When should HRT be stopped ?

[h2878]

Hi T. Whats up ? . Allow me to thank you for the wonderful info u got on your site. I wish i came across it many years ago.

I am a 33 yr old guy with very low T. In the 2010, my five year old marriage ended in divorce because of ED . It is only around then i discovered my T levels were very low ( i wish all the previous doctors i visited told me to get my hormone levels tested ). On 27 of Feb 2012, i had my blood tested and the hormone level read as : -

 TOTAL TESTOSTERONE     261.21 ng/dl
 Free TESTOSTERONE        8.94     pg/mL
 FREE TESTOSTERONE %   0.34

On 2nd March 2012 i had my first shot of Testosterone Undecanoate (1000mg). Since then i had a total of 3 injections till now. I did notice dramatic improvement after my first injection. However, the improvement lasted for a month or so. But i do feel all the more horny than before.

 How long should i be on HRT ? Should it be stopped after a certain stage or a certain Hormonal level has been reached ? Obviously i cannot be dependent on HRT forever.

Your answer will be much appreciated. Thanks.

[PeakT]

Thx for the kind words - much appreciated.

I've just got a sec but let me make a few comments:

--Ouch!  That's low testosterone and I'm not surprised you've been struggling.  Been there...

--How often are you doing the injections, i.e. biweekly, weekly or every two weeks?  The "old school" approach is every two weeks, which leaves a guy with very low testosterone and the end of the two weeks usually.  So many of the more forward-thinking doctors now lower the dose and increase the frequency of the injections.  This makes for a much smoother ride.

--Question:  how do you know that you are not going to want to have kids?  HRT usually hammers your fertility.  I can only hope that your doctor discussed this issue with you.  Just type in "fertility" and "Clomid" in the search at the top of this forum and you'll get a little starter info.

--You wrote that "obviously I cannot be dependent on HRT forever".  Well, this is actually far from obvious.  Unfortunately, the great majority of men with low testosterone never recover their testosterone.  This is a pretty involved subject, but, ideally, your doctor would have tested to see if you were primary (in the testes) or secondary (in the pituitary/hypothalamus) hypogonadal. 

If you are secondary, there is a chance you could get jump started, at least theoretically, that you could get your testosterone jump-started.  However, the only guys that I actually know that have jump-started their testosterone were steroid users.  One of the guys on this site, FightLowT, had his doctor try to do just that but had marginal success with it.  And keep in mind that he was going to one of the most forward-thinking, cutting edge online docs.  Your typical urologist or endocrinologist will not even think of trying this.  In fact, you're lucky if they'll even pull your FSH/LH.

--Getting off of HRT is not that fun.  If you were to quit now, you'd like end up a little lower than you were before for several months and then it would take you months to get back to your total T of 261.

--Is there an exception?  Theoretically, if you are significantly overweight, 50+ pounds roughly, you might be able to lose that weight and then go off of HRT and find your testosterone ramped back up.  But that's theoretical - I haven't known anyone who has done this. 

--Also, keep in mind that it's potentially dangerous to go off of HRT unless your testosterone has truly recovered because it increases the risk for so many medical conditions.  And, as you know, it can be very hard on relationships.

So the bottom line is that you've got to do some research based on your situation and do a lot of talking with knowledgeable, GOOD docs.  These can be hard to find and it takes a lot of effort and time quite often.  But it's worth gold when you find a good physician.

[FightLowT]

I am a 33 yr old guy with very low T. In the 2010, my five year old marriage ended in divorce because of ED

Seems like it's perfectly alright for women to leave a man when he a has a disease( low testosterone is just such a disease) but if a man were to leave his wife if she came down with cancer well that's a different story. He woule be deemed an inconsiderate pig. To be quite honest men usually don't leave their wives over such a thing because they love them. I know several men who have stayed with their wives after they have come down with cancer and spinal meningitis. It really shouldnt shock anyone anymore as to the extent of women's apathy toward their spouses. Western women are becoming legends in the international communities as being known for the heartless, insatiable selfish opportunist they have become. No wonder men are seeking women more and more abroad.

[spiderman]

I am a 33 yr old guy with very low T. In the 2010, my five year old marriage ended in divorce because of ED

Seems like it's perfectly alright for women to leave a man when he a has a disease( low testosterone is just such a disease) but if a man were to leave his wife if she came down with cancer well that's a different story. He woule be deemed an inconsiderate pig. To be quite honest men usually don't leave their wives over such a thing because they love them. I know several men who have stayed with their wives after they have come down with cancer and spinal meningitis. It really shouldnt shock anyone anymore as to the extent of women's apathy toward their spouses. Western women are becoming legends in the international communities as being known for the heartless, insatiable selfish opportunist they have become. No wonder men are seeking women more and more abroad.

Right on FLT...most guys gotta be in top shape in all aspects in today's world to get the woman and be a rock in the bedroom to!...thats a load of pressure on us for a start...and you know what pressure does for stress and stress does for the Test!...its a slippery slope ..don't blame some guys for seeking happiness abroad... am sure some of the girls in particular countries would be so happy just to be looked after properly!...

[PeakT]

Guys,

I understand what you are saying and am actually married (very happily) to someone from out of the country.  But I think there is an underlying issue going on that may men do not want to admit:  they often simply do not put their due diligence in at the beginning of the relationship.  Guys will put a lot of effort into hiring someone at work or picking out a new car or even a compressor.  But, when it comes to relationships, often they act completely clueless. 

By the way, I'm not saying that applies to you guys or anyone in particular - just making a generalized comment that I have seen.  There are many quality women out there saying the exact same thing that you guys are.  The trick is this:  somehow the quality men need to patiently find the quality women and vice versa.  (Of course, some of it has to do with matching up personalities as well.)

There are many forum stories matching what you guys have written.  But I have also received emails and forum posts from women who are patiently hoping that their man will heal and are trying to help them.  So those kind of women are out there, even in the States...

And that's my usual two cents...

One side comment:  I have always loved cross-cultural/international/global topics and just love talking to people from other countries, getting their perspective on things, etc.  If you're this kind of person, then I think a cross-cultural marriage will work out for you.  You've got to be flexible, because they will see things very differently in certain areas.  Otherwise, stick to home and find that good woman in your alma mater.  Yes, that's another two cents for free...

[Paperboy48]

My marriage also has ended recently due to the effects of ED and Low T. I am in my mid-thirties.

Similiar to what Peak stated, I did not due my due diligence during the 3 years I had ED.  At the age of 32 years old, when I informed my doc I had ED, he checked my T levels and gave me a script for Viagara. He told me my levels were in a decent range.  I know now after doing research (after my relationship ended), my levels were too low.

So for three years I was prescribed Viagara....not knowing the route cause for a young guy to have ED. I did not take the time and energy to figure this out, I spent more time on things like house projects, NASCAR races and time with friends. In the meantime I negelcted my wife because I felt inadeqaute as a man.  The result: she felt undesireable and negelcted. During the three years I had ED, we had less than a handful of conversations about the topic and how to solve it. I ignorned it, became frustrated and took it out on her.

 

[h2878]

Thanks for the reply Peak T. My injections (1000 mg each) are spaced out by 90 days. Only between the first and second shot the interval period was 42 days (6 weeks). As for your question about having kids, i did not know that HRT can suppress fertility, neither my doc told me about it. Only after researching on google and of course going through peaktestosterone.com did i come to know this. Anyhow, fertility is of my secondary concern. First i need to get Private Ryan up and about .

[PeakT]

Thanks for the reply Peak T. My injections (1000 mg each) are spaced out by 90 days. Only between the first and second shot the interval period was 42 days (6 weeks). As for your question about having kids, i did not know that HRT can suppress fertility, neither my doc told me about it. Only after researching on google and of course going through peaktestosterone.com did i come to know this. Anyhow, fertility is of my secondary concern. First i need to get Private Ryan up and about .

Yes, just remember that going off of HRT is non-trivial.

[h2878]

Hello peak. I will be having my 6th shot of testosterone undecanoate April 8. I would get a few blood tests before then. Two years before starting HRT i had my LH and FSH tests taken. I do not have results of that test now, but i do remember faintly of them being on the lower side of the normal range. Could i be having secondary hypogonadism ?. Also thinking of using clomid 25 mg/day and anastrozole 0.5 once a week along with HRT. I do not know yet what my estradiol numbers are, but i suspect it to up as there is no improvement to my condition. Libido is almost zero and four months back i had a really bad period of being mentally like a women. I would literally cry watching sad movies. Fortunately it was a brief episode.

How does one use clomid ? And does it need tapering off ? I been reading on various sites that clomid needs tapering off or it could cause problems.

[PeakT]

Hello peak. I will be having my 6th shot of testosterone undecanoate April 8. I would get a few blood tests before then. Two years before starting HRT i had my LH and FSH tests taken. I do not have results of that test now, but i do remember faintly of them being on the lower side of the normal range. Could i be having secondary hypogonadism ?. Also thinking of using clomid 25 mg/day and anastrozole 0.5 once a week along with HRT. I do not know yet what my estradiol numbers are, but i suspect it to up as there is no improvement to my condition. Libido is almost zero and four months back i had a really bad period of being mentally like a women. I would literally cry watching sad movies. Fortunately it was a brief episode.

How does one use clomid ? And does it need tapering off ? I been reading on various sites that clomid needs tapering off or it could cause problems.

Just got a sec here:

--Clomid efficacy sometimes tapers off after X number of months from what I've heard.

--Yes, Clomid can potentially have long term issues.  I wouldn't dream of advising you on that:

http://www.peaktestosterone.com/Clomid_Risk

But it can make coming off HRT much less painful from what I have heard (anecdotally). 

--Yes, that could be estrogen.  Imo estradiol is just as powerful to libido, erections, mood and morning erections as testosterone.

[h2878]

Hi peak. I had a few tests done two years before starting TRT. I had misplaced those reports but fortunately my current doctor had a copy of those reports. Received them today by email from my doc.
These are some of the results of the tests taken on 8-6-2010 : -

LH—1.9
FSH—4.1
PROLCATIN- 4.3
TESTOSTERONE – 12.1  ( Free T )
ULTRASOUND - MICROLITHIASIS CHANGES in BOTH TESTIS.

I do not know what units these were measured in ( doc just emailed me the numbers ), but i assume that LH and FSH are measured in mIU/mL and prolactin  in ng/mL.

My Free T level on 8-6-2010 was 12.1 and went down to 8.94 on 27 of Feb 2012. I had  semen analysis done 3-4 times prior to HRT and was found to be infertile. Each time the tests were done the number of sperms and their motility kept coming down. Also ultrasound revealed microlithaisis in both testis ( I am unaware of what that means).

What do you make of the above ?. Could i be primary or secondary?

[PeakT]

Hi peak. I had a few tests done two years before starting TRT. I had misplaced those reports but fortunately my current doctor had a copy of those reports. Received them today by email from my doc.
These are some of the results of the tests taken on 8-6-2010 : -

LH—1.9
FSH—4.1
PROLCATIN- 4.3
TESTOSTERONE – 12.1  ( Free T )
ULTRASOUND - MICROLITHIASIS CHANGES in BOTH TESTIS.

I do not know what units these were measured in ( doc just emailed me the numbers ), but i assume that LH and FSH are measured in mIU/mL and prolactin  in ng/mL.

My Free T level on 8-6-2010 was 12.1 and went down to 8.94 on 27 of Feb 2012. I had  semen analysis done 3-4 times prior to HRT and was found to be infertile. Each time the tests were done the number of sperms and their motility kept coming down. Also ultrasound revealed microlithaisis in both testis ( I am unaware of what that means).

What do you make of the above ?. Could i be primary or secondary?

LH/FSH provide clues and you look secondary-ish.  But this is just a clue.  Ideally, you'd have a Clomid or HCG or GnRH stimulation test as those can not only answer if you are secondary but "how much" you are secondary.  Search in the forum on stimulation - yeah, you might get a few weird out of context threads! - and you'll pull up some info.