T Nation

8 Week Crash on TRT Cream Looking for Advice

Question regarding the beginning with TRT

52 years

6’1 185lb

over all good shape with healthy diet

PreTRT - 230 total

1 1/2 year on gel - 651 total, 124 free

Last 3 months on cream 150mg 2x day to inner thigh plus DHEA 20mg. current 1200 total and 360 free (full blood results coming in mail)

Main issues - libido crashed, hard to achieve orgasm, sleep, erections not lasting.

Not problem- energy is fine.

Felt better with cream then gel not worlds different though. Libido increased and was happy for it. Main reason why I wanted to go too cream. Was hoping for better sexual reaction etc. It helped some but still had times where didn’t do what I hoped for. But definitely there were improvements.

Main one was ability to have multiple orgasm in a day. Prior even on gel once a day max.

2 months in and the honeymoon came to crashing stop. Libido just went to floor, orgasm very hard to achieve and erections suffered. Went from sex on mind all day to finding excuses.

Didn’t have this problem on gel though. Didn’t reach the heights of cream on gel but orgasms were fine and consistent just lost libido after orgasm. Now very frustrated.

Spoke with doc and he wants to wait a few weeks for new blood work.

Heard about honeymoon period but thought I would have been over all that as I started 18 months ago. I understand the gel is very low with T so 8 weeks sounds about right with cream.

Curios as to what can I expect further? Will this normalize back or am I needed to change protocol up and maybe add a PDE5

I understand its not about numbers but the way I feel and doc thinks numbers are perfect. He’s apprehensive right now to change up but he’s open to lower or raise if needed.

With that said I definitely feel at this point worse sexually then when just on gel. I also felt back a few months ago that maybe adding a PDE5 with gels might have been a smart move. But talked myself out of it thinking it wouldn’t help libido. I understand I might not be just dialed in but man this was a crash. I will have blood results to add hopefully shortly.

Thanks in advance!

Those numbers are pretty robust! You should be a walking boner! I’m happy the gel and creams worked for you. Even at the max dose I was barely in the 300s.

Are you on an AI? I’d be willing to bet with those T numbers, your estrogen is pretty high. That could definitely tank your poking stick. What are your latest estrogen numbers?

Injections?

Waiting on blood work, should be day or 2.
Felt like that for 2 months then bam…
Wondering if will balance out or this protocol is not working at these numbers.

Two possibilities here:

  1. Your serum levels are double what they used to be. If you felt better at lower serum levels, lowering your dose would be the answer. Try a one click am and a click pm. If libido comes back, you’ll know you’re on the right track.

  2. Applying the cream to the scrotum raises DHT levels… Many men report libido increase with increased DHT. However, scrotal skin will absorb way more than inner thigh which means your serum levels will go up even higher. If you did scrotal, you may also be plenty fine with one click am and one click PM. Scrotum needs to be ideally shaved, or hair at least trimmed very short. Applied on dry skin and full rubbed in.

Bonus 3. There is always the possibility that cream isn’t a good fit for you. In that case, injections are considers the gold standard. 150mg split into twice weekly injections is a great starting point.

Hope that helps.

Yes helps very much.

I am appling 1 gram inner thigh 2x day
Thinking .5 gram inner thigh 2x day

Just don’t want to keep rebooting if body will adjust at a specific dose. My feeling is I might be too high.
Waiting on blood results.

Big thanks

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Blood looking a little thick

Not too much of a concern unless you’re seeing symptoms like high blood pressure, headaches etc. I know a ton of guys with hct at that level and higher and are doing just fine.

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HCT is fine. Im at 53 also and feel fine

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Thanks!

I tried cream for a few months and just before I started I read a few accounts of guys sort of crashing 2-3 months in. I remember at least 1 guy being an ex-finasteride guy like me. But, I was able to see some of their dht levels and they were off the charts. I know some people crashed on the propecia forum after using dht topicals also. It got me thinking that elevated testosterone levels seem less likely to cause a crash than elevated dht… just for certain people.

It scared me enough to go with a very low dose and to apply on thighs. Obviously didn’t have a chance to work.

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Update 6 weeks later
Libido still suffering bad with no improvement and actually worse then last month

Currently
I reduced test cream to half for 4 to 5 weeks. Total test dropped from my 8 week high of 1280 down to 987
Free T dropped from 392 to 288
No improvements in libido

Spoke with doc last week and he understands my libido crashed but doesn’t offer much help. Wants me now to go up even further in T. So I was on cream at 150mg 1 gram x2 a day. Now wants me to go 1.5 grams x2 day. He also prescribed Tadalafil 10mg.
The Tadalafil did help with sex to some degree 3 weeks ago but it doesn’t do much now with even further diminished libido.

Really confused at this point and angry.
I felt better libido wise on the gel that only got my total up to 450 range, free was 50.
But I felt the gel just wasn’t enough and my old endocrinologist didn’t want to prescribe a higher dose. So I looked to a specialist.
And again felt at 6 weeks on cream there was a nice improvement and maybe at that point adding in tadalafil would of been a nice working combo, but i crashed like a light switch at 8 weeks and can’t even get back to when i thought is was bad…

Energy is same which has been good even before switching to cream
Sleep isn’t great but i do get sleep in.
Great shape, healthy eater and workouts. Not depressed, no d

rinking
6’2 185

Any advice or help would be great! Thanks

Time to switch to injections. You’re a male biologically speaking, and your body would fair better if T was running through your blood in a far more efficient manner. Skin is protective and its not allowing T to fully penetrate in your case. Man up buddy, and pin yourself

Don’t have an issue with injections but how do I know that is the issue?
My free test was almost 400. Feel something is out of balance

Because its simply not working. TRT shouldnt require that much guesswork when you clearly respond well to it. You’re just not getting what you need through skin absorption.

the big issue is I felt better when i was on the gel with much lower numbers. Even though i didn’t feel libido wise great i could see their were improvements on the gel, just not enough. But again I had noticeable increase in libido and erections.
I felt even better when I started the cream but that has all went away after 8 weeks. I’ve gone down and up and nothing has changed at this point even though numbers look good.
So having a hard time figuring how even more T by injecting will bring back libido.
Everything else (energy, mood) has been good prior to T.
Thanks appreciate the help!

Two tests, neither looked at e2.

Dont bring E into this. If hes taking an AI, then he should stop taking the AI. Other than that E should not be regulated, or even looked at. At 8 weeks he should be settling into his protocol. The topicals are not good enough for this fellow. He wants figure out why the cream stopped working. The problem is the cream and his inability to sustain levels that his body requires. So he needs to switch to shots. But weeks will go by with him asking the same question because he wants a definitive answer that has been posted over an over. Theres a reason why were not raving about T cream over here. But the question of why will continue. Its not his E. Its his T. Clomid and HCG will raise T but not to a point where you will have symptom resolution. He needs pure T in to his muscle tissues versus rubbing it into skin thats over half a century old

I just find it unusual that nobody bothered to test for it. Hormone panels usually contain, you know, hormones. Having that number costs nothing, so I’m curious as to why they didn’t bother to measure it.

Sure, it would be nice to look at, I suppose.