T Nation

HRT Help Required

Just looking for a bit of advice here guy’s.

I got started on 125mg of test e weekly, roughly 3 weeks ago (4th injection tomorrow). It may be early day’s but i swear i feel allot worse than before. I have noticed nothing but negative changes and the day before the next injection (sometimes 2 days before) i need to apply some androgel to get me passed.

I have chronic ED still and literally cannot get an erection without allot of stimulation. Libido is still low and i don’t get spontaneous erections anymore.

My penis is also having a tendency to shrink really, really bad and sometimes appears ‘soft’ and lifeless at times. I know both low E2 and high E2 could cause this but what other factors could effect flaccid size?

I have low t due to varicocele, but not elevated LH/FSH which is unusual. So there “might” be a chance i will respond to HCG stimulation but it’s sketchy. I am seriously considering giving HCG a go to try and recover testicular size and function.

I have a physically demanding job which probably isn’t helping matters but i cannot give it up due to needing the money to pay for treatment and blood work. What a bad situation to be in!

My E2 was low while on androgel 7.5 and 10g’s daily, so i can’t understand why this is happening still on injections. I thought i was going to start seeing improvements.

How long does the test take to kick in and show ED improvements and libido improvements?

Energy seem’s up, but mood is a little hit and miss.

Should i be injecting 75mg bi-weekly instead or should i stick to 125mg weekly and get tested again in 8 weeks?

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I am about i the same spot, I really bottom out in like 3 or 4 days, so I am about to go to twice weekly injections and my balls are shrinking and aching so I am going to push the HCG issue. One thing that has made a difference is the AI, more sex drive, more morning wood. It’s not consistant but I am working on it.

You don’t say if you’re using any sort of AI protocol and I believe this would be important. The varicocele shouldn’t be shutting down your HPTA, so it should be responding to the higher T by pumping out more aromatase and that is going to boost your E. Weekly injections are also more likely to boost aromatase and most guys seem to do better with EOD injections. Transdermals are every day, and that more closely mimics normal T functioning in the body. In general, the closer you can get to “normal” the better off you’ll be.

FWIW, once I got my E under control, all my libido and ED problems evaporated. I think too many TRT docs only think about T and don’t consider E carefully enough. As always, Your Mileage May Vary.

Don’t give up! He who is unwilling to accept defeat can never be defeated.

hehe, well said “Don’t give up! He who is unwilling to accept defeat can never be defeated.”

[quote]happydog48 wrote:
You don’t say if you’re using any sort of AI protocol and I believe this would be important. The varicocele shouldn’t be shutting down your HPTA, so it should be responding to the higher T by pumping out more aromatase and that is going to boost your E. Weekly injections are also more likely to boost aromatase and most guys seem to do better with EOD injections. Transdermals are every day, and that more closely mimics normal T functioning in the body. In general, the closer you can get to “normal” the better off you’ll be.

FWIW, once I got my E under control, all my libido and ED problems evaporated. I think too many TRT docs only think about T and don’t consider E carefully enough. As always, Your Mileage May Vary.

Don’t give up! He who is unwilling to accept defeat can never be defeated.[/quote]

[quote]Megazoid wrote:
Just looking for a bit of advice here guy’s.

I got started on 125mg of test e weekly, roughly 3 weeks ago (4th injection tomorrow). It may be early day’s but i swear i feel allot worse than before. I have noticed nothing but negative changes and the day before the next injection (sometimes 2 days before) i need to apply some androgel to get me passed.

I have chronic ED still and literally cannot get an erection without allot of stimulation. Libido is still low and i don’t get spontaneous erections anymore.

My penis is also having a tendency to shrink really, really bad and sometimes appears ‘soft’ and lifeless at times. I know both low E2 and high E2 could cause this but what other factors could effect flaccid size?

I have low t due to varicocele, but not elevated LH/FSH which is unusual. So there “might” be a chance i will respond to HCG stimulation but it’s sketchy. I am seriously considering giving HCG a go to try and recover testicular size and function.

I have a physically demanding job which probably isn’t helping matters but i cannot give it up due to needing the money to pay for treatment and blood work. What a bad situation to be in!

My E2 was low while on androgel 7.5 and 10g’s daily, so i can’t understand why this is happening still on injections. I thought i was going to start seeing improvements.

How long does the test take to kick in and show ED improvements and libido improvements?

Energy seem’s up, but mood is a little hit and miss.

Should i be injecting 75mg bi-weekly instead or should i stick to 125mg weekly and get tested again in 8 weeks?

[/quote]

We need to get a few things in order first.

First off, weekly injects will not cut it. You want to switch to every 3 day injects using smaller needles. You inject 125mg a week, thats 500mg a month. Every 3 day injects is 10 injects a month. So you want to inject 50mg every 3 days :slight_smile:

Second, hCG is a must. Absolute must. It keeps natural T production going, boosts mood and libido as well as blood flow and improves erections as well as overall sexual function.

After getting those two in order, get retested. Post up TT and E2 levels and I will have a better understanding if you need an AI or not. AI’s are not always needed nor are they a magic bullet that alot claim them to be.

[quote]happydog48 wrote:
The varicocele shouldn’t be shutting down your HPTA, [/quote]

True but the HTPA function is a moot point if one has primary induced hypogonadism from a varicocle. You can have the most fine tuned HTPA axis in the world cranking out all the LH and FSH you need but that will be a pointless battle if testicals are not responding due to primary hypogonadism.

Yes, a varicocle will induce primary hypogonadism. This is common.

Easiest way to find out is to compare TT and FSH, LH, and E2 levels.

[quote]Megazoid wrote:How long does the test take to kick in and show ED improvements and libido improvements?

Energy seem’s up, but mood is a little hit and miss.

Should i be injecting 75mg bi-weekly instead or should i stick to 125mg weekly and get tested again in 8 weeks?

[/quote]

It took me a month to get benefits from injections.

My doctor friend (not an endocrinologist) explained it for dummys:

“Testosterone is not like adrenaline. No instant results. It takes time for it to saturate the tissues.”

If I were you I would call my doctor and tell him/her what you have told us. See if he or she wants to increase dosage now or wait a little while longer. My endo seems to want to look in 4 week intervals.

[quote]Megazoid wrote:
My penis is also having a tendency to shrink really, really bad and sometimes appears ‘soft’ and lifeless at times. I know both low E2 and high E2 could cause this but what other factors could effect flaccid size?[quote]

Overall blood flow, overall cardiovascular condition, E2,TT and prolactin levels will influence this.

Varicocle might only be affecting one testical not both, so as long as one works your OK thats why LH and FSH aren’t exactly elevated. However this may cause less than desirable T levels.

hCG is valuable even in non functioning testicals(varicocle and/or primary hypo cases for example)[/quote]

My left testicle shrunk due to varicocele which caused my low t symptoms. My right testicle was shrunk already due to being undescended as a child. Due to the fact i don’t have elevated LH/FSH, i thought i might still respond to HCG stimulation. Maybe my right (undescended) testicle is still capable of putting out test? Maybe the left testicle would regain some size and function using HCG? I haven’t tried any form of nolvadex, clomid or HCG to date. It’s been noted on various research papers that varicocele sufferers don’t get back lost testicular size but i am willing to give it a go anyway, i know that one other guy in his 60’s had varicocele and recovered size (and maybe function?) using HCG. So i guess there is hope.

I would like people’s input on this, the papers are here:

http://www.ncbi.nlm.nih.gov/entrez/q...ubmed_docsu m

This article is also very intresting but i am not sure what drug they are meaning:

http://www.ncbi.nlm.nih.gov/entrez/q...ubmed_docs um

This article seem’s to refer to needle pricking which i have no clue what that means:

http://www.ncbi.nlm.nih.gov/entrez/q...ubmed_docs um

I still have a sub-clinical varicocele on my left testicle which may or may not be causing problems still. Either way, my testicles are small and not putting out enough testosterone. The sub-clinical varicocele is however causing reflux between the kidney vein and adrenal gland. The main varicocele has been cleared however as i can no longer feel anything. I do get pain sometimes still though, but believe this is purely because my testicle can move around allot more due to be shrunk and sometimes my scrotum hanging low. It’s very difficult to truelly cure varicocele, even in pure surgical cases.

I am running 125mg of test a week and my anti-aging doctor didn’t want to “over-complicate” thing’s by adding in HCG to the cycle, however i don’t want to make thing’s worse but still feel giving HCG a go is worthwhile.

I am taking nothing for AI as i was shown to have low E2 while on androgel.

How should i incorporate HCG into this TRT protocol? Should i stop my weekly injections and do HCG alone instead? I don’t want to use more than 250iu at a time due to E2 fluctations. I would consider stopping treatment of injections and doing 250iu daily to see how i get on.

How effecting on my piturity would this be? Would i be able to stop everything once testicular sixe (or at least function) was regained somewhat and go solo without much problem? I have absolutely no piturity issues.

Any advice would be great guys.

Curious - how low were your levels with the varicole veins? T and free T if you know.

Thanks.