T Nation

Six Months In, Need Some Advice

Early 50’s. I started this process in May after putting it off forever. I was lethargic, my workouts were not doing what they should have been, my libido was shot and had started to develop ED.

I had my labs done and found a clinic that I could work with. My numbers in May were:

Testosterone: 503 ng/dL
Estradiol: 25.4 pg/ML
SHBG: 45.3 nmol/L

I was then put on Cypionate at .7ml a week (140mg) and Anastrozole (.5) every week a day after the shot.

So in July, we drew again, and numbers went to:

Test: 988 ng/dL
Estradiol: 35.3
SHBG: 33.1

The doctor kept me on the same T but upped the AI to .75 a week.

We are about to meet again in a week, and that’s why I’m reaching out for advice, things to focus on in my appointment, etc. I have noticed NO change in libido or ED help. It’s dead still. I will lose an erection in 4 mins, almost every time. It’s become comical. I’ve started to notice somewhat better workouts, but bodyfat is still hanging on inspite of dialed in workouts and diet. It’s changing, it’s just really, really slow.

So, any advice on what to focus on with my doctor? I want to come in somewhat educated. Thank you!

(The doctor is part of the problem)

Libido is a brain process as much as it is a physical one. Some guys have perfect lab work but still don’t have that drive. It’s not abnormal. At 50 it would be unusual if your libido was raging. So ask yourself if that drive is gone for reasons related to your age, your environment, etc. Those things play a big part in making everything work the way it should. So if labs are decent and the issue is still there then consider addressing the things that have been heretofore unaddressed.

As for the ED, have you tried any of the usual suspects? Cialis, Viagra, et al? Maybe see if the doctor can give you a trial and see if that doesn’t help. If it does then that’s useful data.

Your e2 is not high enough to warrant an increase in AI. Frankly trt shouldn’t automatically come with an AI unless there’s evidence that it’s needed. Your numbers can tell a story, but they can’t predict what you need. For example, my trough TT is under 450, my e2 is in the 40’s, and I’m ready to rock and roll any time, any place. Put another guy in the same position and he’s got floppy want syndrome. Your doctor should be open to letting you see if you do better with higher e2. Maybe you’re more like me and you do great with it. Maybe you don’t. But you won’t know unless you experiment.

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Thank you – I’m on daily Cialis (5mg). I get erections during the night just fine, I manage to get hard to start sex, it just goes away quickly and I’m lacking the “drive” to want sex. I’m rather blah about it, while I’m passionate about a billion other things. This was one of the things that lead me to look at my T to begin with. Viagra has no effect on me other than stuffing me up – I respond better to Cialis.

I’ll read more about the AI. It did surprise me that he upped it.

So do you have other lab numbers. Pre trt. 500 for a 50 year old is probably about right.
BUT we need to see your free t.

Your problem could be something else. and if you did not investigate those other issues and you start testosterone you may feel worse.

Did you do a metabolic panel, lipid panel , iron panel, thyroid panel, DHT, prolactin, dhea-s, a1c???
What other medications are you on or did you start recently and what supplements are you on?

What is your height and weight?
Most likely the AI is not going to help you It may make you feel worse.

Here, hope this works.



All I see is the cbc

How about my other questions

The tests above are the ones he ran. I had a physical soon after with other tests. Lipid panel was fine, cholesterol slightly above range, everything else good. But I don’t think any of the other things you mentioned above got tested by either doctor.

I am 5’8" and 210lbs. 22% bf trending down slowly.

I’m on a blood thinner (was before the issue started as well), I take ZMA, OMEGA-3, Ashwagandha and vitamin D. I do a pre-workout drink. Outside of that and coffee, nothing else goes in other than good food.

I hear you here. You WANT to feel desire. That drive to WANT to get laid, even when stimuli is there. But just don’t. You can get hard initially, but then poof. Gone.

I haven’t found the answer either after a few years of TRT. It’s horribly frustrating.

Unlike the other advice, i’d run the arimidex at the increased dose and see how you feel. If things get worse, then go the opposite route. At that point, i’d think about dropping it completely.

ALso keep in mind some guys feel better at lower TT levels. Under 800.

Do you have that drive to watch porn? Do you have any addiction like alcohol, meth, etc? Other than that I’ve read here some guys swearing by low dose of masteron with TRT, have you tried that?
@gawain what about you?

Don’t drink. No other vices (coffee excluded). Watch porn out of fascination and to find things for the wife and I to enjoy during our “time.”

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Did you have your prolactin checked?

If you are injecting once weekly, that may be the problem. There are countless stories of guys having sexual problems on weekly doing even with good labs, increasing the frequency has worked for a lot of guys.

I don’t get erections unless injecting EOD, but twice weekly and nothing happens down below even with high trough numbers. Also the AI use was a bit premature, injecting smaller doses more frequently can lower E2 substantially.