Pellets Have Restored Erections But Still Some Issues

[NLH]

I have been thinking about coming back to update here....along the journey. We are 6 months past the last T pellet injection, we decided not to pursue a 3rd round, unfortunately for hubby, he seemed to actually respond worse most of the time on the pellets. Maybe extra estrogen, maybe just the ups and downs, fluctuations, I don't really know. About two months ago, he felt hopeless about the possibility of sex even working again, it didn't work 90% of the time.

I can't say what happened because none of it makes sense, he has stress, is at a higher weight, and even less active the last two months, but guess what? The penis is functioning, out of the blue, last 1-2 months each and every time. I don't know if it's temporary, but after almost 4 years it's a welcome change and seeing his confidence return has been wonderful as a wife. He hasn't had T measured since 3 months ago. He hasn't had any labs since we didn't return for another round of therapy.

None of it makes sense but I'm taking it one day at a time.

[Balderdasher]

I have been thinking about coming back to update here....along the journey. We are 6 months past the last T pellet injection, we decided not to pursue a 3rd round, unfortunately for hubby, he seemed to actually respond worse most of the time on the pellets. Maybe extra estrogen, maybe just the ups and downs, fluctuations, I don't really know. About two months ago, he felt hopeless about the possibility of sex even working again, it didn't work 90% of the time.

I can't say what happened because none of it makes sense, he has stress, is at a higher weight, and even less active the last two months, but guess what? The penis is functioning, out of the blue, last 1-2 months each and every time. I don't know if it's temporary, but after almost 4 years it's a welcome change and seeing his confidence return has been wonderful as a wife. He hasn't had T measured since 3 months ago. He hasn't had any labs since we didn't return for another round of therapy.

None of it makes sense but I'm taking it one day at a time.

Not familiar with the original details of your story (has he had any labs drawn since starting the pellets?), but it makes sense.  I've not heard of a lot of success stories with pellets, likely due to the reason you mentioned - fluctuating hormone levels.  If he really wants to give TRT a go, I'd highly recommend either asking your current doctor to allow weekly injections with appropriate follow up bloodwork, or to find a doctor that is willing to do this.

[NLH]

Oh yes, he had several labs during the pellet therapy. His T went as high as 877 during the 1st round of pellets, he started at only 298 (age 39). Even at 877, he didn't feel that difference very much, end his ED never improved. We went through 3 years, had numerous tests, saw a naturopath who did tons of supplements, tried diet changes, exercise, etc and in the end we just had to stop. There was no benefit to trying a 3rd round, and we paid for it ourselves ($1000+) for basically no results. Not only frustrating, but difficult on the marriage and hubby's confidence, and mood.

I will say that the T therapy did improve his mood overall. He is definitely having more down periods and fatigue, which I can see creep up as this time goes by since being off therapy. It's time to get a check of his T and see what number he's looking at.

[Balderdasher]

Oh yes, he had several labs during the pellet therapy. His T went as high as 877 during the 1st round of pellets, he started at only 298 (age 39). Even at 877, he didn't feel that difference very much, end his ED never improved. We went through 3 years, had numerous tests, saw a naturopath who did tons of supplements, tried diet changes, exercise, etc and in the end we just had to stop. There was no benefit to trying a 3rd round, and we paid for it ourselves ($1000+) for basically no results. Not only frustrating, but difficult on the marriage and hubby's confidence, and mood.

I will say that the T therapy did improve his mood overall. He is definitely having more down periods and fatigue, which I can see creep up as this time goes by since being off therapy. It's time to get a check of his T and see what number he's looking at.

If he is OK with you posting his complete labs, that would be very helpful.  A number of guys here are more knowledgeable than I, but there are a variety of issues that may contribute to the symptoms you listed.  For example, if his estradiol skyrocketed while he was at his highest level of T, it could negate most of the benefits of therapy.  Similarly, there may be underlying thyroid issues that can often mimic low T symptoms.  That said, it really does require an in-depth look at the labs to tell for sure. 

[PeakT]

I have been thinking about coming back to update here....along the journey. We are 6 months past the last T pellet injection, we decided not to pursue a 3rd round, unfortunately for hubby, he seemed to actually respond worse most of the time on the pellets. Maybe extra estrogen, maybe just the ups and downs, fluctuations, I don't really know. About two months ago, he felt hopeless about the possibility of sex even working again, it didn't work 90% of the time.

I can't say what happened because none of it makes sense, he has stress, is at a higher weight, and even less active the last two months, but guess what? The penis is functioning, out of the blue, last 1-2 months each and every time. I don't know if it's temporary, but after almost 4 years it's a welcome change and seeing his confidence return has been wonderful as a wife. He hasn't had T measured since 3 months ago. He hasn't had any labs since we didn't return for another round of therapy.

None of it makes sense but I'm taking it one day at a time.

Congrats on some improvement.  Remember that it usually takes awhile for most guys to find the root issues.  It it is much more common for guys to start recovering after a few months on TRT, which is what I think you are saying.

Comment:  don't fly blind here.  You have no lab reads and you need to pull lots of them more than likely.  I probably mentioned this to you before, but you really should scan through these pages and match up his symptoms with these:

http://www.peaktestosterone.com/peak_testosterone_program

Does he have symptoms of hypothryoidism?  Then test him.  Does he have symptoms of low cortisol?  Then test him.  You'll see when you read through those pages.  But, if he's not feeling good yet, then you've got to keep digging and spend a little money to find out what is going on.  And, of course, if he is overweight, sedentary with a pro-atherogenic diet, etc., then he will continue to slide downhill even if hormones prop him up for a little while.

How can you make testing affordable?  Well, in my opinion, there are several labs on here with very cheap prices that should make it doable for most couples:

http://www.peaktestosterone.com/testosterone_labs

[NLH]

Well I don't actually see that the therapy did anything for him- he hasn't had any treatment since 6 months ago and just now started to regain function- are you saying the pellets restored his erections, in a delayed way? Not while actively on it but months after he was due for another round?

I have read here about men being low on T for so long that their muscles actually atrophy so to speak and it takes time for the penis to be restored, that said now that he is off therapy, will he in time revert to the way it was then?

[euphorixx1]

Impossible to know without blood work prior and during the pellets.  If his T went up to 800s, but E2 went into the 50s-60s... it wouldnt make much difference I would guess.

[PeakT]

Well I don't actually see that the therapy did anything for him- he hasn't had any treatment since 6 months ago and just now started to regain function- are you saying the pellets restored his erections, in a delayed way? Not while actively on it but months after he was due for another round?

I have read here about men being low on T for so long that their muscles actually atrophy so to speak and it takes time for the penis to be restored, that said now that he is off therapy, will he in time revert to the way it was then?

Oh I missed that - sorry. 

You know we have some younger guys on here who went on testosterone therapy, quit and then suddenly were doing much better.  Why I cannot tell you.  Maybe it's just coincidence, but I have seen it four or five times on here. 

And, yeah, maybe it's building up receptors again in those pelvic floor muscles.  Or maybe its temporarily restoring erectile tissues from some venous leakage.  Or maybe it's coincidence. 

http://www.peaktestosterone.com/venous_leakage

Again, tho, put together a list of his symptoms and then read the above, examine his lifestyle and come up with something (with a good doc or two) that wil get him feeling good again.  He's  younger if I remember right?  If so, he should not be struggling.  I can't emphasize enough, though, how important lifestyle is.  It can take out young guys, especially on the brain side of things.  Inflammation knows no age in that regard...

[Sam Duxbury]

Well I don't actually see that the therapy did anything for him- he hasn't had any treatment since 6 months ago and just now started to regain function- are you saying the pellets restored his erections, in a delayed way? Not while actively on it but months after he was due for another round?

I have read here about men being low on T for so long that their muscles actually atrophy so to speak and it takes time for the penis to be restored, that said now that he is off therapy, will he in time revert to the way it was then?

I applaud his attempt at T pellet HRT.

Just quick questions:
Did your doctor (whatever flavor) put him on an Aromatase Inhiibitor AND hCG injection ?

Did he get monthly blood labs to track serum levels?

These all work together to maintain the HPT axis, and then it might take a year plus to get everything going and balanced.....

I have been on HRT (T and DHEA pellets), Letrozole, and hCG injections for over 4 years now. And I am having better sex than in my 30's. My serum T level is stable in the 1,100's.

Physically, I am doing hard farm work that I never would  have tried 8 years ago.

For now, I suggest another round of blood work, checking Cortisol, sensE2, Free T. I'm sure the real SMEs will recommend more tests.

My best wishes to you and him on his recovery path.

This is the best forum for information to help him and you.

Cheers ! Sam D

PS: I understand completely the costs involved. I pay $ 2,700 USD per year out of my pocket for all my drugs. Not 1 penny from the damn
insurance company. I wouldnt stop at all, the benefits and sex life are worth it.

[NLH]

I will dig up the labs and share....no, his E never went above 30-35 even when his T was 800. I really felt like it was the E spike making him feel so lousy, 1-3 weeks after having pellets inserted he was miserable, tired, grumpy, depressed, definitely no sexual function or desire.

No, his dr didn't have him on anything else, we were working with a naturopath at the same time who was checking estrogen and had him on a few different supplements to control conversion to estrogen. I believe myomin was one of them (natural aromatase inhibitor). Naturopath was aware of all of that and said we could move on to rx if estrogen became an issue- with an MD he works with, urologist had no part in estrogen, he was useless beyond putting pellets in.

I will post pre-TRT numbers and during, and the couple estrogen labs.

Bear with me:

3/2014-- we see primary doc after 2+ years of ED and loss of libido (because as a wife I feared other health issues)
He ran glucose, cholesterol, thyroid, etc all normal and a total T. He wouldn't run free T because he said "it wouldn't matter because be wont treat a man at a normal total T level". He was told it's not testosterone, try some Viagra. At 37 years old. No thank you. Moving on.

3/2014- total T 531

Fast forward to 1/2015- now about 3 years of ED, meaning inability to sustain any erection, 90% of the time unable to finish, if so very diminished orgasm, lack of sensitivity, loss of libido, fatigue, depression.

Urologist checks total, free, and also free T4 thyroid labs, prolactin, LH.

1/2015- total T is only 298, free T 70 (clearly a problem)

Urologist says time to try TRT. We opt for pellets.

First insertion 2/2015

6 week labs after pellets inserted:

3/2015- total T 877, free T 156.6
3/2015- estradiol 34, estrone 35

Wow. This looks great on paper, but not much difference aside from more energy perhaps.

3 month labs, 5/2015- total T 497, free T 132
                     5/2015- estradiol 33, estrone 30

Urologist says this isn't low enough to do pellets sooner, so second round is done @4 months

This time labs aren't checked until 3 months on 2nd round pellets.

9/2015- total T 460, free T 80


Here we are December, 6 months since last pellets. Haven't done any more testing. We made the choice to stop pellets, honestly I believe hubby needed a break. I'm sure you guys know what I mean, just needed to not get labs, not talk about it, no supplements, and felt the most hopeless he had been about it. He decided ok, let's just dive in to exercise, getting fit, etc. I supported him in this although I felt disappointed that there was no longer an "answer".

Lo and behold, last 6-8 weeks we have a normal functioning sexual life. Out of the blue. He has actually been under a lot of stress, with his company, is at a higher weight than he has been, not exercising, and off the wagon somewhat with healthy eating. Go figure. So why is it working, I have no earthly clue.

It's a fluke. And it's tough because I still struggle with the root cause, in my 40 year old husband.

[PeakT]

Hey, you said "out of the blue."  But has he been exercising a lot more.  Exercise is probably the best natural solution - as long as you don't overdo it - to raise dopamine, improve mood and fight depression.  Exercise is also a huge nitric oxide producer.  If that's the only change, then maybe that is it?

[NLH]

NO Peak, that is my point, he is in a down period of no exercise, poor eating, and in reality there is no good reason these sexual symptoms should be reversed. It has been 6 months since any T pellets and his level was in the 400s 3 months ago, so I would imagine it to be down pretty low now. (I hope to have him checked soon)

One thing is daily hot flashes. He can be fine and then it just hits him, headache/hot flushed face and just gets really fatigued and tired/down. But he doesn't have the fatigue and total lack of energy that he had pre-T therapy. His moods change like crazy. I feel like I have a different person from one time of day to the next. There is no reason or explanation, it just hits him and he has no explanation for feeling down or "deflated".

I feel like the therapy repaired his penis, I said this earlier, maybe it's stupid but that's what it seems like, and I fear it is temporary. As the T drops more, I suspect over time we will go back.

[PeakT]

NO Peak, that is my point, he is in a down period of no exercise, poor eating, and in reality there is no good reason these sexual symptoms should be reversed. It has been 6 months since any T pellets and his level was in the 400s 3 months ago, so I would imagine it to be down pretty low now. (I hope to have him checked soon)

One thing is daily hot flashes. He can be fine and then it just hits him, headache/hot flushed face and just gets really fatigued and tired/down. But he doesn't have the fatigue and total lack of energy that he had pre-T therapy. His moods change like crazy. I feel like I have a different person from one time of day to the next. There is no reason or explanation, it just hits him and he has no explanation for feeling down or "deflated".

I feel like the therapy repaired his penis, I said this earlier, maybe it's stupid but that's what it seems like, and I fear it is temporary. As the T drops more, I suspect over time we will go back.

Noted.  Hey, don't know if anyone has said this, but our theory on here is that the hot flashes occur with fluctuating, usually low, estradiol levels.  I know you've done some measurements, but maybe you should look into this a bit more?

[Cronos]

Try weekly or bi-weekly Injections. At the three month point his T was down to the 400's. I know he didn't seem to get any benefit when his levels were in the 800's BUT it may take many months to a year to see any real benefit. He may have needed to go higher with his T levels and stayed up in the higher range for a sustained period of time. With the fluctuation of his T in that 3 month period I don't think he got a chance to have T really act on his tissues... I wouldn't give up on T therapy just yet theirs different types and combos of things to try...

Now as far as him getting better when diet ect got worse I have no explanation.

[NLH]

So it took about 9 months time before his symptoms resolved, just looking at this timeline. He hasn't had any more T since 6 months ago. What I'm understanding is that he had such low T for so long, that it really did some damage, and to get his T to a sustainable level took more time. It has now improved his function and even libido, but are we to assume in time it will go away? I know you guys say on here that having a "restart" is rare and you've only seen it a few times.

So his T levels as we speak could be even under 300, as they were when we started, but his sexual function is back because of the T he was receiving months prior. It's interesting. Makes sense. Even with a T of 877 he had the same ED and function issues, meaning that T just hadn't had enough time to get into the tissues and really replenish the loss that he was experiencing.

Definitely not giving up on the journey, right now he is very content not having to deal with it and talk about it, I think he is just glad to have a break and feel more confident. Obviously we need to check his levels and realize that this is probably not a permanent situation.

It is not only the function and libido that has changed for the better, there were specific issues before like I mentioned- he was unable to stay excited through my touching and oral stimulation, in the shower was a total non-possibility, he couldn't have sex in the morning 90% of the time, he couldn't have sex again the next morning if it happened night before, etc. now all of these things are possible and also intensity has returned. He never reached full erection before, for the last 3 years, now it is continuous and suatained during our time which is such a turn of events. I think it must take some time to accept it and not be afraid of what may happen.