Low Libido/Drive on TRT

I’m current 36 and have been on TRT for about 4years I’ve currently running 170mg T cyp 1x a week and I was on a therapeutic dose of nandrolone 200mg 1x every 14 days until about July (was on it consistently for about 2 years)

My wife and I are trying to conceive so the doc prescribed 50mg clomid ED for at least 3 months along with 500iu HCG 2x a week or 1000iu a week. We stopped the nandrolone due to its negative effects on fertility.

I’ve been running the above protocol for the last four months and have since stopped the HCG and dropped the clomid down to 25mg ED when I noticed my libido significantly decreasing in the last month or so.

For the first time since Ive been on TRT I’ve experienced a significant loss of sex drive or low libido difficulty getting and maintaining erections. Sensitivity is still moderate to high and often ill start to get an erection but it won’t be full and will go soft quickly.

I was considering getting off the TRT all together but would value some opinions here on what could be the cause or what I can do next?



Test - 1022ng/ml
Free T - 22.6pg/ml
TSH - 4.59
LH - 0.6
FSH - 0.8
Estradiol - 18.7pg/ml

Previous labs 06/13/2022

Test - >1500ng/ml
Free T - 43pg/ml
TSH - 3.12
LH - <0.3
FSH - <0.3
Estradiol - 59.2pg/ml

You should take a closer look at other thyroid markers, mainly the fT3. The low libido and erectile issues cause be from excessively high androgens. From both labs tests you’ve either had low E2 or well above the normal range.

This might by the problem, weekly dosing isn’t optimal for everyone, some needing frequent dosing to get libido functioning optimally. You dosage is higher than average for a TRT protocol.

Do you have a red blood cell deficiency? I’m guessing by your >1500ng/dL TT labs that this was “gains deficient therapy” rather than you being anemic, but correct me if I’m wrong.

Your Estradiol is crashed. The newer labs are when you’re off HCG, correct?

I don’t understand stopping the HCG if the concern is fertility… pump HCG, use minimum effective dose of AI, get her preggo, then stop HCG.

Yeah you’re correct it was “joint pain” but we really know what it was for.

That’s the first thing I noticed was my Estradiol since it was high last labs. Newer labs, I had just stopped the HCG maybe about a week or so prior.

I only stopped the HCG because I was reading that it can create high estrogen within the testies and create all sorts of other issues at higher doses and longer term use. I had been running it at 250 units 2x a week for a while prior to using it for fertility.

I’m not sure what the cause is here just trying to narrow it down as clearly the erection issues are causing issues in the bedroom. Do you suggest coming off TRT just running HCG clomid and AI then stop the HCG?

Ive got only a few thyroid markers. Should I look into lowering the dosage and running 2x weekly injections or lowering the dosage all together 1x a week has never been an issue until now.

Reverse T3 Serum - 9.5ng/dl previous labs were 23.7ng/dl
T4, Free 0.95ng/dl previous labs were 1.59ng/dl

I think 250IU HCG 2x per week is too low a dose for fertility purposes.

Id continue with TRT, possibly split dose for 2x injections weekly. I’d also start up HCG at 500IU 3x per week and AI as needed (seriously, minimum effective dose though).

You can also read here for more information though.