T Nation

ED after Only One Week on TRT?

Been on TRT 1 week now. 100mg test cyp and 1500 IU’s HCG split 3x a week (mon, wed fri)
basically since the first shot my erections have not been able to get that hard (like 75%) whereas before they would always be 100%. im guessing my estrogen has spiked due to the hcg, i feel much better at lower e2 level. im going to lower my hcg dose to 750, do you think this will solve my problems or should i take an AI?

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If you’re goal is to feel good, have normal sexual function, then ditch the HCG and AI because most of the time these two compounds just cause problems.

You should use the Test only in the beginning and should you run into ejaculation/testicular atrophy issues down the road, you can introduce a reasonable HCG dosage.

Those just starting out on TRT don’t realize what’s going on inside the body when you introduce exogenous testosterone, your pituitary is starting down the road to being shut down and natural production will cease in the coming weeks.

What hormonal homeostasis you had previously is no more and any change in protocols require 6 weeks to reach a stable state.

You say you feel better with lower E2, but are on HCG which increases E2 and a whopper of a dosage at that.

You are probably thinking the AI is a tool to get the E2 down to a comfortable level, don’t be fooled because anastrozole is powerful stuff and usually takes things too far in one direction.

You need to rethink your game plan.

hi, sorry for not making it clear in the original post: background: im fairly young, 21 years old and have tested between 350-400 total T with bottom of the range free T. my shbg lies around 27-34 so middle of the range. i done a sperm count check before starting trt, it was very good and i wished to preserve fertility as much as possible thus the doc put me on hcg, im not using it because i want to but because i HAVE to.
would you then recommend me reducing my dose to 750 IUs per week, or what would you recommend for someone trying to maintain fertility while on trt?
by 750 ius per week i mean 250 iu on mon, wed and friday

A lot of people report an improvement in sexual desire and function when introducing HCG. Could you please explain to me your rationale in why it would do the opposite? Thats not a dig, thats a genuine ask for help in understanding.

For the men on long term TRT, when its time to have kids there are a few options to restore fertility for those whose LH and FSH are supressed. Clomid is used often to jumpstart LH and FSH and TRT is stopped for a time, or HCG and FSH can be introduced to your TRT protocol.

HCG will usually cause numerous side effects, it does work great for some, but the majority of the time it throws a wrench into sexual function, so while you are using HCG for fertility, you are might be trading it for your sexual function.

The AI’s are bad for your health and it doesn’t appear your doctor is up to speed on things TRT related as the HCG dosage is unusually high.

As for the HCG dosage, 150 daily, 250 EOD and 350-500 is more reasonable. As a rule of thumb, never inject more than 500 iu at a time.

What is the prescribed dosage for your anastrozole?

I have been on these TRT boards for quite awhile now and seen most report problems with HCG and if it’s not the HCG causing the issues, its the AI dosing that presents a problem (over-responder) which is needed because of the HCG jacking up E2.

This isn’t just my experience on T-Nation, but also many others forums as well. I did mention that some lose sexual quality later on and how HCG can be used to rectify sexual issues and also that it works great for some.

i have seen increased sexual desire, but my erections have been weak. the reason why i believe this to be true is that my dose of HcG is pretty high, and a lot of people who took this dose also reported high e2 symptoms. one symptom of high e2 is weak erections, which i currently have (didnt have before i started trt). also, some people love having high e2 which is probably who you are talking about, others have better sexual function with lower e2 which i believe i am part of.

yes, he is a decent doctor as he gave me a good amount of test with a good protocol (3x a week). although, after research i realised the hcg dose was far too high, still he is better than the majority i have talked too.
also, in regards to the AI, i wasnt actually prescribed it by this doctor and i havent taken any AI so far. it was from a previous protocol where i was on clomid + ai (clomid sending my estrogen to around 47 with total t being only 750) so i still have it on hand, but i have not used it yet while being on the test +hcg.
also, as im lowering my hcg dose to 750, would i accompany it with increasing my test dose slightly, or is 100mg enough?

Well its tough to say, its probably the absolute minimum weekly dosage excluding outliers like myself.

The HCG will allow for your testicles to produce some testosterone and estrogen on top of the exogenous testosterone you’re injecting. Be aware that the AI is unable to affect estrogen produced inside the testis, so if you find that the AI isn’t getting E2 to decrease, you know why.

I have heard some cycle the HCG every other week so as not to keep the LH receptors constantly stimulated which isn’t how things are naturally.

i see, my shbg is mid range though around 30 ish so im guessing i dont have as much free t as someone with lower shbg.
would 120mg +750 IUs be better than 100mg +750 with respect to my original hormone levels,
what im saying is that if you had to pick what would you choose?

1000iu split into 3 injections max for HCG imo. That’s total! Not 1000 each injection. Way too much HCG. It made me feel like shit at any dose. Lower the dose and take labs in a few weeks. Normally labs are taken 6-8 weeks but if ED persist get the done a little early. Without them it’s just a guessing game.

Dig everyone miss this.

Stay the course with the hcg and testosterone for 6 to 8 more weeks … Do not introduce and ai.
You will have ups and downs until you stabilize.

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In my opinion, and this is just me, I wouldn’t bother with this shit based on your background. Granted, you didn’t state why you needed it, but you mentioned you’re 21 with normal T and have functioning testicles.

For more men than this forum would like to admit, hormone replacement is a long road full of bullshit side effects, some of them permanent. If you truly need it, go for it, but weigh out the risk vs. benefit if you don’t.

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There are more people who get issues from the stuff than benefits. A small portion of TRT guys get benefits. Most report issues that they didn’t have when doing trt alone. I sway people away from it unless fertility is of utmost concern or if they tried it at a low dose and found a benefit.

Most men I work with get T dialed in alone with some requiring dhea and/or thyroid.


Thread hijack-

My DHEA sulphate has dropped a lot since starting TRT. What benefits does supplementing DHEA bring?

I assume you are referring to concurrent HCG use?

If so, what are the issues guys are reporting that are causing them to stop? Legit curious so I know what to look for.

Loss of libido, acne, overall feeling of malaise. Estradiol is one of those things that the body regulates on its own and hcg has been known to spike it which throws off the balance the body is trying to maintain. It’s a hormone derived from the urine of pregnant women which is not exactly something the male body recognizes. Some guys do great on it and others not so much. Just one of those things you need to try for yourself and see what the outcome is. Start low and slow.

It’s a steroid hormone made in the body. You can do a search for ‘dhea benefits’ online. There are tons of sites that discuss the benefits. We typically like to see DHEA-S serum levels at the higher end of normal. If they are low you can supplement with DHEA. Lots of men report increased libido and erection strength from it as well.

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Thanks, I’ll keep an eye out for them. Is there any reason it would lower E2?

If anything, DHEA will raise E2 but differently from the way HCG raises it.