1st post, been reading forums for several months. I’m 42, relatively healthy and fit, started TRT in December from a GP with pellets. Didn’t have a great experience, it did alleviate a lot of my low T sides but had some increased anxiety and the procedure was more invasive than I was led to believe. Fortunately my GP is pretty
flexible and offered injections, gels or creams instead.
After reading a lot of the studies and some of the success stories here I decided to try compounded scrotal cream. We started on a pretty low dose, 50mg once a day. I’ve been on it a week and not feeling a lot of benefit so I think the dose needs to increase, however I’ve been feeling some pressure and feeling of “fullness” in what I believe to be my prostate area (between testicles and rectum). No urinary issues fortunately and no family history or prostate problems, my PSA was .5 prior to starting TRT. I know scrotal cream heavily favors increased DHT which can cause prostate issues, although all the studies I’ve read haven’t seen a correlation and certainly not in a weeks time.
My question is - for those that have transitioned to scrotal cream, any experiences like this? Since it’s only been a week I’m hoping it’s just transient but I certainly don’t want it to get worse, especially if I increase the dose to get some real benefit. Unfortunately my doc doesn’t have a lot of experience with scrotal cream, just regular application and injections so I’m looking for some guidance or if I should be concerned this early on.
Normally scrotal cream is used twice per day, your dosage is low and only once per day. Men with low testosterone tend to have urination issues, you dosage is low and testosterone must also be low. Low testosterone is not prostate friendly, low testosterone equals inflammation. I believe this is your problem, you need scrotal cream 200mg 20% twice daily.
I was pretty low free T before starting TRT in Dec. 427 TT and 6.0 free (range started at 6.8) and never had any prostate issues. Just seems like an unlikely coincidence that within a week of starting scrotal cream I’m experiencing potential symptoms.
Oh natural production is shut down for sure, thinking I still have a little residual exogenous from the pellets as I don’t feel as bad as prior to any TRT. Was trying to put off blood tests until I got feeling good on the cream but the prostate issue has put a wrench in those plans.
I am on a scrotal cream and have DHT almost 3x the range currently and have no prostate issues. I tested PSA same time I checked DHT levels and I am 0.6.
I too started around 50mg I believe and I only went up about 40 points from my original 307 total test that I started with. So yes you are more than likely still low.
If I’m understanding you correctly, you’re saying your test only went up 40 points
on 50mg? What’s you’re dose and TT now?
I guess I really need to do bloodwork to see where I’m at. I got nervous and decided to stop the the cream 2 days ago, prostrate starting to feel a little bit better. I’m also considering switching docs to a specialist, Dr Meehan is a couple hours away from me and runs a combo of injections and cream. Will be a lot more expensive than my GP of course.
Yes I only went up 40 points. You need to remember though that my testosterone production was shutdown. I wasn’t adding on what I already had because by that time I wasn’t producing any I was completely replacing it.
Currently I am applying 160mg I believe. My last labs have me at 800 total test, 25.7 free, and 250 DHT. I am on a 20% cream and apply 8 clicks in the morning after I shower. I refuse to go to twice a day so I may need more than others as I also run labs 10 hours after application and have dropped from where I peaked. I am not positive but I believe mine is 20mg a click. Some applicators I have seen one click equals nearly 5 of mine though which is why enackers says 2 clicks.
Responding to this. DHT applied transdermally hasn’t been found to effect DHT levels in the prostate .
“however I’ve been feeling some pressure and feeling of “fullness” in what I believe to be my prostate area (between testicles and rectum). No urinary issues fortunately and no family history or prostate problems, my PSA was .5 prior to starting TRT. I know scrotal cream heavily favors increased DHT which can cause prostate issues, although all the studies I’ve read haven’t seen a correlation and certainly not in a weeks time.”
Let me clarify. When the prostate is inflamed the docs correlate this to DHT. This is why there was a big discussion a month ago between dr nichols and Meehan. Meehan said scrotal cream or DHT cream can cause prostate issues and the levels should be watched.
The problem with that statement is that all of the studies for and against DHT have proven that the DHT levels within the prostate are not effected by topical application of hormones.
I and others looked for studies that showed this can cause an inflamed prostate and we could not find any supporting evidence. Dr Meehan could Not either .
That makes more sense. I thought I knew what you were getting at but your wording didn’t make sense to me. Mostly because you were talking about DHT being applied which wasn’t being discussed and the whole intra-testicular part. I wasn’t sure if you were arguing that scrotal testosterone cream does not increase DHT either.
I was more under the impression that DHT does not necessarily have an affect on the prostate as previously thought and is actually caused more by lower levels of other hormones like system alluded to though. Not that the extra DHT created by cream just didn’t affect the prostate as “normal” DHT would. Same line of thought just different way of getting there I guess, as DHT is not the villain it has been made out to be.
Is there a podcast or youtube video of this discussion that you are talking about? .
Update on this, “prostate” is feeling a little better and I resumed the cream. I had somewhat forgotten that I’ve had issues with a pelvic floor muscle strain in the past and I think I aggravated it with a set of heavy squats, timing just coincided with starting the cream. It causes a tightness
and somewhat burning situation in the
taint area, something like what I imagine a prostate issue feels like. Going to get bloodwork soon to be sure.
You guys are also correct that my
dose is way too low. Trying to decide if I want to move to a TRT specialist or stick with my doc (much cheaper) and see
if he will increase the dose at refill. Thanks for the help!
TRT can induce insecurities do to hormonal fluctuations which can cloud judgement or cause a panic situation especially when levels are nowhere near optimal. We see this often in guys just starting TRT.
It’s entirely possible the muscle pain is because you are feeding you muscle a lower level of testosterone do to the unusually weak dosage than what you had naturally and this was the pain you felt.
Also the prostate will become inflamed below a certain point if testosterone is low enough, higher testosterone is more friendly to the prostate.
When I started that is what my doc wanted me to use, that is the only reason for me. I imagine a lot of others do cream instead of shots as they are nervous about injecting. Then others that have libido issues move over to cream hoping the uptick in DHT conversion will give them the missing piece to get it back. Those are three reasons that pop into my head, I am sure there are more.
so does the cream work better for libido issues then the shots?
Also if the cream is more likely to increase the DHT are you more likely to start to loose hair on the cream?