T Nation

Problems with HRT Routine

Hello all,

Presently I’m following this routine;
MONDAY: 500iu HCG, .25mg AI

The routine works very well in that I have great energy, good appetite, and overall feelings of wellbeing. HOWEVER, I do not have any morning wood and my libido could use improvement. My erection quality is good, though.

I’ve tried routines where I split everything into twice a week and ran into problems. When I split the test into 100mg twice per week, I am left very lazy and unenergenic, plus have a weakened sex drive. If I dose HCG or adex twice a week, I send my e2 either too high or too low, and feel like shit.

So, based upon that, what can I do to bring back morning wood and improve my libido?

I was thinking about maybe moving the AI to the same day as the test or the day after test. I was also thinking about maybe moving HCG to several days AFTER I take the test and AI.

Thoughts guys? Comments? Any help would be greatly appreciated.

Morning wood is not a reliable indicator. Healthy men have nocturnal erections throughout the night - whether you happen to notice them upon waking up in the morning just depends on the specific sleep stage you happened to be in just before waking. If you don’t notice problems with day erections, then you are almost certainly having good sleep erections and just don’t notice them because you happen to wake up when you are not in the REM sleep stage. If you have a bed partner, you can ask her/him to check on you, or you can do the postage stamp test, but really I wouldn’t worry about it for the reason explained above - that kind of test is mostly of concern if people have ED, which you don’t.

200 mg is a bit of a steep dose. Some people’s libido is better at lower doses. I know this sounds paradoxical, but for libido, beyond replacement doses more T is definitely not necessarily better.

Likely you are having problems because you are taking twice the starting dose of T, which is 100 mg per week.

Not every guy needs to inject twice per week. When I take T cyp, I inject 100 mg once per week and do fine and test regularly at above 700 ng/dl post mid-week, which likely implies I am at 800 to 1000 at the start of the week.

I never used an AI while on T cyp and you likely won’t need one if you cut your dose of T.

HCG is usually used in small amounts while on T, but I didn’t use it while on T. All I used was 100 mg of T Cyp once per week. No HCG, no AI. Most who use HCG while using T cyp use 250 IU EOD or 500 IU twice per week.

You are making this more complicated than it is–timing of this, timing of that, etc.

Please read these stickies:

  • advice for new guys and note the first paragraph as well
    – we need to know a lot more about you! [young or old?]
  • protocol for injections

200mg once a week is a problem

100 mg/week T, 50mg twice a week
1mg anastrozole per week, 0.5mg at time of injection
250iu hCG SC EOD

The do these labs and post:
prolactin if <35YO
cholesterol [can be too low]

Labs are important, but only in the TRT context of a described protocol that has been steady for some time.

Elevated E2 can mess with libido, energy and mood
Low thyroid function can do that as well.
Check body temperatures as described in the thyroid basics sticky to eval overall thyroid function.
If you have not been routinely using iodized salt, thyroid function can suffer.

There can be combinations of E2 and thyroid imbalances and these affect individuals in different ways.

I am currently 24. I was diagnosed with hypogonadism at age 13 and have been on testosterone since.

I was given a lot of test to get through puberty and it worked great. Grew a lot, developed fully, had erections 24/7.

At age 17 once I was done with these crazy high shots they started me on HCG monotherapy (2500iu 3x per week). That worked until age 19 when it started to become ineffective (perhaps desensitized). So for a while I was on nothing. I did okay but had to use cialis.

At age 20 I went back on TRT due to low numbers. Was taking 500mg every two weeks which didn’t work so great. Went down to 450mg test plus 2500iu hcg three times a week which would work okay but the three times a week HCG shots were too much. Eventually I was taking 450mg test and 2500iu hcg on the same day every two weeks and it worked great. Constantly hungry, crazy libido, great energy. However this caused too many sides (hair loss, body hair increase, water retention) so I went to 200mg test and 2500iu weekly. This worked okay but I had less energy and a weak sex drive.

Since the beginning of this year I’ve been trying to find a better routine. I’ve tried all sorts of routines that have included, in one way or another; 100mg test per week, 100mg test 2x per week, 500iu hcg 2x per week, 250iu hcg 2x per week, .25mg adex, etc.

Anything below 200mg leaves me lazy and unenergetic. Anything about one shot of hcg per week (regardless of dose) sends my e2 too high. Anything more than .25mg adex sends my e2 too low, etc.

Last BW from about 6 weeks ago at the end of the week:
T: 631
E2: 37


Your problem clearly has a major factor with E2=37

What was protocol for labs and what was lab timing relative to prior injection?