T Nation

Here I Am!

Here I am at 43 years old and thanks to a wonderful, patient girlfriend I’m finally realizing there’s something wrong with my sexual performance, or rather lack thereof. And in hindsight I’ve always had some problems but none of my past partners opened my eyes to the truth. But my current gf of three years has been telling me how I rate to her past partners and those of her friends as well.

Long story short, when what she was saying finally hit me, I realized that I suck in bed. That’s a tough pill to swallow. I never thought of myself as a Don Juan but I thought I was competent. Nope. Turns out I’ve had erection issues my entire adult life but not to the point where I couldn’t perform; I just wasn’t consistent nor reliable in that department. I simply thought I was a nervous person when it comes to sex. All these years I’ve been trying to calm my “nerves” to do well sexually when I really should have been doing something about my testosterone and/or estradiol.

Historically, from my teens to about 40, I could usually get an erection for sex but keeping it was sometimes difficult and achieving orgasm has always been a fair amount of work and not always possible.

However in recent years (now in my 40’s) what little sexual capability I had started to dwindle away. I knew I had a problem when it was getting difficult to get/obtain an erection for masturbation; something which I was always “good” at. Off I went to the doctor to get some tests.

My general physician’s test was taken on Feb 1, 2013 with the following results:

Total Testosterone: 323 (> 200 “Normal” Range)(taken at noon)

White Blood Cell Differntial:
Neutrophils %, automated count 55 41-79 %
Lymphocytes %, automated count 30 13-44 %
Monos %, auto 12 5-14 %
Eosinophils %, automated count 3 0-6 %
Basophils %, automated count 1 0-2 %
Neutrophils auto count 2.4 2.1-7.4 K/uL

Complete Blood Count CBC w/o Differential:
WBC COUNT 4.3 3.5-12.5 K/uL
Red blood cells count 4.98 4.10-5.70 M/uL
Hgb 14.8 13.0-17.0 g/dL
Hematocrit 45.6 39.0-51.0 %
MCV 92 80-100 fL
RDW, RBC 13.0 12.0-16.5%
Platelets count 205 140-400 K/uL

LDL:
151 < 129 mg/dL

HDL:
57 > 40 mg/dL

Cholesterol:
229 < 239 mg/dL

Glucose:
73 60-159 mg/dL

The doctor said all is normal and gave me a Levitra prescription. Of course I’ve tried Viagra in the past with some success but by now, even Levitra/Viagra couldn’t help me get erect for my gf. We went an entire exotic vacation without having sex. Needless to say she wasn’t happy and started to demand improvement.

Off to the endo doctor this time. He checked me over, asked some questions. Wasn’t concerned with anything visually but said my 323 Testosterone was marginal. He wanted it checked at 8am; so in late February I did. He also wanted to rule out thyroid issues so took a TSH test along as well.

Total Testosterone:
400

SHBG:
42.5 10.0-60.0 nmol/L

Albumin:
4.6 3.7-5.7 g/dL

LH:
3.2 1.0-12.0 mIU/mL

Prolactin:
18 2-18 ng/mL

TSH (Thyroid Stim Hormone):
3.03 0.10-5.50 uIU/mL

The endo told me a 400 is normal and sent me home.

I decided to research online and quickly learned 400 is not so good for a man of 43. I also found an online Free Test calculator. Using this I estimated my Free Testosterone to be:

6.75 ng/dL on a range of 9-30

My data:
I’m 6’1", 170 lbs., exercise regularly but switched from aerobic to strength training last summer but am not able to put on much muscle. I eat fairly healthy. No fast food, sodas, coffee, drugs, no alcohol in the past couple years. I take fish oil, multivitamin (no iron), Zinc (50mg), Vit C, Resveratrol. Rarely have morning wood.

Seven weeks ago I decided to try generic Clomid 25mg/day, no presciption. Within a day or two I started getting harder erections, morning wood, and cumming easier. My gf and I started reaping the benefits and our sex life took off. I was thrilled and she was too. However, after about 4 weeks the erections weren’t cooperating as well and I needed the Levitra to help out. Shortly thereafter, all was lost and I was back to sqaure one, with one added problem- I was hella irritable, with pounding heart, difficulty sleeping, short fused. Last weekend I was so tense, I decided to drink alcohol to try to calm my nerves. This was a bad idea as it combined stupidity with temper. I got mad at my gf for the silliest reason. Unfortunately, I ended up scaring her and she wants me off the Clomid. I do too.

Two weeks ago when I realized the clomid effects were waning I researched and realized that my E2 levels were probably rising and to blame. I never had them check from the get-go so I don’t have a baseline. However I have an appointment to do so in May. I ordered some generic Arimidex, which just came in a few days ago. For now, I’ve been cutting back the Clomid, first to 25mg EOD to now trying to cut it out entirely. I tried 1mg of the AI on Tuesday and now I feel less tense and some improvement in erections, no morning wood yet. But it’s only been two nights since the AI dose.

I know this is a long post but my questions boil down to:

What do you think has caused me sexual difficulty my entire adult life?

Now that it’s gotten worse in my 40’s, what should I do?

Assuming my E2 levels were elevated most of my life that might mean I’m an over-aromatazer. In this case should I simply have tried the AI to see if E2 levels would go down, T levels would go up? Or should I combine with a SERM?

Lastly, do you think Clomid caused my temper issues or is that from the E2 most likely being high?

Thanks

Just curious but why is your endo not looking at your tsh? Have you had a full thyroid panel?
Read all the stickies ( top 6 threads at top of page)
it’s good that you’re trying to learn!! Me 2
May things could cause ED…
Your labs seem a bit funny over 200 being normal?
free testosterone is also very important, they say bioavailible is the most accurate.
Why didn’t they check free? Cause they didn’t want to see a low?
People Will need more labs!! Why no fsh or liver markers? Ast alt?
Prolactin is poping out a little also

TSH (Thyroid Stim Hormone):
3.03 0.10-5.50 uIU/mL

I will ask for additional tests such as free testosterone and E2 when I go in next month.

Read this:

What I meant is ur tsh is a bit high. Endocrine society says over 2.5 is a concern. We see on this site that many people with lower T also have thyroid problems and/or adrenal fatigue. 1 seems to be the number u want to be around with tsh and even still one could be having problems with rt3 and the liver ast and alt may tell a story with both rt3 and E2.

You will also want to test fsh as lh seems to move around a lot and isn’t always accurate. If it was me I would want to find what the root of the problem is not just the problem. Testosterone is not the fix all believe me. My testosterone is maxed out and I still feel like shit.