E2: 50 pg/mL sensitive (8.0-35.0), DHEA-S: 278 ug/dL (71.6-375.4)

golfboy307

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Re: Sudden loss of libido and ED while on TRT
« Reply #11 on: November 06, 2017, 10:28:28 am »
I am going to try a bit lower dose for the next couple of weeks and see if that helps. 

Peak, regarding the list of possible suspect hormones, which of those could possibly cause a rapid hit to erection quality like I am experiencing?
Age 50, 5'10, 155 lbs
Cholesterol 157 (HDL 51, LDL 94, Trigs 78, LDL-P 850)
Fasting Glucose 90 (down from 97 pre TRT)
A1C:  5.2 (down from 5.7 per TRT)
Homocysteine:  12.4 > 11.0 > 10.2 > 8.9 using B vitamin therapy.  MTHFR positive 

BP  120/78 (using plant based diet and 10 mg Lisinopril ACE Inhibitor)  145/90 prior to meds.

Current protocol:  70 mg Test Cyp IM every 5 days. 
2/15/17 labs:  Total T (peak day): 1169 (250 - 1100 ng/dl).  Free T 198 pg/ML (46-225).  Sensitive E2: 40 High.  Previously 32. PSA 0.2  Hemocrit 44.2. SHBG: 32


Supplements:  Multivitamin, plus additional B12, B6, D, K2, Fish Oil, Magnesium, and Coq10

Evening stack:  3g Cittruline, 100 mg Pycnogenol, 2.5G Kyolic garlic, 1 LEF Endothelial defense   2 mg Cialis EOD, or as needed

Mindscape

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Re: Sudden loss of libido and ED while on TRT
« Reply #12 on: November 06, 2017, 10:52:01 am »
I am going to try a bit lower dose for the next couple of weeks and see if that helps. 

Peak, regarding the list of possible suspect hormones, which of those could possibly cause a rapid hit to erection quality like I am experiencing?

E2 and prolactin, when was the last time you had prolactin tested?
Age: 45, Ht: 6'0, Wt: 230 lbs
First Protocol: 75mg weekly
Second Protocol: 50mg T Cyp 2x/week
Third protocol: .25ml 100mg EOD

Pre-TRT labs:
Total Test: 119 ng/dL  348-1197 ng/dL
Free Test: 5 ng/dL
SHBG 25 nmol
TSH: .58  0.35 - 4.00 mcIU/mL
-------------------------
4 weeks into TRT May 2017:
Total Test: 531 ng/dL trough 451 ng/dL 264-916 ng/dL
Free Test: 15.2 ng/dL
SHBG 18 nmol

Osprey

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Re: Sudden loss of libido and ED while on TRT
« Reply #13 on: November 06, 2017, 11:15:17 am »

*Waking up anxious, hard to get an erection (normally this is my BEST time)
*Sleep has gotten very choppy
*Stressed again, but maybe just because of items 1-3.  Panic starts to set in, which only makes 1-3 worse


My 2 cents is to work on these. Reduce stress and clean up your sleep. Get DHEA-S tested as many guys report taking DHEA (and sometimes pregnenolone) improves anxiety and sleep issues. Lowering your T does can also help is this situation.

golfboy307

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Re: Sudden loss of libido and ED while on TRT
« Reply #14 on: November 06, 2017, 11:44:19 am »
Thanks for everyone's responses!  I can always count on this group.

I think it has probably been two years since the prolactin test, back to when I was getting going on TRT. 

I am going to run sensitive E2 and T levels again in a week or so on the lower dosage.

Hope for a rebound in the meantime.
Age 50, 5'10, 155 lbs
Cholesterol 157 (HDL 51, LDL 94, Trigs 78, LDL-P 850)
Fasting Glucose 90 (down from 97 pre TRT)
A1C:  5.2 (down from 5.7 per TRT)
Homocysteine:  12.4 > 11.0 > 10.2 > 8.9 using B vitamin therapy.  MTHFR positive 

BP  120/78 (using plant based diet and 10 mg Lisinopril ACE Inhibitor)  145/90 prior to meds.

Current protocol:  70 mg Test Cyp IM every 5 days. 
2/15/17 labs:  Total T (peak day): 1169 (250 - 1100 ng/dl).  Free T 198 pg/ML (46-225).  Sensitive E2: 40 High.  Previously 32. PSA 0.2  Hemocrit 44.2. SHBG: 32


Supplements:  Multivitamin, plus additional B12, B6, D, K2, Fish Oil, Magnesium, and Coq10

Evening stack:  3g Cittruline, 100 mg Pycnogenol, 2.5G Kyolic garlic, 1 LEF Endothelial defense   2 mg Cialis EOD, or as needed

Peak Testosterone Forum

Re: Sudden loss of libido and ED while on TRT
« Reply #14 on: November 06, 2017, 11:44:19 am »