I’ve been on TRT for about 4 months with Defy, and it’s been a challenging but at times very rewarding experience. Working with Dr Saya has been entirely excellent - nothing against them!
This all started when I finally saw a dr a couple years ago to address sexual issues I’ve had for over a decade. Turns out my prolactin was slightly elevated (drifts between 30-70) and I have a 5mm pituitary adenoma. Cabergoline and bromocriptine have done nothing positive for me. My TT was in the 400s, and I finally got it into the 500s with a lot of work. FT has always scraped the bottom of lab ranges (7-10ish). There have been other hormonal abnormalities, like low-ish FSH and big swings in cortisol. I don’t have visual field problems, but I’ve never had great vision, and there are fluctuations in it (unsure if related to the adenoma, but I’ve heard of removal improving vision in some). After a year of consideration, I started TRT.
When I finally learned to be patient and not mess with it, things got a lot better. 3 months in, my libido skyrocketed and erectile function improved a little. I’ve been able to maintain a normal weight (160-165) without eating 4-5k calories a day, which has been amazing. Some of the other benefits to my mood, energy, and mental clarity have faded away unfortunately. The confidence boost has faded as well, and I’ve been generally more socially awkward as a result of anxiety.
However, my girlfriend, one of my best friends, and my coworkers have all noticed a substantial increase in anxiety and anger. This is quantifiable too - I’ve burned a couple bridges with partners at work, done/said some inappropriate things when angry, and suffered an increasing amount of panic attacks and latent anxiety. Missed a few days of work due to panic attacks, and have had to really fight urges to drink to mitigate this. At times, I’d say the anxiety has become “crippling.” The anxiety has reached a point where my PCP is insisting I go on anxiety meds (I have not). Losing my temper has shifted from cussing and storming off, to at one point splitting my head open after smashing it into my microwave. At first I thought my reactions might just be from taking a clearer look at problems in my life, but all in all, I’ve suffered more detrimental events since starting. I’ve also noticed my weekly visits to my therapist have shifted from celebrating my progress to digging me out of more problems. He and I are now discussing a more intensive outpatient therapy program; a year ago he was extremely proud of how far I’ve come. Lastly, my girlfriend has noticed that I’m pushing the limits more in being interested in other girls, and I really do not like this, I’m a one lady kind of guy and I take a lot of pride in that.
I’m not posting this to say “4 months later think I might just stop oh well”, but rather trying to take this advice given to me as an opportunity to check myself and see if this is best for me (and those close to me).
This leads me to the next thing…before starting TRT, there has been a notable decline for me over the last decade in things TRT typically improves. I finally sat down and did a bunch of reading on what a non-functioning (aka not secreting hormones) pituitary adenoma can do, and a LOT of the issues I have line up, including it still affecting hormone levels to a degree. My girlfriend admittedly pointed this out a while back, but I was optimistic that TRT would fix it.
I’m now starting to wonder if I would have a better quality of life having the adenoma removed, instead of trying to treat hormones. I’ve read some pretty positive reports from people with non-functioning ones as well that have me wondering if taking care of a quantifiable tumor versus raising low-ish hormones would help more. And possibly bring my natural T levels up a bit, as well as bringing my prolactin down. I’ll also add that my neurosurgeon believes my slightly elevated prolactin could be the “stalk effect” - the tumor pushing on the stalk and inhibiting dopamine transmission.
I’m meeting with a new neurosurgeon this week, and plan to discuss removal options, and if that’d allow me to drop TRT, hopefully improving the anxiety and anger issues.
Really just looking for opinions here, thoughts, and any insight into how long restarting would take after 4 months on TRT if I decide to go this route instead. I’m 35, so not sure if that still lands me in “young guys who stop and recover quickly and sometimes feel better than before they started” or not.
Edited to clarify it’s been closer to 4 months on TRT versus 6