Great forum and have enjoyed reading about all your expert opinions. Before I go into my story, a little about myself to give some context;
33 year old male
5 ft 7"
Circa 16-18% BF
BP - normally around 125/80ish
Training - Bodybuilding type training - 4 x weight sessions per week / 2 x light 20min cardio sessions
Nutrition - Again bodybuilding style nutrition - 4/5 meals per day - Carbs - between 300 - 500g per day (depending on goals) - Protein 220g per day - Fats 70g per day
Now for my story…
Life was going well until I hit 30/31 and this is when my symptoms started. Libido nosedived, I was extremely tired after the gym but the main thing I noticed was a complete decline in erectile function. No nocturnal activity, and when the time came for it to be used I either experienced no activity or I was able to get one with much work, however the quality of the erection was way off.
Long story short the journey led me to my primary care dr who wanted to see my hormone panel. Bloods came back 3 times with Total/Free T and E2 on the floor. My total was 6nmol (6-29nmol), and my free 0.2nmol (0.2 - 0.6). After much too-ing and throw-ing I eventually started my TRT journey in Jan 2019.
Now I am at a loss, as we are now 2 years down the line and the quality of my sexual function has not improved in the slightest. I can get one if I really try, however this takes a lot of work and the quality is just not right and not where it needs to be. I am constantly trying to work with 60/70% function which I struggle to maintain. This is regardless of whether with my partner, alone or nocturnal.
My Dr and I have made so many protocol tweaks during these 2 years to try and get it to work, but to no avail. I cant list them all as there are so many! But the gist of things we have tried over the 2 years are…
Testosterone Cyp - Range of dose from 70mg to 125mg weekly - Tried daily and EOD administration
HCG with and without
AI with and without
Transcrotal cream with and without
We typically make a change, wait 6/8 weeks or so and have bloods, it doesnt make a difference with symptoms and then we try another tweak - this has been going on for 2 years now.
so as of 1 year ago I decided to go back to basics, drop the HCG and everything else and try and just dial in T. I tried 115/125mg a week, nothing else and let it run for 3 months. Erectile function was awful. I ran labs and everything was over range Total T 40nmol (6-29nmol), Free T 1.5 (0.2-0.6) and E2 260pmol (59-159). So we dropped everything down to 105mg a week and added in 50mg Proviron daily, to see if my issues would improve with a DHT boost.
I ran this for 2 months (no improvement in symptoms) and went for blood work, this is my latest set of bloods on the following protocol;
105mg Test Cyp via daily administration
5mg Tadalafil daily
Total T - 27nmol (8 - 29)
Free T - 0.6nmol (0.2 - 0.6)
E2 - 185pmol (41 - 159)
DHT - 2.34nmol (1.14 - 4.13)
SHBG - 26nmol (18 - 54)
Prolactin - 165 (86 - 324)
Everything looked good, with the exception of the skewed Test to E2 ratio, so suggest micro dosing Aromasin at 1mg E3D to bring E2 back into a more favorable ratio to Testosterone. I have been on this for 4 weeks now, and at this present moment in time there have been no improvements.
Other lifestyle factors, as you can see I am active with a bodybuilding style training plan. Sleep is good, limited alcohol and no smoking or recreational drug use (that got binned many years ago!).
I am at a loss now as to what to do or try, I have probably made 20 protocol adjustments over the past 2 years with no avail and I really am started to get desperate now, I cannot continue like this it is all encompassing and it feels like this has ruled my life for over 2 years now. I’m not looking to be superman, I just want to be strong, healthy and above all, happy.
My Dr has mentioned it may be worth trying Bupropion next, I’m not sure why or how this would help erections, but I feel like it may be a case of throwing stuff at a wall and seeing if something sticks.
If anyone could shed some light on this or offer some help, I would really appreciate it.
Thank you anyone for your time in reading this.