T Nation

Low Semen Volume 3 Months into TRT

Hi guys

I am 38. Started TRT 3 months back after being diagnosed with secondary hypogonadism (something to do with my pituitary). The problem is I had delayed puberty and never even orgasmed/ejaculated till I was 35. Infact I never really had sex. I tried a couple of times but had problems with erections and to be honest I didn’t know it was a medical problem until I developed gynacomastia and went for medical help. Long story short, am on TRT now and can confirm life has been better ever since. Infact I feel alive now. My worry now is that when I ejaculates, the semen volume is usually extremely small. Last time I did semen analysis, the volume was 0.1ml whereas the average should be from 1.5ml upwards. 3 months of TRT and no much difference

Are you using HCG? If not then there’s your answer.

The lack of ejaculates could be do to hormone imbalance and posting labs will lead to recommendations, it could be do to no HCG as some men require it to make TRT work. We see a lot of men on TRT where doctors have put men on less than ideal protocols.

We need labs and describe your TRT protocol.

I am not. As a matter of fact, I haven’t gotten it checked yet. Is it injectable?

These were my pre TRT labs. I am yet to repeat them since starting. Testosterone was 72ng/dl but jumped to 1,100ng/do after 6 weeks of TRT

HCG is injectable only, the oral options do not work.

TSH 2.24 ulU/ml
Free T3 2.01 pg/ml
Free T4. 0.7 ng/ml
Cortisol. 65.0 ng/ml

Ranges please, range are like people, we are all different as are the ranges from different laboratories.

I’m going to push back on this a little. My compound pharmacy makes me sublingual troches that I use rather than injections.

You may prefer sublingual troches to injections, but this doesn’t change the facts that sublingual troches are destroyed by the gut.





TSH 2.24 ulU/ml. (0.4 - 7)
Free T3 2.01 pg/ml. (1.4 - 4.2)
Free T4. 0.7 ng/ml. (0.8 - 2.0)
Cortisol. 65.0 ng/ml. (30 - 230)
Bicarbonate 28.0 MEq/L. (22 - 32)
Potassium. 3.39 MEq/L. (3.4 - 5.5)
Chloride 94.6 MEq/L. (92 - 108)
Sodium. 145.9 MEq/L. (132 - 145)
UREA. 6.7 mmol/L. (2.1 - 7.1)
Creatine. 73.57 umol/L.(80 - 115)

I only got them because they’re more convenient for travel. How much is actually bioavailable?

Free T4 is abnormally low, Free T3 is sub-optimal and not even mid-range which should be the absolute minimum. TRT will increase demand on thyroid and it seems your thyroid is unable to match pace with the increased metabolic demands TRT brings to the table.

I’m willing to bet TSH would be closer to 1.0 (optimal) if Free T4 were at least close to mid-range and would also expect Free T3 to be mid-range or slightly higher which is where you want it.

How do you feel sexually and energy wise?

I do not expect enough to be available to make a difference, you’re just wasting your money.

Not great actually. Still battling ED tbh. And I still feel a little fatigued. Though I feel better than I was, pre TRT. How do I raise my Free T4 and T3? And yes, am getting my HCG level check in the morning

Def try the HCG. You have what we in the TRT community refer to as idiopathic hypogonadotropic hypogonadism.

In some studies as many as 10% of the men were able to discontinue TRT after 6 months or so and fully recover natural levels. Must have been the androgen receptor stimulation.


Sustained reversal of normosmic idiopathic hypogonadotropic hypogonadism and the Kallmann syndrome was noted after discontinuation of treatment in about 10% of patients with either absent or partial puberty. Therefore, brief discontinuation of hormonal therapy to assess reversibility of hypogonadotropic hypogonadism is reasonable.

Reversal of Idiopathic Hypogonadotropic Hypogonadism

So after 6 months to a year, or whenever you get your protocol dialed in. You should take a brief break and see if the TRT jumpstarted your system.

If not you have a dialed in protocol and can jump right back on it. As suggested I would also start HCG right away.

You may even consider doing a HPTA Restart to move things along.

Hope this helps

TRT is more than just injecting testosterone, I do not know where my head has been but I never did get any detail about your protocol, how many mgs and how often you’re injecting. ML (volume) doesn’t tell me anything. I need to know the strength of testosterone and what type of ester.

I’m one of those that if I do not inject 7-10mg every day, I get mediocre results that has more to do with a combination of SHBG on the lower side (22) and my tissues being a testosterone glutton. I metabolize testosterone like a a guy in a pie eating contest and need to be replenished often.

If I inject testosterone EOD I still respond well, I just do not feel mentally as good. You get more anabolic action when moving injections closer together, everyone is different so mileage may vary.

It wouldn’t hurt to run an iron panel and ferritin, thyroid problems can cause iron problems or low iron can cause thyroid problems. I mention the iron panel because you mentioned fatigue, I started TRT almost 3 years ago and found out I’ve been iron deficient the entire time and was always fatigued.

My T level was 72ng/dl before I started TRT. I was then placed on Sustanon 250mg every 2 weeks. Six weeks later & after 3 injections, my T level jumped to 1100ng/dl which was slightly above the range. At that point I felt great both sexually and strength wise. And I wasn’t feeling fatigued no no more. But my doctor felt it was way too high and adjusted my dosage to once a month giving me a 6 week break. By the end of the 6th week I feel like shit again with all the pre TRT symptoms back. Now I have taken another shot 17 days ago, felt good the first week after the injection but feeling a little fatigued now. I checked Sustanon website and saw that the recommended dosage is once every 3weeks cos it’s made up of four different esters (propionate, phenylpropionate, isocapriate & decanoate). So now I intend injecting every 3 weeks for the next couple of months and check my levels again

You really need to be injecting at least once a week, really more like 2x a week, at the absolute minimum.