T Nation

Sexual Problems Even After Stopping Antidepressant

Hello,

I (27 y/o) want to ask if these hormone levels are fine so that I can exclude them as root cause.
Background: I tooked Trazodone in december 2017 and go through several sexual symptoms since then which include:

-libido loss
-loss of spontaneous/night/morning erections
-weaker orgasm
-weaker erections
-less semen
-less genital sensitivity

First test results from december 2020:
LH 2.1 U/l (2-10)
FSH 1.1 U/l (1-7)
Prolactin 243 mU/l (<500)
Testosterone 19.0 nmol/l (>12)
Free testo 357 pmol/l (>250)
SHBG 41 nmol/l (11-71)
Oestradiol not measurable (<250)
PSA 0.2 ug/l (<4)
Vitamin D3 22.1 ug/l (25-70)
Cortisol basal 168 ng/l (62.4-180)
IGF-I 179 ng/ml (83.6-259)
TSH 2.07 uU/ml (0.27-4.2)
Free T3 3.66 pg/ml (2.0-4.4)
Free T4 1.56 ng/dl (0.93-1.7)
Androstenedione 1.37 ng/ml (1.3-4.3)
17-OH-progesterone 4.34 nmol/l (0.15-4.85)
DHEAS basal 4.17 ug/ml (1.6-4.49)

Some results from second test a month later:
LH 1.3 U/I (2-10)
Estradiol 41 pmol/l (<250)
Cortisol basal 60.5 ng/ml (62.4-180)
Androstenedione 1.15 ng/ml (1.3-4.3)
Vitamin D3 26.8 ug/l (25-70)

regards

Estrogen = libido. A mechanism in the brain needs the aromatase to occur . Your estrogen is low. Stop the AI or whatever can lower it.

Your problem is estrogen as far as I know. Wouldn’t be surprised if there are other issues.

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It does look like your estradiol is a tiny bit low. I personally don’t see much of an affect on libido with low estradiol, but many do.

I am have been on Trazodone (for sleep) for years and never had sexual side affects. Sexual side effects aren’t very common with that drug either. My question is, was it prescribed as an anti-depressant or a sleep aid? The dose difference between the two is huge.

What is your trt protocol? HCG? Arimidex?

Could be. Might not be. Don’t give false hope.

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Definitely could be the problem. His E2 is currently a little below range on his latest test 41pmol/l (normal range starts at 50).

We definitely don’t have the whole picture with protocol, antidepressant history, doses etc.

My guess is that there is more than one thing going on, and fixing only the estrogen might not fix his problem.

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Ok agree. estrogen is the most important when talking libido: without that you will never know what works beyond that for underlying issues.

I saw Oestrodial and didn’t see the other below . Good catch :slight_smile:

Unfortunely not tried so far. My Andrologist want first make a sequence analysis of my androgen receptor gene before put me on TRT. He first wanted to prescribe it to me to increase estrogen since estrogen directly would lower T again, but the second test is now “normal”. I ask about HCG instead because of my low LH/FSH but he said it’s not necessary. Only prescribed me Vitamin D.

What you mean with AI? I take nothing at moment except Vitamin D and licorice root for my adrenals but it can also increase estradiol.

Think that also. I just took 100-200 mg on 9 days in december 2017 and with that all the symptoms started. Also took SSRI between summer 2015 und spring 2017, but was fine while and after them.

Same shit happened to me but whit sertraline, 2 pills and all the symptoms you described plus dick shrinkage, no believed by doctors, “horror stories from internet are fake” “is a very safe drug” blah blah, I been there. talk about bad luck,
I have been on T a while and all the symptoms have improved. Libido has been even to much sometimes, but not constant.

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SSRIs will kill libido. Trazodone not so much that I know of.

I’ve tried a few SSRIs in my life and they all destroy my libido within a few weeks and it lasted a while after I stopped taking them.

The second test is not “normal”. And why did he completely discount the first test once he saw the second test? Dumbest shit I’ve ever heard, and doctors do it a lot. Based on your reference range of <250, “not measurable” is also normal.

I would go find a trt doctor and get some real blood work done with proper reference ranges.

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I wouldn’t exclude hormones as root cause. They may or may not be, but your TT, and FT are lowish, your LH is low, your E2 is low. These things can make some men feel off.

To me it looks like minor secondary hypogonadism. Your pituitary is not signaling your balls very much. You are then not getting a high amount of T, and because of that E2 is low.

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Estrogen is the sleep hormone and is important for libido. Free T is converted to estrogen, so if your Free T is low, it’s not surprising to see low estrogen. Stay at this estrogen level for a long period of time and you will be diagnosed with osteoporosis.

The low LH and FSH typically indicate secondary hypogonadism, a pituitary problem. The low cortisol can also be linked to a pituitary problem.

Being in the normal ranges doesn’t mean your levels are normal, doctors don’t get it because they are taught in range is normal, so when you complain of symptoms and levels are normal, doctors are taught to ignore the patient concerns.

Look at my testosterone, at 500 my Free T is at the top of the ranges, yours is 547 ng/dL and Free T is closer to the bottom of the ranges. So you can’t compare your hormones to mine, except that is what your doctor is doing, comparing your hormones to everyone else’s.

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Thanks guys, I will order TRT in internet then, I don’t want to wait longer. The date for the gene test would be mid april and I do not even have certainty that I get TRT after the result. Doctors are somehow quite reluctant to do this. Any serious suppliers in europe?

Just to be clear. I am saying hormones may be your issue, not that they are your issue. I would not start DIY TRT yet (I think that is what you are proposing).

I know but what have I to loose? Better than waste even more time and continue to suffer.

I agree with @systemlord that low LH and/or FSH without exogenous hormone use is a problem. I think it would be wise to get your pituitary checked before going on TRT.

Well you could jump on TRT, and not have it fix much for you. Then you would be hypogonadal. It is akin to randomly replacing parts on a car that isn’t working properly. It is best to try to diagnose the issue.