T Nation

2yrs of TRT. Almost Zero Sex Drive. Doc Won't Help with TRT


#1

Background: 25-year-old male with ADHD-PI, lifelong treatment-resistant depression/dysthymia, and social anxiety.

I had been taking 200 mg testosterone cypionate IM every two weeks (I know, I know!), recently changed to 100 mg testosterone cypionate per week, for a period of about a year and a half. I recently switched to Androgel.

For reasons too complex for me to understand, I think the exogenous testosterone has caused my libido to become nonexistent.

Even when my depression flared up (it’s in remission currently), I always had decent libido.

Long story short, it seems like TRT has completely wrecked my libido, and I don’t know what to do. My doctor absolutely refuses to prescribe clomiphene for whatever reason, and I don’t know what other kind of Doctor to see for this.

How can I restart my HPTA axis on my own? I’m in desperate need of help because my quality of life is low with zero libido.


#2

Testosterone is simply ONE hormone that needs to be at the right levels for you to feel good. If your Total and Free T are top of the range but your estrogen is too high you will feel bad in many ways, including sexually.

For now you haven’t provided enough info for anyone to help you. If you want help, you need to do lab work and read the stickies. You can’t rely on anyone to help you - not doctors, not people on this forum. You need to educate yourself as much as possible and take your health into your own hands.


#3

Do you have any blood work/labs you can provide? Do you know where your estrogen, specifically where your e2 is? Are you taking any aromatase inhibitors or hCG?


#4

The problem is not exogenous testosterone, the problem is an incomplete protocol and poor management, which is exactly what you get from most doctors.

Androgel and other transdermal delivery products have the highest T–>E2 conversion. Elevated E2 lowers energy, mood, tolerance, libido.

Estradiol needs to be checked and managed.

Labs need to be in list format with ranges:
TT
FT
E2
CBC
hematocrit
AST/ALT

Reference protocol:

  • self inject 50mg T twice a week
  • 0.5mg anastrozole at time of T injections
  • 250iu hCG SC EOD to preserve testes and fertility

Please read the stickies found here: About the T Replacement Category

  • advice for new guys
  • things that damage your hormones
  • protocol for injections
  • finding a TRT doc

Evaluate your overall thyroid function by checking oral body temperatures as per the thyroid basics sticky. Thyroid hormone fT3 is what gets the job done and it regulates mitochondrial activity, the source of ATP which is the universal currency of cellular energy. This is part of the body’s temperature control loop. This can get messed up if you are iodine deficient. In many countries, you need to be using iodized salt. Other countries add iodine to dairy or bread.