T Nation

Gradual TRT Success. Question About Libido Improvement

Hi all,

I got on TRT because I was diagnosed with secondary hypogonadism and had low T, low libido and ED. I’ve been on TRT now for 2 months, 6 weeks I was doing weekly 100mg and saw mild improvement on my libido and ED, we moved to 150mg weekly injections and for last 3 weeks I’ve been doing that.

I’ve seen very gradual improvement, I do feel like every week I’m getting slightly better but still not as good as before I had low T. My instinct is to switch to biweekly injections at some point but have some pause in changing protocol given that my improvement is occurring albeit very slowly.

I’m curious if everyone’s experience with their libido improvement just clicked at one point when they were finally dialed in or if it was a slow progression even at the correct dosage that eventually got them to where they are?

Thanks!

Two months is about when you should ‘start’ feeling better. Its a long game not a short one. I think you made a good choice switching to 150mg if supported by labs. Stick with 150mg for another 6 weeks and re-evaluate. What do your labs look like by the way? Can you post them with range values specifically the male hormone portions? CBC and CMP won’t be needed for this part of diagnosing.

Okay I’ll add my labs to look at, is there any harm in switching from weekly to biweekly injections still at 150mg? Or will even a change like that mess with my protocol?

Nah… really no harm in increasing injection frequency other than the burden of it.

Here are labs
Pre TRT:
LH: 1.6 (1.7-8.6)
FSH: 2.1 (1.5-12.4)
Test: 220 (264-916)
Free T: 8.6 (8.7-25.1)
DHT: 23 (30-85)
E2: 8.2 (7.6-42.6)

After 5 weeks of 100mg weekly:
Test: 270 (264-916)
Free T: 9.3(8.7-25.1)
DHT: 27 (30-85)
Estrogens: 85 (40-115)

After that lab we moved to 150mg weekly and I do feel slightly better but still not all there after 3 weeks of it. Not sure why he did estrogens test instead of e2 for the second test

Yeah you are still in the toilet dude. You need more T and yeah at the very least increase frequency so you spend more time in the higher range.

EJE110221f04

1 Like

Did you have SHBG checked? Guessing it’s low, more frequent shots would help if it is

I haven’t got SHBG tested but that’s going to be on my next test.

I do think I may need closer to 200mg a week to feel normal, going to switch to biweekly injections next week at 150 before we decide on changing dosage.

When/if you make the change your hormones will start fluctuating like when you first initiated treatment and you may experience symptoms on and off for about 4-6 weeks until hormones become stable again.

Also you don’t seem particularly sensitive to test and I’ll bet you are under dosed even at the 150mg weekly. Splitting up your dosage twice weekly should see your levels a bit higher at trough.

Injecting EOD at the same weekly dosage of 150mg would see your testosterone even higher.

I think you’re right, that test was a week after 100mg injection so I’m sure my T was higher throughout the week but that was right before my next injection.

I started TRT at the start of this year actually and my doctor put me on a horrible protocol (200mg every 3 weeks). I was new and had no clue how this all worked so I did it, at first I felt amazing within days, then my estrogen spiked and had ED again after 2 months.

I’m honestly thinking 200mg a week with biweekly injections is prob what I’m going to need.

It’s hard to tell what yout dose will be that will work for you. It’s not a linear thing. You may feel great after a few more weeks on the 150mg. Don’t get caught up I’d the t levels once they’re on the higher side of normal. You won’t necessarily feel any difference between levels at 900 vs 1200, maybe, maybe not.

I divide mine up in 3 doses most of the time, occasionally it’s only 2 depending on the week, but I dont notice any difference.

Also libido can be complicated, mine came back slowly, still could be better, but it’s currently higher than my ability to perform or my wife’s desire (trying to work on that), but it wasn’t like turning on a light switch, more of slowly turning up a dimmer switch. I suppose actually as some of my ED resolved my libido improved, I suspect because I started thinking I might be able to actually perform.

That’s good to hear, I will say when I first started TRT at the beginning of this year it was like an immediate boost in libido that lasted 2 months until e2 spiked. The problem is my protocol was awful doing injections every 3 weeks because my doctor had no clue what he was doing.

I was kind of expecting something similar once I was dialed in but it’s been far more gradual this time around. My plan is to switch up to biweekly on 150 and see how that goes for another 3-4 weeks. If nothing big changes I’ll try upping to 200mg per week.

Doesn’t seem unreasonable on adjustING the test dose.

I’m not convinced that an e2 spike was your issue after the first 2 months. I suspect that you finished up the honeymoon phase when all your natural systems shut down because of the injections. It can be a challenge/impossible to find something close to that again. E2 gets a bad rap.

Remember it took a long time to get to where you were before starting trt and it will be a while to get back out.

I hear ya, but I did get labs and my estrogen levels were very high and even after an injection and my T levels were massively high I felt no different at all. That as well as my first schedule of injection (every 3 weeks) kind of leans toward causing an estrogen spike, no?

The injection frequency certainly didn’t help anything, and the wildly fluctuating test levels, I think, can contribute to elevated e2. So more frequent injections is usually the solution, up to daily shot as well as dose adjustments. It might be the ratios of e2 to test more than the absolute value. I was reading something about a study on that recently.

Anyway, you have a plan and I’d just work it and see how you fell. Might be worth keeping a small journal, while dialing in, makes it easier to refer back rather than just using your memory.
Dose, diet, exercise, sex life, etc.

Quick question, are you saying switching from weekly to bi-weekly injections with same dosage will likely cause a hormonal imbalance for 4-6 weeks?

Yea good advice, I’ve been doing that in my phone noting whenever I noticed changes. The positive is I’ve been improving, a little slower than I would like but it seems I’m on the right track. Was just curious with everyone else who saw great libido success if it was an overnight thing after finally dialing in correct dosage and frequency or much more gradual to finally reaching the great levels they’re at.

Exactly.

I think systemlord over states this a bit.
I couldn’t figure out how to post the image but I charted it out on steroidplotter and while it takes a bit to hit your new normal, your levels start to be more stable the first week of increased frequency.

1 Like

I agree, I can make large changes, and feel about the same (I can’t perceive a difference). I think some are more sensitive than others though.