T Nation

TRT + ED = Nightmare

Hey everyone,

Been on TRT for about 2 years now. 200ml/week test cyp divided into 2 doses (100 ea) every 3.5 days. Adex currently at about 1/8 per week (im an extreme over responder). I also take cialils 2.5 daily but when the hormones are in balance I dont even need it…and if not in balance the cialis doesn’t even work.

I had hoped it would cure my ED issues that I’ve had on some level since my 20’s. I’m in my early 40’s now.

Late 30’s is when I was diagnosed with low T and also when ED issues became rather serious.

When I took my 1st dose of T I immediately noticed a wonderful sense of well being within a couple hours and out of nowhere an erection showed up. I thought all was well again, and it indeed was for a few weeks until Estrogens started creeping up.

After that I started on adex and ever since then (approx 2 years) I’ve been chasing this elusive ‘window’ of hormonal balance. When things are balanced I feel like I have 10% of an orgasm just sitting around doing nothing. It’s like i’m 16 again. It’s a wonderful feeling and sex is fantastic when I’m in the ‘window’. Erections are right on and sensitivity is there. It’s exactly what I’m trying to achieve.

That’s unfortunately only a percentage of the time.

It’ seems I’m a hyper-over-responder to adex. I’m also an over-responder to the T because my E2 quickly raises and then the adex VERY quickly crashes it. I’ve been reducing the amount of adex over a long period and no matter what it seems like I still crash from it. When I take a week off of it to recover my E levels, it seems I quickly go too high because I feel myself pass into the ‘window’ from below and then the pleasant state disappears along with my ability to get/keep an erection and I have to assume I’m then going too high…

It seems as soon as I take another tiny dose of adex I’m quickly crashing again. It’s absolute insanity.

Also I live in a state where I’m not allowed to get online blood prescrips so I have ordered and then driven to the next state to get it drawn. Talk about a pain in the ass! By the time I get it checked and the lag period in between I’m already in or out of the window with no idea of which direction to go. Bloodwork every 3 months from doc is basically useless.

My doctor has been nice but I can tell he’s basically throwing his hands up at this point because he just wants my numbers to stay stable and be done with it.

It does seem that if I’m around that 22 e2 number I’m in balance and life is good. The trouble is finding some kind of adex dose that keeps me floating tightly around that spot. If I go over 30 then its ED and If I go under 20 it’s ED.

Any suggestions? Should I switch to aromasin? Should I try dosing T daily? I’m getting desperate here because I keep getting teased with this ‘window’ and I want it to stay.

Did you ever not take an ai and wait 2 months with just testosterone injections? Waiting is the hard part

You need to give your body time to find it’s e2 level.

Trust me I chased e2 =22 with ai and it was a rollercoaster. Any bit of ai crashed it. I stopped ai and it solved the problem.

I would stop ai lower t dose to 150mg split in 2. Wait 2 months and see how you feel. Do labs.

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You should post your relevant labs because your dosage could be excessive then creating E2 problems. It sounds like your only hope to control E2 in more frequent smaller injections, this will minimize E2 spikes. You’ll never stay in the sweat spot if an over-responder.

If daliy T injections doesn’t work, I doubt anything will. If you over-respond to anastrozole, then it probably means you over-respond to medications in general and aromasin will be no different.

I cannot even tolerate a small pinch of powder of anastrozole or aromasin.


I’m on 185mg/week IM EOD w/ no AI (recently started taking tamoxifen but for a different reason) and had side effects but at about the 2.5 month mark they subsided and I feel normal. Dick works like an 18 yr old and I’m on medication that before trt made me have zero sex drive. The advice given by the posters above is legit. Try dropping the AI and get through the next 8 weeks. They’ll go by fast. Then adjust your T dose of needed.

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Dump AI, get your protocol in order. Lower dose if necessary. Highest priority is NOT using an AI.

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Yes when I first went on TRT I was good without AI for maybe a month or so and then had ED issues again. That’s when I got bloodwork dont and E2 was up over 60. After that I went on adex and I’ve been chasing my tail ever since. The problem is I feel like I’m so damn close right now to the sweet spot but just can’t stay in it.

A couple of months ago too I had my own blood draw in the next state over and E2 was in the teens so I went off of AI for about 10 days and sure enough during those 10 days i passed right through the sweet spot and went too high because got another blood work done that showed E2 in the low 30s.

Thanks for posting, at this point I’m taking so little of the AI anyway that’s probably the best solution.

Yeah might just have to do that thanks for the reply.

Yeah that sounds like me at the moment. I’m taking adex about the size of a grain of sand and I THINK it’s still pushing me too low. I feel so close though it’s driving me nuts. It’s impossible to keep making the drive across state lines to get blood drawn every time and then like i said the lag time in between getting the results I’m already swung one way or the other again. Maybe I will try lower dose of T a little and inject every other day to see what that does.

Big thanks guys!

Here is my advice if you want to take it.
Been in your exact same situation, i actually had to come off TRT for a year just because i wasn’t able to dial it in.

F**k Ai, it will not work for people who over respond to it like us.

So what to do ? You need to prevent as much T to E conversion.
1- split your dose even further , i do EOD injections now and it works great
2- switch from IM to SubQ injections: abdominal fat slows down the absorption of T so you get less spikes which result in less E, plus the insulin injections are almost painless :slight_smile:)
3- finally cut down alcohol as much as u could, specifically beer and lose weight .

Good luck

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Adex is too strong for you. You could try switching to aromasin, or you could try weaker OTC stuff like DIM or Zinc, or even hot lemon water. You aromatise too well. Some guys will say that means you’re too fat, but the truth is that there is a wide variance in natural levels of the aromatase enzyme and you could just naturally have a lot of it, the same as it’s possible to not produce it at all.


Thank you for posting. Yeah I think I’m seeing the answer after reading everyone’s input. I think I’ll reduce T amount and stop the AI, and go from twice per week to every other day. I did recently switch to subQ and although I’m not ripped I am in good shape and llift and do cardio multiple times per week. Much appreciated.

Yeah adex seems to be way too strong for me although there was a period during last christmas holiday where I seemed to be in balance perfectle for about 2 weeks straight and I was taking much more AI than I am now. Maybe I’m just aromatizing less and don’t need as much now? Not sure but I think it’s time to ditch the adex anyway based on the feedback.

Just to share my own similar experiences: Each time I increased T dosage frequency, I felt better. Went from E7D, to E3.5D, to EOD, to ED. It causes a decrease in E2 conversion due to less excess, aromatizable testosterone present in the body at any given time (particularly post injection). Splitting 200mg into more frequent dosing, and then lowering my dose from there really helped me to get estrogen in control. I still use an AI but I think you could probably get away without one. But in your case, I think switching to EOD or an ED injection protocol would help!


Excellent thank you!

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Yea good luck,
Also the EOD along with SubQ usually results in higher T then the once or twice a week IM injections. You may do very well on a total of 120mg T / week. Start slow and increase if needed. Trust me More is not always better in this case . Finally give yourself at least 4 weeks ( 6 is preferable) between switching from one protocol to another, and get Blood work done. I understand you live in a fuck up state but it is only temporarily until you find your sweet spot. Again good luck

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Very good to know:+1:

You didnt go through a sweet spot. If You drop the ai and let your body adjust that will be your sweet spot. Going no ai your first month of TRT is not considered trying no AI. Your levels hadnt even peaked at that point. You need to give your body proper time to adjust. Im somewhere in the 50-60 range and feel great.

This one is simple. Drop the AI immediately. Give it several weeks and just be patient. You’re already giving yourself a decent dose. When you first started you felt good for the first month because you were adding testosterone to your natural production. But when your natural production became suppress, your natural levels dropped. You need to take only the testosterone and absolutely nothing else of any sorts. Give it several weeks and then assess. If after four weeks you are still not feeling great you can bump up your dose a little bit and give it another four to six weeks. I absolutely promise you if you do it this way you will get better. It would definitely help if you provided your Labs so we could see what levels your free T are at using your current protocol.


Thanks for your input!

I will be able to get a copy of last bloodwork from doctor which was a couple of months ago or so. Will upload sometime this weekend and if anyone wants to take a look it’ll be there. The only thing is that I’m pretty sure that when I got that bw I was feeling in balance and everything was functioning properly.

I often do feel in balance and everything is great but then it’s just gone.

Not sure what the other posters have said but this is my advice: drop the AI, wait 6 weeks, if the symptoms aren’t better reduce your dosage by 50mg per week. Wait AT LeAST 6 weeks, if you still hav symptoms I would reduce another 25-50. Doing this will hopefully get your e2 low enough to not need an AI.
If all fails you could try more frequent injections. At this point it’s most likely going to be trial and error. Remember whenever changing your protocol wait atleast 6 weeks for things to normalize.

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This is absolutely incorrect. Unless you free T levels are in the stratosphere you do not lower your dose when you have symptoms, you raise them. You don’t need to get your E2 “low enough”. E2 is what gives you libido, erections, cardio vascular health, cognition, and on and on and on. You never touch E2 and raise T until symptoms resolve.