T Nation

27 y/o. T-Levels of 88, Zero Libido


Hello All,

After starting TRT my libido and sex drive have completely decreased and my t-levels have dropped to only 88!! Please help!

Some background:
I've been lurking here for a while but this is my first time post and I'm really hoping to get some good information. I'm a 27 y/o 5/11 and 165 lbs and in what I consider to be relatively good shape. I work out 5-6x a week for over a hr and am generally in good energy. I've had sex 2x times a week on average since 16.

However, for the last 5-6 years I've had to use some type of ED supplement on occasion though I was able to achieve erections on my own I sometimes had trouble maintaining them. On my last visit to a new urologist (previous had retired) he noticed that my t-levels were down and suggested that I begin TRT.

Results from 9/10
FSh 2.9
LH 2.6
Testosterone, total 238
Testosterone, % free 2.79
Testosterone, Free 66.4

The urologist at the time started me on 10mg of Testim everyday so that was 2 tubes a day. He was adamant in recommending against injections since they cause spikes and are not consistent. I also asked him about adding some HCG after reading this forum but he wasn't comfortable with that at the time and though it best to see how I react on the testim alone. Initially I noticed that my sex drive was much higher at around the 3-4 week mark but has since completely decreased! My testicles have also significantly shrunk down to grape sizes. I'm rarely in the mood with my gf and is seriously affecting our relationship.

Here are the test levels with E, 2 months later 11/10

Testosterone, total 88
Testosterone, % free 2.33
Testosterone, free 20.5
Estradiol <32

My urologist has since recommended that I stop testim and see an endocrinologist instead as he's not sure what to do. I realize that I may not have all the necessary tests but I'm working on scheduling a appointment with an endo. I've also scheduled another opinion from Dr. Bar Chama in nyc as i've seen the name mentioned on the forums here a bit.

If the testosterone isn't being absorbed and resulting in the low levels, then why are my testicles still shrinking? I would think that it would just result in the same levels and not lower them so drastically..

Can anyone offer some suggestions here? Should I try androgel to see if it absorbs better? Should I get some clomid to try to restart my testicles? I've gone from being able to achieve erections and having minor problems to having the major problem of not being able to at all. This is very depressing especially at my age..

Thanks for any help..


You are absorbing enough to shut down your HPTA, but not enough to raise your T levels significantly. You should have your thyroid numbers checked. Injections may be your only option. Frequent injections can even out the peaks so they are no more significant than gels. I doubt if Androgel would work any better for you.

Endos are just about as bad as urologists. Look for a good doctor that is skilled in hormone replacement.


Honestly, I've found it's incredibly difficult to find a good doctor. I'm actually shocked at how little information there is out there on good reputable docs. My GP's use to suggest that my problems were all mental. It wasn't until I visited urologists that I got any help at all. I've had other recommendations for doctors but then don't all accept my insurance (Aetna) either which is a problem.


Read the protocol for injections stick and the estradiol sticky.

Non absorption of transdermal T is common [universal?] with hypothyroidism. Thus this is a symptom of hypothyroidism. Note that many of the symptoms of hypothyroidism and hypogonadism are common to both. If you have both, the symptoms can be more severe than one condition alone.

-are you using iodized salt?
-eating sea food?
-iodine in your vitamins?
-get cold easily
-dry skin, brittle hair or nails?

Check your body temp when you first wake up. Ideal is near 97.8, 97 is definitely a problem.

you may also need ferritin and rT3
if rT3 is a problem, a four sample saliva cortisol test

You want TSH near 1.0
You want fT3 and fT4 near middle of lab range
If fT3 is good and waking body temps low, problem can be elevated rT3 and/or low ferritin
Low cortisol can lead to elevated rT3
Low cortisol - you the read about adrenal fatigue and life style changes

Need a doc, tell us where you are located. Your urologist simply needs to have half a brain to see the merit in that. If you are wanting to have [more] kids some day, you must use hCG.

In any case, your only option is injecting T. If you self inject T often, there are no issues with T peaks and valleys at all.

Your HPTA may be worse off than ever now, hence the shrinkage.

Get a proper male panel:
pay out of pocket if you have to to get such work done.

More in those stickies, go read and then ask for clarifications.

Problems can be caused by other conditions, drugs [Rx and OTC], alcohol, stress, injury to the head/pituitary.


Thanks for the replies. I live in NYC now and could use a good doctor recommendation. I made an appointment already to see Dr. Bar Chama as I've seen the name mentioned a few times before but he isn't available till December.

In regards to the additional tests, I'm definitely going to ask for the full panel to be done if possible. Do doctors typically resist against this type of testing? When I asked my current urologist he wasn't familiar with many of these tests. Any suggestions for a knowledgeable doctor would be appreciated?

For the next month, since I'm discontinuing testim, should I try to start on some clomid to restart my testicles? I have a prescription for it now since the TRT failed but am contemplating waiting till I see a better physician.

I'm only 27 so fertility is definitely important to me. My recent spem analysis showed that my sperm concentration levels were only at 3.8 which should been much higher..


Clomid will do that, nolvadex might be better for you. I may increase your T levels and provide some interim relief.

Long term, inject 250iu hCG SC EOD will maintain your testes.

Many issues are outside of urology, but we can tell you what lab results mean here.

Costs and insurance are definitely concerns when it comes to lab work.

Stickies = power


I've had trouble convincing doctors to prescribe HCG so far.

My prescription for Clomid is 50mg for 10 days then 10mg for 10 days so its just 20 days total. That seems different than what I've read about only taking it eod. Can you tell me what a good doseage is?

Thanks again.


hCG is EOD, SERM's are every day. I would like to see you on the SERM until you start self injecting T AND hCG.

50mg may be more than you need. Many of the old dosings are more than what is needed. High does may jack up E2 levels and if LH goes high, this can down regulate LH receptors just as high dose hCG.

If you do research, you will probably be better ignoring much of what you read that is posted by body builders and steroid forums.


I'm the one who mentioned Dr. Bar Chama and Dr. Bruce Mellinger (my doc, whom a few people on here are now seeing) several times here. I've also mentioned Harris Nagler (Manhattan) and Bruce Gilbert (Great Neck - takes NO insurance). Dr. Paul, a urologist in Lake Succes, LI, is very good too, but I don't think he's fond of giving testosterone to young males, which is why he'll just send you to the andrologist-urologists I mention here. Dr. Schoor in Smithtown LI deals with TRT and fertility a lot too. This is more than a fair selection to help you. They key is to get a urologist that deals A LOT with reproductive, hormonal, and ED issues. A lot just deal with other diseases and are impossible to deal with on these matters. Barry Schuval is a good endocrinologist in Great Neck who prescribes T also. But I like sticking with docs who really zero in on this stuff.