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Low Libido 2 Years into TRT. Advice?

Been on TRT for a little over 2 years and libido has never really been good (Low Libido). 48 years old, pretty decent shape, try to exercise at least 3x week, not over weight. My current protocol is:
60 mg Test Cypo 2x per week, every 3.5 days (200mg/mL), ¼ tablet (.25mg) of Anastrozole 1mg 3x week.
Other medications are Singular 10mg, Lisinopril 20mg, Omeprazole 20mg all taken daily. Also have an enlarged prostate (BPH) and taking 2 Uroxatral 10mg and 1 Tadalafil 7mg daily. Any advice and/or feedback would be greatly appreciated.
Last test results:
SHBG: 24.5 nmol/L (range is 16.5 to 55.9 nmol/L)
Estradiol: <15pg/mL (range is <15-33 pg/mL)
Testosterone, Total: 722 ng/dL (range is 150 to 684 ng/dL)
Testosterone, Serum: 779 ng/dL (range is 264 to 916 ng/dL)
Testost., % Free+Weakly Bound: 47.5 % (range is 9.0 to 46.0 %)
Testost., F&W Bound: 370.0ng/dL (range is 40.0 to 250.0 ng/dL)
Prostate Specific Ag. (PSA): 3.54 ng/mL (range is 0.00 to 4.00 ng/mL)

You can’t have libido if estrogen is low, erections might be troublesome with low estrogen. You could possibly decrease aromatazation by injecting daily, some guys aromatase like a lot on moderate doses.

If you dose anastrozole 3x times a week you’re not giving estrogen a chance to rebound. This can lead to osteoporosis if kept low long enough.

I’m curious what your pre-TRT labs looked like and whether you actually need an AI. Most guys do not and only need more frequent injections, example daily injections. I did just that and no longer need an AI.

I couldn’t even find the right dosage either, it always ended in very low estrogen. Cialis has been known to change T/E2 ratios over time decreasing estrogen.

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Not good and needs corrected. Would not be at all surprised if that is your biggest cause there

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Ding ding ding, we have a winner

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Estrogen is way too low. Mine is almost 6 times higher than yours and I want to fuck 24/7 (and can). After going so long without much libido it’s still crazy I get to feel this way. I didn’t feel that way when I was keeping estrogen low. Also, you could probably increase the T another 20-40mg (in addition to dropping the AI) and have a much better libido. You’re T levels could stand to be higher.

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TOO much Arimidex bro WAY too much. Your estrogen is crashed.

Thanks for the reply. Best I can remember, pre-TRT labs are
Estradiol: 55pg/mL (range is <15-33 pg/mL)
Testosterone, Serum: 245 ng/dL (range is 264 to 916 ng/dL)
Testost., % Free+Weakly Bound: 22.3 % (range is 9.0 to 46.0 %)
Testost., F&W Bound: 54.6ng/dL (range is 40.0 to 250.0 ng/dL

Thanks for the reply. Original protocol was 150 mg Test Cyp per week (200mg/mL). PSA went from 2.06 to 3.98 in a little over a year, Doc cut back to 120 mg per week. PSA is down at last check. Doc also said Test could be having a negative effect on enlarged prostate.

Thanks for the reply. Cutting the Arimidex completely out as of today. How long before I should notice a difference?

This is estrogen dominance because the estrogen is higher in relation to testosterone. This explains why the AI was prescribed, now it’s just about the proper dosage. You can get anastrozole in 0.050-.125 from compounding pharmacies or you might try aromasin and cut it up into smaller pieces.

The aromasin is milder and not so fast acting. The idea is to be on the AI short term and to drop weight to decrease aromatization, on rare occasions guys are just high aromatizers.

@dextermorgan This sounds awesome. Just curious what your protocol is and where your levels are at. I realize we are all different but would like to hear what is working for some people.

*Basically 185mg/week doing daily IM shots in the delts using 28g 1/2 inch needle 1CC insulin syringes

*I use 185mg for two weeks then switch to 200mg for two weeks then repeat. (helps with libido but does nothing else). I wouldn’t recommend this until you’ve been on a set dosage that works optimally for you for a year.

*My levels on 185mg/week 24 hrs after 28.6mg shot (daily shots) so my levels stay constant (both trough & peak are the same for the most part)


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e2 is too low, that is most likely why your libido suffer.

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What is 35.8pg/ml in pmol?

Google say

36 pg/mL = 132.156 pmol/L

Why do you need to take anastrazole on such a low dose ?

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Yes i know but that has to be incorrect.