Yeah mine started with Paxil. The doctors didn’t seem to mind the long term effects of that.
That’s actually really reassuring. We likely essentially have the same problem. What did your numbers look like after Paxil? High SHBG, low free T?
Many people on PSSDforum have hormones in normal range, yet still experience sexual dysfunction as a result of their previous SSRI use. I’m hoping mine is strictly hormonal.
Pre-trt labs had total T close to 600 and the non sensitive estrogen test was like 48. They didn’t check free T or SHBG and I didn’t know any better to ask. I didn’t get any better libido on lower amounts of T. I started at 220mg once a week and it was way too much at once (plus I didn’t realize what to expect and that it would take a couple months regardless before I got any better). So I found this forum and read. I stared taking an AI which crashed my E2 and then eventually dropped my dose to 100mg. That didn’t help so I upped it 20mg every 3 months and started twice a week injections. I felt great when I got to 180 but still had swings. Tried more frequent injections until I got to daily. I felt amazing on 185mg daily sub-q. I currently alternate 185mg & 200mg every two weeks doing daily IM in the delts. I can’t imagine it being any better than it is now.
After TRT (close to a year later) my SHBG was 39.9 & free T is mid 30’s. Libido is out of control and I always have a hard on for no reason. It’s one of them good problems.
Pre-trt labs had total T close to 600 and the non sensitive estrogen test was like 48. They didn’t check free T or SHBG and I didn’t know any better to ask. I didn’t get any better libido on lower amounts of T. I started at 220mg once a week and it was way too much at once (plus I didn’t realize what to expect and that it would take a couple months regardless before I got any better). So I found this forum and read. I stared taking an AI which crashed my E2 and then eventually dropped my dose to 100mg. That didn’t help so I upped it 20mg every 3 months and started twice a week injections. I felt great when I got to 180 but still had swings. Tried more frequent injections until I got to daily. I felt amazing on 185mg daily sub-q. I currently alternate 185mg & 200mg every two weeks doing daily IM in the delts. I can’t imagine it being any better than it is now.
After TRT (close to a year later) my SHBG was 39.9 & free T is mid 30’s. Libido is out of control and I always have a hard on for no reason. It’s one of them good problems.
How long were you on Paxil for?
Hmm weird that you had high estrogen. Maybe your free T was fine in that case? I believe my E2 (non-sensitive) is so low because there isn’t enough to even aromatize. Both low T and low E2 have me feeling like hell.
Since my LH is ok and my FSH is pretty low, I might first try Clomid to see if pushing my numbers up can reset my hypothalamus and pituitary a bit. They seem sluggish. If that doesn’t work, I’ll buck up and try TRT.
Those numbers are nice. You probably feel great. Are you going through a clinic or buying online (less legally…)? The clinics seem outrageous. I know I won’t get any insurance coverage for mine, considering it looks okay on paper (in spite of being symptomatic as hell).
Edit: assume that you don’t care about fertility/testicular atrophy. Have you experienced a lot of shrinking and or pain?
@justpanicnodisco
I was on Paxil for about 2 years (sophomore & junior year of high school) maybe longer then switched to Lexapro. The Paxil had me almost completely impotent.
I care tremendously about fertility. I’m 35 and plan on having several kids. This is talked about in the forum a lot so I won’t go into too much but going on TRT does not mean you can’t have kids. I have two best friends that blast and cruise that both had kids after being on for over 2 years straight. Plus I’m in medical sales and until a month ago lived in NYC and had regular meetings with some of the top fertility docs in the US and they both told me there is basically zero chance of TRT alone making you forever infertile. Worse case scenario you have to go off TRT for a while but usually adding hcg, hmg, etc is enough to do it.
I probably could have lived without TRT but it’s like being a normal person vs being Kobe Bryant. Literally every aspect of my life mentally, physically and emotionally is tremendously better. I look better than I did when I was 25 and I looked good at 25. That said as young as you are I would definitely try and restart and see if there are any other options and then when you get into your 30’s hop on the TRT train. It’s not always an easy road getting dialed in.
My balls have shrunk some but not really noticeable to anyone else. They went from saggy like crazy to never sagging so personally I prefer it over how it was previously. I think some people over hype the balls shrinking thing (or maybe they have really small balls to begin with?). No girl wants giant saggy nuts smacking their face.
Appreciate the reply.
I see. So did your sexual dysfunction continue after discontinuing all the antidepressants, or did it remain lower until you got on TRT? I assume your function returned, given that you said you went from feeling normal to like Kobe.
I was on the poison for about a year, and went from hypersexual to an almost non-existent libido, no morning wood, and weaker erections. Three years later, my sexual function still sucks. I’m kind of at the end of the road with regard to waiting and trialing other meds to improve my status, especially when it’s now apparent my hormones are off. “Kobe” would be nice, by I’d kill for even normality. The best years of my life seem to be passing by me while I’m stuck in this mess.
Good to know about the fertility - and yeah, the balls are more just aesthetic. Girls proooobably care more about a function dick than a huge sack.
Definitely will keep reading more into this.
I lol’d at giant nuts smacking their face, lol.
K in all seriousness my pre TRT numbers were pretty similar. High shbg, low free t and low e2. I was told that basically total T is only high because shbg has been “storing” the test you are making for so long and at such a high rate. As soon as you start freeing that up your total T is going to drop like a rock and then your free T will follow not long after.
I’m on 200mg/ml cream. Made a huge difference from barely able to have sex 2-3x a week to every day is no problem. My shbg was 150 and it’s down to 90 now. Free test is over the high end of the range and total t is over 1500. I may lower my dose some, haven’t decided yet.
Given your age I’d agree with trying some kind of restart. Slim chances of it working but it’s worth a shot first. I’d look into having sperm frozen just to be sure, if you’re super concerned about fertility. Not sure what it costs but I don’t think it’s too bad
Thanks for the reply.
I’m just confused as hell about where the problem lies. It appears my pituitary is functioning well enough, given my mid-range LH. Is it primary hypogonadism? Perhaps testicular damage from fluoxetine (Prozac). There actually are some studies on this, though I believe they were conducted on rats and in higher doses. But in that case, wouldn’t my LH be higher (as it tries to crank out more T but can’t due to the damage)?
Where does the problem stem from? Does it matter?
What would you recommend as a means for a “restart”? I’m considering a SERM, like nolvadax (sp?) or clomid, based on what I’ve read about people doing PCT. I guess I’d do a less intensive PCT of sorts. Is that a good idea? Very new to all of this.
@justpanicnodisco
My libido never fully recovered. I was literally and I mean literally impotent on Paxil. When I got off I could get hard but libido itself never fully recovered. I didn’t even realize until TRT just how bad it was. When you live with something for so long you don’t realize you are basically disabled.
The normal vs Kobe comment was more about the difference. I didn’t feel normal prior to TRT. Far from it. I just didn’t realize how not normal I felt until I felt better.
I remember seeing a class action lawsuit against Prozac. Not sure if that applies but may be worth checking into.
Yeah, there’s now evidence that SSRIs downregulate androgen receptors, among a host of other anti-sexual effects (decreasing dopamine and glutamate, increasing prolactin, etc.). It’s no wonder my body is fucked.
Luckily, increasing androgen levels actually increases androgen receptor density, so it may be possible to reverse some of the damage by getting the sex hormones in the higher end of the range for a long period. I’m currently trialing DHEA (100mg/day) for this purpose. Haven’t noticed many changes yet, but may take some time.
Keep me updated with how it goes. I just listed to a Joe Rogan podcast with David Sinclair (anti aging scientist) who spoke about DHEA along with metformin and HGH reversing ageing in a study of 9 people by 2.5 years. I’d be interested in what positive effects you get from it over time.
SSRI and libido/ED issues have been know for some time. I would rather be addicted to whiskey than an SSRI/SNRI or benso they all numb the prefrontal cortex.
Not to mention whiskey seems to help with the libido. Why do you think there are so many alcoholics in this world.
justpanic you really need to find a drug (((not a supplement))) that is know to reduce SHGB. Your nuts are working fine. You only problem is your SHGB is binding up all your T and E2 rendering it useless. Get your SHGB down below 45 and you will be normal without stabing yourself 2,3,7 times a week and risking future children. Just because Joeblow on the internet got his lady pregnant on TRT does not mean you will be able to.
I was aware they were associated with sexual sides,but had no idea that the god damn sexual sides would continue upon seizing the meds. They obviously fucked up some feedback loop; otherwise, the body would return to homeostasis as it typically does.
Haha see what I mean about all the different opinions about how to handle this situation!
Lowering my SHBG with a simple oral drug would be much preferred to injections for the rest of my life. One of the guys above said that lowering SHBG would tank my overall T, though. Shrugs
What kind of drug lowers SHBG? I’ve searched the internet top to bottom, and all I’ve come up with is proviron, which is not sold in the US (and would probably suppress T production to some degree anyway, given it’s an anabolic).
There’s a quality placeo-controlled study showing 100 mg / day in young males, over a month long period, increases both DHT an androstenedione 2.5 fold and testosterone by about 20%. This suggests most conversion is probably occurring through the alternate pathway, rather than being reduced by 5-alpha reductase.
It’s also protects tissues from excess cortisol.
Surprised it’s legal here. Cool stuff. I’ll have to listen to the podcast. I’m sure I’ll be posting here more over the next several months as I unveil and solve my problems once and for all.
Look you have to be very careful about taking advice from randoms on the internet. This forum as well as many other have some guys that are really out there. Spewing total bullshit and the mods don’t ban them. They let bad advice roll. It’s sad really because I know the admin here is very knowledge about these things. His advice when he post is always spot on. I have been here long enough to block all of them so I don’t see their bullshit advice anymore. As a new member just be careful. Use your common sense.
Can you recommend any drugs that lower SHBG significantly?
I only know one forsure method to drop your SHGB but this is the wrong forum. Mine was 38 it is 25 now.
Stop thinking about TRT for the rest of your life. At you age the bad side effects are thru the roof. Start researching T only 12 week cycles. That is all I will say in the forum. Go to the pharma forum state your case, post your bloods (that’s important it means you are serious) and see if anyone will help. Best of luck to you.
Sure. Can you link me to the “pharma forum.” I’m not sure to which forum you are referring.
If links aren’t allowed, you can PM it. Thanks!
I assume my 15 years on and off of 11 different SSRIs are the reason I’m on trt. Funny thing is once I started to have normal testosterone again I didn’t need the Prozac. Weird how that works. (It’s not weird; we are over medicating men and boys and it’s been disastrous)