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Messages - Cataceous

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It's not a dopamine agonist, but PT-141 was recently approved by the FDA for treating low libido in women.

This is of interest to ME. Not so sure for my wife.

TRT has done nothing so far for her libido. Although her free T has not come up past the ministry threshold they list for women.  And part of my wife's issue with libido may be more mental than physiological.  If the driver doesn’t really want to drive to a destination, it doesn’t matter how much fuel is in the tank! 

What is PT-141?


FDA approves new treatment for hypoactive sexual desire disorder in premenopausal women

The U.S. Food and Drug Administration today approved Vyleesi (bremelanotide) to treat acquired, generalized hypoactive sexual desire disorder (HSDD) in premenopausal women.
Vyleesi activates melanocortin receptors, but the mechanism by which it improves sexual desire and related distress is unknown. Patients inject Vyleesi under the skin of the abdomen or thigh at least 45 minutes before anticipated sexual activity and may decide the optimal time to use Vyleesi based on how they experience the duration of benefit and any side effects, such as nausea. Patients should not use more than one dose within 24 hours or more than eight doses per month. Patients should discontinue treatment after eight weeks if they do not report an improvement in sexual desire and associated distress.

It works for guys too.

Dopamine Agonists have reportedly caused hyper sexuality (hyper libido). Apparently they suppress prolactin.

Where can I get dopamine antagonist for my wife who has like zero libido???

It's not a dopamine agonist, but PT-141 was recently approved by the FDA for treating low libido in women.

The local article doesn't mention gaining weight per se, but it does mention some dietary correlations, including the possibility that "increasing protein intake can lower SHBG."

What age threshold is considered “younger” and “older”?

The link is here. "Younger" means a mean age of 34 year, "older" means a mean age of 74 years.

In addition to raising DHT as ghce suggests, have you tried all of the following?

• Test serum progesterone and supplement if low.

• Use a protocol that gives a significant diurnal variation in serum testosterone, such as a 50% drop from peak to trough. This is not necessarily easy, as transdermal testosterone won't create large swings for everyone, and excess DHT is a problem for some. A combination of a testosterone ester and pure testosterone may be injected daily, but it's not something everyone could stay with.

• Experiment with PT-141.

The Meaning of SERM?  ...

Selective estrogen receptor modulator. A class of drugs that includes clomiphene/Clomid and tamoxifen/Novaldex.

One study found that in younger men hCG stimulates progesterone production. The result was not seen in older men.

Some restart protocols discussed here: https://www.peaktestosterone.com/Testosterone_Restart.aspx

Generally you start with hCG to stimulate the testes, then switch to a SERM. Using hCG with a SERM is questionable, as hCG is suppressive and may override the stimulation of the SERM.

How would one treat Aldosterone? (rhetorical). ...

Fludrocortisone, brand name Florinef.

The Tru-T free testosterone calculator yields a value of 11 ng/dL. This is with a normal range of 16-31 ng/dL. Therefore low testosterone does seem to be the most pressing issue.

It is 0.9% benzyl alcohol and water. No sodium in the versions that I've seen/read about.

Do you know how long the vial is safe to use? ...

Unopened it would be at least as long as the date given, and probably a good bit longer, though I wouldn't go nearly as long with water-based stuff as I might with oil-based. I keep these vials refrigerated, especially after using them, and have probably pushed things by continuing to use them for a few more months, but without incident. Official instructions probably say either to use immediately, or possibly to refrigerate and use in less than a month.

Aside from testosterone undecanoate, Nebido contains benzyl benzoate and castor oil.

Note that a 4 mL vial contains a total of 1,000 mg testosterone undecanoate. This is on the light side for 12 weeks. The dose is equivalent to 90 mg testosterone cypionate per week, which would be fine for some, but not for others.

As long as sterile storage is possible, there's no reason that one couldn't injection smaller doses more often. Wikipedia puts the half-life at about a month, so it's hard to see how guys do well with one injection every three months, In theory serum testosterone could drop up to eight-fold over that period.

Serum testosterone levels achieved with Nebido will be very individual, and based on factors such as SHBG, body weight, metabolism, etc.

It is 0.9% benzyl alcohol and water. No sodium in the versions that I've seen/read about.

Do retest prolactin. It is capable of suppressing testosterone production on its own. However, although yours was elevated, I don't think it was high enough to suggest high risk for a pituitary tumor, or to cause so much testosterone suppression.

Re: high vitamin D, likely at 10K IU/day

A "honeymoon" phase with TRT is quite common, and it's disappointing when it ends. One of the reasons for it is that initially you have an additive effect, with the injected testosterone combining with your own production. Over time your production shuts down. Although you can compensate for lower testosterone by increasing the dose, this can cause side effects, including excess estradiol, high hemoglobin/hematocrit, and it doesn't address other effects of an HPTA shutdown, including reduced progesterone. Adding hCG to a protocol can help in many cases. Progesterone supplementation is something to consider if you end up with low levels.

Welcome to the site. Here are some of my thoughts: Was anything done to address your initial elevated prolactin level? Did it improve? Did you have an MRI? In my opinion 50 mg is too much Clomid, especially as a starting dose. It should be slowly titrated upwards from 12.5 mg daily or EOD. I personally would be uncomfortable taking such large doses of pregnenolone. You're probably overdosing on vitamin D as well. Pushing serum levels above 50 ng/mL may have risks. Combining Clomid with testosterone cypionate is most likely going to be counterproductive. There are a few scattered reports of HPTA activity with this kind of treatment, but in most cases the exogenous testosterone overrides the stimulation provided by Clomid. Overall it seems like too much at once. I'd have preferred to see the prolactin addressed first, then maybe thyroid, and finally testosterone if it hadn't improved with the other treatments.

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