T Nation

Ruptured Testicle = Low T. Clomid Fixed?

Hey guy’s so first a little background.
27 year old male, been lifting heavy, hiking, doing metcon’s about 8 years.
6’ tall
165 lb’s (down 10ish pounds since the injury)

In early February during some combative’s training someone fell on top of me, this resulted in my left testicle being torn in half. The following day I received surgery, the doctor was able to save half of the testicle, and I healed up pretty quick.

In mid March approximately six weeks post surgery I expressed some concern about reduced libido and energy to my surgeon in a follow up visit and he had my free T level checked. Came in at 450 with reference range of high 100’s to low 800’s.
He explained it was a perfectly normal level but I knew I didn’t feel like I did prior to the injury. He said I was completely healed and my T level was too high for him to feel comfortable recommending me TRT / HRT.

In early April I met with a doctor that specializes in HRT for athletic males. He confirmed my T levels with another blood test and prescribed me Clomid 25 mg per day (started Clomid April 15th). His reasoning behind the Clomid was to see if I had a “software” or “hardware” problem.

After a few days on Clomid I was starting to feel more like my old self, but after 8 or 9 days I totally crashed. I felt awful, lethargic, exhausted, libido non-existent. When I would work out I would feel pretty good but the rest of the time I felt like trash.

On 5/15 I had another blood draw, and the following day stopped taking Clomid.
Here are the results:
FSH 11.3mIU/mL (ref. 1.55 - 9.74 healthy males)
LH 11.3 mIU/mL (ref. 0.8 - 96.9 (no ref for males))
Progesterone 2.28 ng/mL (ref. 0.1 - 22.7 (no ref for males))
Prolactin 7.5 ng/mL (ref. 3.7 - 17.9)
Cortisol 7.1 ug/dL (ref 4.46 to 22.7 (based on time of blood draw))
Estradiol 50.2 pg/mL (ref. 5.37 - 65.9)
Testosterone 1330 ng/dL (ref. 132 - 813)

Within 3 days of stopping Clomid I felt amazing, possibly even better than I did prior to the injury.

So I met with my doc today to review the blood work and he said he saw no reason for me to feel so poorly on Clomid but he was glad I stopped taking it and was now feeling much better. He then prescribed me 0.8ml Test Cyp every 7 days.

At this point I am wondering if any more treatment is even necessary?
Is it possible that the Clomid was able to “reboot” my system and my body can return to regulating itself in a healthy way?
Could continuing with the Test Cyp protocol potentially make things worse or counteract all the good the Clomid did for me?

Appreciate any advice and feedback.

Your testicles work very well. They responded nicely to clomid.

It’s possible that your system was rebooted.

You can wait 6-8 weeks without clomid or testosterone. Then retake labs. If you do it this way you will feel better about going on injections. Or you can try 25 mg clomid EOD instead before injections. 25 mg may be too much for you everyday. My Dr had me EOD

Labs

Total t
Free t
Estradiol
LH
Fsh

Do thyroid panel to if you haven’t.

Also do you feel your testicles got bigger on the clomid? Just curious cause that happened to me.

Thanks Charlie.
I am quite surprised I reached such high T levels, it gave me some confidence that I am in fact healed from the injury and that makes me very happy. It also gives me hope that I could return to a life without any form of HRT and still maintain hormones at levels that make me feel good and perform well.

Thyroid labs:
T3 uptake 33.5% (ref. 23.5 - 40.5)
T3 Free 3.73 pg/mL (ref. 2.8 - 5.3)
T3 Total 127 ng/dL (ref. 97 - 169)
T4 Free 1.02 ng/dL (ref. 0.78 - 2.19)
T4 Total 6.2 ug/dL (ref. 5.5 - 11.0)
TSH 2.02 uIU/mL (ref. 0.5 - 4.7)

He said he wants to run the test cyp for 4 weeks then pull labs again. I am inclined to follow his direction seeing as I have already received the first injection. I do kind of want to not take anything for awhile and run labs again and see what my body is just doing naturally after that Clomid cycle, but I really am not sure. I am not a doctor, have no experience with HRT/TRT/ PEDS so that is why I am here, gather some opinions from people more knowledgeable and experienced than myself to help guide my decision making and not making me 100% reliant on a doc.

I did not notice any change in testicular size with Clomid. I had a lot of buddies who use performance enhancing drugs telling me my balls were going to swell and I would be ejaculating significantly more but that never happened. I think my injury could be a contributing factor to that though.

Clomid increased LH and therefore testosterone, it also increased estrogen while simultaneously antagonizing the estrogen receptor and why men feel good in the beginning and terrible as time goes on. Stopping clomid would eventually see you return to the state you were in prior.

The effect clomid had on you will end and then you will need TRT for life because there was nothing wrong with your HTPA, the problem is in the testicles do to the injury. Test Cyp is a hormone that your body evolved to handle without side effects provided you have no other medical problems.

One should know his pre-TRT estrogen and SHBG levels, no TRT protocol should be considered until SHBG is known. Higher SHBG men do well on once or twice weekly dosing, lower SHBG men do better on multiple doses per week.

Elevated estrogen is the number one cause for low libido and poor erections on TRT, it can even cause you to feel awful, lethargic, exhausted and have a non-existent libido.

Can you expand on this a little more about your doctors intentions, does he intend to keep you on TRT for the indefinite future?

Thanks for the response systemlord.
It sounds like my response to Clomid was somewhat normal based on what you have said.

I do not have my first set of labs but I believe the only hormone testing in it was testosterone.

I do not see SHBG any where in my labs, would it be acceptable to continue with his prescribed Test Cyp every 7 days for 4 weeks until my next prescribed lab or should I hold off and go get the lab asap?

Your response to clomid was a typical one, most cannot stand the side effects. It makes no difference now to allo levels to return to baseline to suffer for lab testing.

I going to assume fertility is important for you, there are a few things you can do to restore fertility while on TRT if it becomes an issue, adding HCG and when not enough on its own add FSH injections to your TRT protocol will go a long way to increase sperm production, you can also restart your system again using clomid to restore fertility.

You mention you’ll be on 0.8ml Test Cyp every 7 days, is this drawn from a 200mg vial or 100mg vial of Test Cyp?

Systemlord, I am unsure of his intentions. In January I will not be able to be on TRT (which he is aware). He said he wants to try this for 4 weeks, do another set of labs and “go from there”.

Fertility is not of importance to me, getting snipped next week.

I am also unsure of the dosing of the Test Cyp. something else I should follow up on.

TRT is for life, there isn’t a good enough reason to stop TRT, surgeries can be done without hormone deprivation therapy. I’m going to guess you will be deployed. T-Pellets while not optimal can last for months.

I appreciate the suggestion. I will inquire with my doctor about this next time I meet with him. Anything to keep me at normal levels for a few months would be very helpful.

Now would have been perfect time to see what your produce naturally after clomid restart. I see how your thinking which is great. Your thinking will not make you rest until you see what Natty levels are. I would talk to Dr and tell him your thinking. He must incorporate what you think in treatment.

Maybe since you already took a shot , no more shots and take 25 mg EOD of clomid for 2 weeks and stop everything for 8 weeks then labs.

If you go on trt now you will always think what if… And drive yourself bananas