T Nation

TRT and Erections


Good day forum.... Long story short...... I have been on TRT 100mg E7D for 12 weeks now....and feeling good!! 31 years of age BTW

Test results.... Around week 8 of TRT
PSA= 0.8
Estradiol= 35
Total Test 1103... <---but that was 2 days after injection so I now it is not that high

I am retracing my weak erections for my past.....

  • this week will be week 2 of abstaining from Porn and masturbation. (could my thyroid and adrenals be weak from to much porn use and excessive masturbation??)

  • My father has diabetes...don't know which type....(2 days ago I have a fasting BS of 99 in the morning and today my fast BS in the morning was 110..... I do not take in high glycemic foods....Health low glycemic, protein and vegetable diet.

I know high blood sugar can interfere with dilating the blood vessels and NO production that could cause weak on non existent erections...so I got my eye on that!!

I am a former strength athlete so I know how to workout...could add cardio to my program.
* Stopped drinking last july to maximize my TRT program

  • no noticeable Gyno of feeling bad at all!!

  • I wonder if I have a cardiovascular issue from my previous powerlifting career??

But back to the point...what test or tests do I need to take to find out the tail of the tape as to why I still have weak erections!!!!!

Let me know what I need to do because I want fix this!! ASAP!!


There are WAY more things than T and E2 that play into erections. WAAAAAY more.


[quote]brentf13 wrote:
There are WAY more things than T and E2 that play into erections. WAAAAAY more.[/quote]

Yeah I don’t need viagra just bring me someone that makes me horny.

(11th time)


Abstaining from porn and transitioning back to “normal” relations is near impossible. You’ve burnt out the ability to get excited from normal activity and normal relations. Yours is a common problem. You have to wait it out.


Not impossible.

After months the brain will begin to rewire.


To each his own, but when I watch porn, I have way more sex with my wife.
For me, it stimulates my already TRT stimulated libido…I am 44, she is 33 and we bang min 5x per week.
If we weren’t so tired from jobs, businesses and our family it would be more.
Porn is great !

To the OP, looks like your E2 is creeping up on you, that right there will effect erection strength and libido.
Before I went all test crazy, I’d get that E2 down.
Are you using an AI at all ?


Thanks everyone for responses… Question now is where to take my complete Comprehensive male panel test at. I went to ANYTESTLAB and showed them what the C Male panel intels… and they said it would cost $1,635 dollars… I don’t know about all that!! So guys… just need to know where i can go to get the complete story of labs so you can diagnosed whats going on and what i need to do from that point on…

Let me know,


Read the lab, blood work sticky, there is a part about ordering a female panel and saving money etc.


Well…first course of action is to get a … Male Anti-Aging Ultimate w/Free (Direct) Testosterone… from Privatemdlabs.com

Here are the test specs:

Male Anti-Aging Ultimate w/Free (Direct) Testosterone

Description: The Male Ultimate Anti-Aging Panel is our Ultimate Anti-Aging Panel, with the addition of Ferritin, Prostate-Specific Antigen (PSA) test and includes Estradiol, Sensitive and Free (Direct) Testosterone. The Male Ultimate Anti-Aging Panel contains the following tests:

-Lipid Cholesterol Profile
-Complete Blood Count w/ Differential
-Estradiol, Sensitive
-Hemoglobin A1c
-Cardiac C-Reactive Protein test, High Sensitivity
-Insulin Growth Factor (igf-1)
-Thyroid-Stimulating Hormone (TSH)
-Gamma Glutamyl Transpeptidase (GGT)
-Insulin, Fasting
-Comprehensive Metabolic Panel
-Luteinizing Hormone(LH)
-Testosterone, Free (Direct), Serum With Total Testosterone
-Sex Hormone binding Globulin, Serum
-Urinalysis, Routine
-Follicle-Stimulating Hormone (FSH)
-Magnesium, Serum
-Thyroxine (T4) Free, Direct
-Ferritin, Serum
-Prostate-Specific Antigen (PSA)
-Iron Serum w/TIBC
-Dehydroepiandrosterone Sulfate (DHEA-S)

There will be no need for LH and FSH but I figure this will be a good start.


Think it would be a great idea if someone put together an Erections sticky. I know lots of guys who seem to be here for this reason alone, and sometimes it feels like TRT is only one component of restoring healthy erections. Like someone posted above, this can be wayyyyy complicated and sometimes it’s almost impossible to figure out.


And here are my labs 7 days after injection of 100mg test cyp every 7 days. I have already addressed my high Hematocrit levels by donating blood.

WBC 5.3 3.4-10.8 x10E3/uL MB
RBC 5.32 4.14-5.80 x10E6/uL
Hemoglobin 17.7 12.6-17.7 g/dL MB
Hematocrit 53.4 HIGH 37.5-51.0 % MB
MCV 100 HIGH 79-97 fL MB
MCH 33.3 HIGH 26.6-33.0 pg MB
MCHC 33.1 31.5-35.7 g/dL MB
RDW 13.8 12.3-15.4 % MB
Platelets 227 155-379 x10E3/uL MB
Neutrophils 61 40-74 % MB
Lymphs 31 14-46 % MB
Monocytes 5 4-12 % MB
Eos 2 0-5 % MB
Basos 1 0-3 % MB
Neutrophils 3.3 1.4-7.0 x10E3/uL MB
Lymphs(Absolute) 1.6 0.7-3.1 x10E3/uL MB
Monocytes(Absolute) 0.3 0.1-1.0 x10E3/uL MB
Eos (Absolute) 0.1 0.0-0.4 x10E3/uL

Baso (Absolute) 0.0 0.0-0.2 x10E3/uL MB
Immature Granulocytes 0 0-2 % MB
Immature Grans (Abs) 0.0 0.0-0.1 x10E3/uL MB
Comp. Metabolic Panel (14)
Glucose, Serum 76 65-99 mg/dL MB
BUN 19 6-20 mg/dL MB
Creatinine, Serum 1.22 0.76-1.27 mg/dL MB
eGFR If NonAfricn Am 78 >59 mL/min/1.73 MB
eGFR If Africn Am 90 >59 mL/min/1.73 MB
BUN/Creatinine Ratio 16 8-19 MB
Sodium, Serum 142 134-144 mmol/L MB
Potassium, Serum 4.7 3.5-5.2 mmol/L MB
Chloride, Serum 103 97-108 mmol/L MB
Carbon Dioxide, Total 26 19-28 mmol/L MB
Calcium, Serum 9.9 8.7-10.2 mg/dL MB
Protein, Total, Serum 7.1 6.0-8.5 g/dL MB
Albumin, Serum 4.6 3.5-5.5 g/dL MB
Globulin, Total 2.5 1.5-4.5 g/dL MB
A/G Ratio 1.8 1.1-2.5 MB
Bilirubin, Total 0.8 0.0-1.2 mg/dL MB
Alkaline Phosphatase, S 53 44-102 IU/L MB
AST (SGOT) 18 0-40 IU/L MB
1 of 3
ALT (SGPT) 13 0-44 IU/L

Urinalysis, Routine
Specific Gravity >=1.030 ABNORMAL 1.005-1.030 MB
pH 6.0 5.0-7.5 MB
Urine- Color Yellow Yellow MB
Appearance Clear Clear MB
WBC Esterase Negative Negative MB
Protein Trace Negative/Trace MB
Glucose Negative Negative MB
Ketones Trace ABNORMAL Negative MB
Occult Blood Negative Negative MB
Bilirubin Negative Negative MB
Urobilinogen,Semi-Qn 0.2 0.0-1.9 mg/dL MB
Nitrite, Urine Negative Negative MB
Microscopic Examination Comment MB

Lipid Panel
Cholesterol, Total 198 100-199 mg/dL MB
Triglycerides 71 0-149 mg/dL MB
HDL Cholesterol 51 >39 mg/dL MB
According to ATP-III Guidelines, HDL-C >59 mg/dL is considered a
negative risk factor for CHD.
VLDL Cholesterol Cal 14 5-40 mg/dL MB
LDL Cholesterol Calc 133 HIGH 0-99 mg/dL MB
Iron and TIBC
Iron Bind.Cap.(TIBC) 240 LOW 250-450 ug/dL MB
UIBC 114 LOW 150-375 ug/dL MB
Iron, Serum 126 40-155 ug/dL MB
Iron Saturation 53 15-55 % MB
Testosterone,Free and Total
Testosterone, Serum 791 348-1197 ng/dL MB
Free Testosterone(Direct) 23.7 8.7-25.1 pg/mL BN
Hemoglobin A1c
Hemoglobin A1c 5.1 4.8-5.6 % MB

Thyroxine (T4) Free, Direct, S
T4,Free(Direct) 1.31 0.82-1.77 ng/dL MB
DHEA-Sulfate 331.8 160.0-449.0 ug/dL MB

TSH 3.200 0.450-4.500 uIU/mL MB
Luteinizing Hormone(LH), S
LH <0.2 LOW 1.7-8.6 mIU/mL MB
FSH, Serum
FSH <0.2 LOW 1.5-12.4 mIU/mL MB

Prostate-Specific Ag, Serum
Prostate Specific Ag, Serum 0.8 0.0-4.0 ng/mL MB

Insulin-Like Growth Factor I 201 71-241 ng/mL BN
C-Reactive Protein, Cardiac
C-Reactive Protein, Cardiac 0.52 0.00-3.00 mg/L MB

Estradiol, Sensitive
Estradiol, Sensitive 14 3-70 pg/mL BN

GGT 13 0-65 IU/L MB
Magnesium, Serum
Magnesium, Serum 2.0 1.6-2.6 mg/dL MB
Insulin 4.5 2.6-24.9 uIU/mL MB
Ferritin, Serum
Ferritin, Serum 125 30-400 ng/mL MB
Sex Horm Binding Glob, Serum
Sex Horm Binding Glob, Serum 40.4 16.5-55.9 nmol/L MB


Your numbers look good.
Still the same issues ?

You got the sensitive e2 test, which shows you being too low.
In many cases, the sensitive test reads very low…and for our purposes
is misleading. I know Dr. Crisler insists on the sensitive test, but KSman (who has
way more credibility IMO) says to only use the std e2 test.

I’ve seen test results with samples drawn the same day
differ by 40pts from the sensitive to std e2 test, with the std test
score being more accurate based on symptoms.

Have you started an AI at all ?


No AI. I am taking 30mg zinc a day (Just started BTW). I figure if my Estradiol was 35 2 days after injection and 14 7 days after injection i am kinda on the low side like you said.

Went to Endo and Uro. Endo said with my TRT there should be nothing stopping me from having erections. Endo believed i had a vascular issue. so went to Uro… We talked about trimix and he was not cool with that.

My goal now is to research Prostaglandin E1 E2 and how to increase that naturally. This is key if my problem is vascular and not hormonal.


Here is an excerpt from another thread on T-Nation:

“I’ve tested both consistently since been on trt for 8 months and always get drastically different results.
I’d be crying everyday, moody ,holding water ,have elevated bp, and the standard panel would read
55H(7-42.6) while the sensitive panel 19(3-70).”

There are a very small amount of guys that can take Testosterone and not require
an AI, less than 1%. Forget about zinc, DIM, and all the other OTC methods
of controlling e2, none of them work (I’ve tried them all).

Get the std e2 panel, or try a low dose AI. At this point it’s a simple fix, and could solve your problem within
a week.


Your TSH is a problem. Please read the thyroid basics sticky and take your oral body temperatures a the specified times. Thyroid problems can be from a problem with the thyroid it self and/or from an iodine deficiency. If your body temperatures are low, that can be a factor with sexual performance as low thyroid function can have major effects on brain function.

Note that most of they symptoms of low T are common to the effects of low thyroid function. Thyroid function regulates body temperature by regulating mitochondrial function in your cells, which is really controlling your overall metabolic rate, which affects burning blood born cholesterol, fats and glucose. You cannot function properly if your thyroid function is bogus.

If you are not using iodized salt, you and everyone else in your home may be iodine deficient. If your body temps are low, check everyone else’s too.

Avoid iron fortified foods and vitamins. Read the labels.

You had E2=35 and that can affect libido, mood and energy. Your lower E2 at day 7 might not be representative as your E2 may be much higher earlier. Zinc is really not known to be very effective at controlling E2, however people want to believe otherwise. The exception would be the response when one was zinc deficient. When you get your levels steady [below], E2 may need an aromatase inhibitor to get near E2=22pg/ml which is thought to be near optimal for libido and energy.

If anything can wreck libido and sexual response, it is elevated E2. Your E2 peaks earlier in the week can leave many E2 receptors saturated with effects that linger even as E2 levels fall. And E2 affects brain function and lowering E2 when elevated will improve brain function over weeks 2-4. Your liver ALT/AST numbers are good from the prospect of E2 clearance by the liver.

Labs at day 7 are meaningless in some regards. Your levels are moving a lot during the week and the readings at day seven are just that. You need to inject at least twice a week so your T and E levels are not all over the place. If those are steady, then your labs reflect reality across time. Steadier levels will also improve brain function and sexual function is mostly brain activity.

CRP is not cardio specific as was once believed. Homocystine is. If you want to consider such things, your blood pressure is a key factor.

TRT typically can be expected to improve insulin sensitivity and reduce BP, as well as total cholesterol.

Do not let yourself become dehydrated for your fasting lab work.

Be sure to study the advice for new guys sticky as well as protocol for injections. In there you will seed that age, height, weight, waist size, body composition and body/facial hair are important info… and other things. Do not have T tunnel vision, consider other factors and events.

Labs at LEF.org are very affordable and available for most states. The basic male lab does not have LH/FSH and covers more than what you did. Routine urinalysis is not needed.

Please read all of the above carefully.


It is still possible your erectile problems may be due to estrogen levels. Some guys’ erections are very sensitive to estrogen levels for some reason. Perhaps not just E2 but other estrogens such as E1 and DHEA (which also hits certain estrogen receptors). Unfortunately there is no single E2 level that is optimal for everyone. It is very individual. The only way to fix the problem is often just trial and error.



Everyone is always saying high and low E2 have a lot of the same symptoms, what exactly does high E2 cause? Joint pain, brain fog, fatique etc?


As far as I can tell:

High E2 - weak or absent erections (even with Cialis/Viagra) but good libido and sensitivity, balls and penis hang tight/shrunken, anxiety and/or depression

Low E2 - joint pain, strong erections but weak libido and little sensitivity possibly causing difficulty orgasming, balls and penis hang loose and long


forgot to add. the estradiol of 35 was done 8 weeks after start with TRT @ 100mg test CYP E7D. The estradiol reading of 14 was done 5 months in on TRT @ 100mg test CYP E7D

Thanks for the info people… I will look into TSH stickies. Almost a year in on TRT and feel normal.

BTW… for my TRT I got ahold of HCG… and when on that for the first 2 weeks my erections were alive then died down after that believe Estrogen rising was the cause.

Maybe my body needs that hormonal pathway lite up…

The search continues… and thanks again.


[quote]KSman wrote:

If anything can wreck libido and sexual response, it is elevated E2. Your E2 peaks earlier in the week can leave many E2 receptors saturated with effects that linger even as E2 levels fall. And E2 affects brain function and lowering E2 when elevated will improve brain function over weeks 2-4. Your liver ALT/AST numbers are good from the prospect of E2 clearance by the liver.


This is BEYOND interesting. On trt at first i was controlling my e2 and was feeling great, than for whatever reason I let it raise up. after 2 month of letting it raise up, i tried arimidex again cause i was starting to get side. result was EVERY time i took arimidex , i felt shitty, but the estrogen side were going away.

after i while and not understanding why i was feeling now shitty on trt, idid a bloowork (the day before i took a good amount of arimidex)
the next norming and tested at e2=10, i didn’t felt better that day borderline worse. So i tough arimidex= feeling shitty and and let my e2 creep back up.

I know that estrogen act as a MAO-I, so i guess its why with high estro I felt OK but not great like the first week of trt(when controlling e2), and when I was taking and anti estrogen after being high estro for so long, i didnt had that mao-i effect anymore… but i didnt let myself the time to stabilise with normal estrogen level…

Maybe the solution what to let myself stabilise with normal estrogen level and would have after a while started to feel like the first week of trt again?

when you say"lowering E2 when elevated will improve brain function over weeks 2-4. " maybe i should off kept the e2 lowered a little longer.

cause i felt better pre trt than ON trt with highish estrogen…