43-year-old male. 6’4" and 180 lbs. Not overweight, generally lean, low blood pressure, and no known health issues. Not on any medication, but occasionally use ED drugs. I have the following history of symptoms:
Libido: noticed it starting to diminish in late 30s, now it’s pretty much gone. I have no desire to initiate sex, ever.
ED: also noticed this starting to occur in late 30s, but wasn’t too bad at first but it has become much worse over time. Now, if my girlfriend initiates sex, I can perform if I’ve prepared with Cialis, but it’s a crap shoot. If I’m able to perform without drugs, which might not happen at all, maintaining the erection is a challenge, and sometimes I just focus on making sure the lady is taken care of and then give up rather than try to maintain until completion. I NEVER get morning wood or spontaneous erections. It’s been years since either of those have happened.
Sleep issues: this has been a growing problem over the past few years. I’m able to reduce severity, but not entirely cure, if I really focus on good sleep hygiene.
Depression: I definitely have it. Probably mild Major Depressive Disorder. I’ve tended towards the depressive side my whole life. It’s MUCH better than it was in my 20s, and I have learned how to cope with exercise and lifestyle habits so I wouldn’t have to resort to medication, but my girlfriend and others often comment on me being grumpy.
Mental clarity and memory: I can tell I’m not as sharp as I used to be but I’m sure that happens with age. My memory used to be 100% solid, but it’s definitely not what it used to be. I’m not forgetting where I live or anything, but I don’t recall conversations and details as well as I used to.
Honestly, if not for the sex issues, I would just deal with everything else.
I got tested when i was 40 and the above issues were starting to bother me. Total T came back at 760 so i obviously wasn’t a TRT candidate. I even saw a urologist, who prescribed Trimix, which works really well for the ED, but who wants to have to stick a needle in their dick anytime they want to have sex?
Now, at 43, all the symptoms are worse, so I got tested again (twice in the last week actually). First test was just Total T and second test was full panel. I’m including labs, but the gist is:
Total T: first test was 523, second test was 576 (264-916)
Free T: 7.5 (6.8-21.5)
Estradiol: 29.2 (7.6-42.6)
Doc at the T clinic said that even though Total T was in the mid-normal range, because free T is at the bottom of the desired range, he’d like to see me with total T over 700 at least and free T much higher than it currently is. He’s recommending the usual 100mg a week. What are your thoughts?
Thanks in advance.