T Nation

Reasons for ED From TRT?


I am 45 . Never had ED issues except once when I experimented with a cycle of Test E when I was 20. I started TRT Test C 3 months ago . no AI at beginning. 2 months into TRT I got ED every other time I tried sex . I suspected estrogen conversion ( with you guys help ) and had dr test E2 - came back 62 ( 12-42 normal range ) dr still would not give me rx for ARIMIDEX so I got it from research chem site .

I have been taking 1mg per week ( split into 2 doses ) for about 12 days . My nipples are less sensitive so I suspect the stuff is legit . I get my E2 levels checked in a week again and see another dr ( urologist who seems up to date with AI use ) my question is : why does my ED happen every so often and other times I am like a porn star . Also would addition of HCG help this . situation . Could it be as simple as the AI and T needing a bit more time to adjust E2


Sir T, I suspect from your threads that you are very sensitive to the effects of E conversion. I went through the same thing on T alone. I slid through my E sweet spot and was like a horny teenager for a matter of only a few days. Once my E became elevated I experienced the typical high E sides likes lack of libido and weak erections and even Gyno that I treated with Raloxifene.

Thankfully I am not an Adex over responder and found my sweet spot quite quickly with 100 mg of Test E EOD and .25 mg of Ananstrozole EOD. Remember that other influences in your environment will influence your sex drive and performance. Be patient, find a baseline and then make small adjustments to dial in your numbers.


You didn't mention your T dose but it is possible that it is too high. What is your blood level of T? If your T dose is too high it is preferable to reduce the T dose rather than use an AI.

By the way, T that is too high itself can cause ED in some guys irrespective of E2.

Hook, no offence, but at 350 mg T per week you are not on TRT. Let's call a spade a spade.


T cyp 50mg twice weekly . Total T level 570


Sir T,

I definitely think you should up your weekly dose of T. 570 In my eyes is still considered low. I wasn't to far off from that number before I started HRT and once i got that number around 1200/1300 I obviously felt great. I did have to take Arimidex (1mg per week) do keep my E2 levels in check. I also take HCG (300IU twice per week).

I don't think that level of T would be considered too high and would cause ED. I'm sure when you were a teenager your T levels were much higher and you could get erections all day. For the most part anyone can get good erections regardless how high there T levels are as long as there E2 levels are where they should be. So I would first try increasing your total T and see if that helps. If not you should have a Doc look closely at your BW and see if something else is off.


I didn't write that as accurately as I should have. 100 mg a week divided into three equal doses and administered EOD.


When my T level was 120 - before TRT I had no problems with ED - getting dr to up T dosage is going to be the battle .



Do you know your shbg level ?


No idea of SHBG level - what would treatment be if it was out of range


Did you fix your ED?

There is no treatment for SHBG, the reason I ask - people with high SHBG do better on high test levels, low SHBG - low test levels.


My test level was 560 total on 100mg per week - I added anastrozole 1mg per week 3 weeks ago after 3 months on TRT . I recently upped my T dose to 60mg 2x week - funny thing about my ED is : 2 nights ago I was not able to get fully hard ( about 60% ) and I tried for a half hour . Last night I was hard as a rock and had great sex . The ED is hit or miss - tmmrw I get some labs on E and T and I can ask for the SHBG too .


As many have said, there is much more to erections that testosterone. I can be full of T and if I am stressed or pissed off, forget about it. With that said, I have recently dropped and held at 60mg/week for a few weeks in the attempt to come off of TRT. However, I am getting more consistent nocturnal E, have more libido and better response sitting at 60mg than when I was on 100mg/week, by a wide margin. My TT was around 800 on 100mg, so i imagine it is a good bit lower now. Just saying there may be many things contributing.


Agree it's more than likely E2. If Adex doesn't do the trick try 12.5mg a day of Aromasin. Worked for me when Adex didn't. Also you can lower SHBG. Proviron.


I had great sex last night as well . The pattern is so random it is hard to tell why it happens .


Got some labs back - total T 586 ; Estrodiol 20.4 - seems like ED is gone also - if I were to tweak my E level one way or the other ( I remember a 4-5 day sweet spot of rock hardness , high libido , great gym pumps about 3 weeks ago ) which way would you go ( I can adjust anastrozole amount - and for that matter I can add more T if that seems appropriate . I have no SHBG level