T Nation

1.5 Years on TRT, Positive Experience But Still No Libido/ED

So I’ve been on TRT for almost a year and a half now, it’s made an overall positive impact on my life in terms of mood, depression, anxiety, muscle mass, and basically every positive of having high testosterone except for my libido and on/off erectile dysfunction (due to low libido).

The only thing that seems to help is adding HCG, before HCG my penis would be cold, sometimes freezing cold a lot of the time (it’s an uncomfortable feeling) and I’d have trouble getting an erection; this feeling would come in on & off and occasionally my dick will feel normal temperature again. HCG works great for about a week, as soon as it kicks in it’s like proper blood flow returns to my penis and it feels hot/warm to the touch. Sensitivity also greatly increases and with it my libido would be sky high (like what you would expect from TRT), however after a while (a week and a half-ish) HCG stops working, not sure if it’s because I aromatize a lot on HCG or not.
Please help, TRT is great but the low sex drive and on/off phases of erectile dysfunction are really starting to hinder my life and self-esteem. Thank you.

Is it possible to post your most recent lab results?

Total Testosterone: 900 NG/DL
E2: 28 PG/ML

This is on 40MG EOD no HCG.
Not sure what it is on my protocol 100 IU HCG EOD.
Currently experimenting with 50mg EOD + 100 IU HCG to see if higher test + hcg will fix my problems (no AI).
If it fails will be trying 30 mg EOD with 150 IU HCG.

I’m 10% bodyfat and I’m not usually a high aromatizer but on HCG my nipples seem to get a little bit “puffy”

I’m trying to maintain as much muscle as possible as I used to cycle (but took a break) and hoping I can have a high libido with a good amount of androgens. If that fails, then I will sacrifice losing muscle if that means getting my libido back.

Your SHBG is too low. This is a very tough thing to get corrected, because it takes so long for it to bounce back. I know of 1 guy that it never corrected and he never ever felt good on TRT, we literally tried everything, he may have been suffering from early onset diabetes. Also, men with really low SHBG report feeling ill after a shot. I postulate this is because SHBG is responsible for preserving T in the blood stream, and when you don’t have enough you flood your blood stream.

Upping your T dose is not the answer here, it will just drive your SHBG lower, although you are right to stay away from the AI for now. I would consider increasing the HCG dosage, in hopes to stimulate some E2 production and with it a rise in SHBG.

Did you take a high dose of aromatase inhibitor leading up to this blood test?

Will try upping my HCG dose, how does increasing testosterone dose decrease SHBG?

Also my SHBG was 25 before TRT, and I was at 15-18 when I was injecting twice a week. Injecting EOD seems to have crashed my SHBG.
Interesting that diabetes does run in my dad’s side of family, but I keep an eye on my blood sugar and it is actually mid-normal (fasted).

And no I didn’t take an AI leading up to the blood test, I’m just very lean and don’t aromatize very much (10% bodyfat), I also carry a really good amount of muscle.

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Well injections specifically are really good at increasing free T as compared to other routes of administration. So I should have been more clear, that specifically injectable testosterone lowers SHBG quite a bit. The higher you go the more pronounced this effect is.

You could consider the cream for a while with injectable HCG. This could give your SHBG levels some relief. The 20% works good, but you may have to rub it on multiple times per day if you metabolize it fast. But the HCG will also really help keep things stable, you could even consider mono-therapy with a dash of clomid, it is good at increasing SHBG. Keep me posted on what you do and how it turns out. Hope this helps.

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YOur body will decrease SHBG in the continued presence of high levels of test, and will raise it with continued levels of low test. Your body uses it like a wharehouse. If you have a lot of test all of the time it sees no need to save up for a rainy day.
What specifically did you used to cycle, and how recently?

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Thank you for your input, I never ran anything more than 500mg of testosterone and some Dbol. Last cycle wasn’t too long ago, maybe 2-3 months ago.

It’s the dbol. You’re probably gonna have to wait that one out, and it can take a while.

Not sure what you mean, what does the dbol do exactly could you please elaborate a little bit more? And how long do I need to wait?

Your SHBG is low in your free estrogen must be sky high while regular estrogen looks all innocent and in range.

I would expect to see SHBG decline in people with hypothyroidism. Total T is way to high given your SHBG.

You should be on daily injections.

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Look up “Deca Dick”, You’ll find plenty of info.

Dbol isn’t Deca though, they are two very different compounds. One is a testosterone derivative and the other is a 19-nor.

Makes sense, however even when I used to take a lot of Arimidex my sex drive would stay the same. Also, I have no signs of E2 dominance like bloating/puffiness or any mood issues.
I must say that using everyday protocol with HCG could really work in my sex drive but I’m trying to avoid injecting every day as much as possible.

I think a lot of guys today are getting ED or libido loss due to too much porn. Do some research into no-fap if you regularly spank it to porn. All of my symptoms improved after 60 days off porn.

Check fasting insulin levels.

And fasting glucose

Also, check thyroid. TSH, free t3 , free t4, thyroid antibodies.

These are simple blood tests

Lots of side to d-bol. You probably down regulated your receptors on the cycle and have to wait for regeneration.

60 days! Impressive. Lately, I’ve been so horny and haven’t had spousal reciprocation… I can’t make it past 3 days without having to snap my carrot.

Lol. I massage my best friend everyday. I recently Am trying to go by waiting for the weekend sex we have. It’s hard… lol

Btw he said no porn not no fap

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@charlie12 phew…

I think I need to work on going longer between home games… I had sex 1 day after fapping and couldn’t finish. Was sorta pissed. Not sure what the issue was… libido and arousal worked as designed, but the last part didn’t.

Oh well…glad to hear I’m not alone with carrot snapping.