T Nation

TRT Libido Problems


Hey all,

Long time lurker here in attempts to dial in TRT. I have been on it for about 8 months so far with varying results. Every facet of my life other than libido has increased substantially. I take 125mgs once a week (which is now going to be changing with the newer recomendations from here for the 2x a week subq). I also take aromasin 12.5mg ed, and HCG eod @ 200iu.

My desire for sex is non existent as well as my erections at times. I haven’t had prominent morning erections during pretty much the entire time I’ve been on TRT. Sometimes they will show up, but they aren’t strong or long lasting. The only time I have had strong morning erections is when I take cialis. I feel like this whole TRT thing is a giant roller coaster. Sometimes I feel good, other times I feel terrible with doing the same exact protocol week in and week out. But, even when I feel good I don’t have a normal sex drive, its just my erections are back to normal.

Here are my most recent blood results:

CBC With Differential/Platelet
WBC 5.3 3.4-10.8 x10E3/uL 01
RBC 5.77 4.14-5.80 x10E6/uL 01
Hemoglobin 17.8 HIGH 12.6-17.7 g/dL 01
Hematocrit 50.7 37.5-51.0 % 01
MCV 88 79-97 fL 01
MCH 30.8 26.6-33.0 pg 01
MCHC 35.1 31.5-35.7 g/dL 01
RDW 12.8 12.3-15.4 % 01
Platelets 278 150-379 x10E3/uL 01
Neutrophils 51 % 01
Lymphs 36 % 01
Monocytes 10 % 01
Eos 2 % 01
Basos 1 % 01
Neutrophils (Absolute) 2.8 1.4-7.0 x10E3/uL 01
Lymphs (Absolute) 1.9 0.7-3.1 x10E3/uL 01
Monocytes(Absolute) 0.5 0.1-0.9 x10E3/uL 01
Eos (Absolute) 0.1 0.0-0.4 x10E3/uL 01
Baso (Absolute) 0.0 0.0-0.2 x10E3/uL 01
Immature Granulocytes 0 % 01
Immature Grans (Abs) 0.0 0.0-0.1 x10E3/uL 01
Comp. Metabolic Panel (14)
Glucose, Serum 59 LOW 65-99 mg/dL 01
BUN 12 6-20 mg/dL 01
Creatinine, Serum 1.01 0.76-1.27 mg/dL 01
eGFR If NonAfricn Am 100 >59 mL/min/1.73 01
eGFR If Africn Am 116 >59 mL/min/1.73 01
BUN/Creatinine Ratio 12 8-19 01
Sodium, Serum 141 134-144 mmol/L 01
Potassium, Serum 4.4 3.5-5.2 mmol/L 01
Chloride, Serum 99 96-106 mmol/L 01
Carbon Dioxide, Total 25 18-29 mmol/L 01
Calcium, Serum 10.0 8.7-10.2 mg/dL 01
Protein, Total, Serum 7.3 6.0-8.5 g/dL 01
Albumin, Serum 5.0 3.5-5.5 g/dL 01
Globulin, Total 2.3 1.5-4.5 g/dL 01
A/G Ratio 2.2 1.1-2.5 01

Bilirubin, Total 0.8 0.0-1.2 mg/dL 01
Alkaline Phosphatase, S 79 39-117 IU/L 01
AST (SGOT) 19 0-40 IU/L 01
ALT (SGPT) 24 0-44 IU/L 01

Lipid Panel
1 of 2
Cholesterol, Total 165 100-199 mg/dL 01
Triglycerides 65 0-149 mg/dL 01
HDL Cholesterol 44 >39 mg/dL 01
VLDL Cholesterol Cal 13 5-40 mg/dL 01
LDL Cholesterol Calc 108 HIGH 0-99 mg/dL 01

Thyroid Panel With TSH
TSH 1.080 0.450-4.500 uIU/mL 01
Thyroxine (T4) 7.9 4.5-12.0 ug/dL 01
T3 Uptake 29 24-39 % 01
Free Thyroxine Index 2.3 1.2-4.9 01

Testosterone, Free/Tot Equilib
Testosterone, Serum 550 348-1197 ng/dL 01

Testosterone,Free 18.86 5.00-21.00 ng/dL 02
% Free Testosterone 3.43 1.50-4.20 % 02

Prostate-Specific Ag, Serum
Prostate Specific Ag, Serum 1.1 0.0-4.0 ng/mL 01

Estradiol, Sensitive
Estradiol, Sensitive 4.9 LOW 8.0-35.0 pg/mL 02


The e2 level was mind blowing to me. The day of the test I felt like I described above, however days after I had normal erections again. ETA, usually in the past my e2 levels have been high, so the extreme low e2 was odd to me. I’m basically just here, like the rest of you looking for answers. I know the answer with these test results are to dial back on the aromasin quite a bit. I just never feel like this whole process is steady. Which is odd to me because back in the day I used to abuse anabolics and never had so many issues with E2 levels.


I’ll tell you what I did. Right or wrong it has been working for me. I went from very high e2 to very low and it scared the hell out of me. I inject test twice per week, hcg 500 iu twice per week and 1/10 of a 1mg adex twice per week. If I feel tired no drive and especially if my right nip starts to get sensitive I know my e2 is getting high. I dose 1/20 adex and give it a day. No lab tests just listening to my body. Slowly lower your e2. You’ll know when your balanced because everything will feel right. Just remind yourself it’s going to take some time. Just my 2 cents.


It is better to test fT4 amd fT3 and not those methods that are not obsolete now that direct measurements are available.

TT and FT results with weekly injections are determined mostly by lab timing. Injecting twice a week and always testing half way between injections will be most useful.

Low E2 wrecks libido for sure. Try reducing aromasin to 6.25mg EOD and test E2 again in 4 weeks. You should feel a change. Speed things up by skipping 4 days of aromasin.

Your post needs more data, such as age, height, weight, waist size, other health issues, etc.

Please also check body temps as per the last paragraph in this post to eval overall thyroid function.

Please read the stickies found here: About the T Replacement Category

  • advice for new guys
  • things that damage your hormones
  • protocol for injections
  • finding a TRT doc

Evaluate your overall thyroid function by checking oral body temperatures as per the thyroid basics sticky. Thyroid hormone fT3 is what gets the job done and it regulates mitochondrial activity, the source of ATP which is the universal currency of cellular energy. This is part of the body’s temperature control loop. This can get messed up if you are iodine deficient. In many countries, you need to be using iodized salt. Other countries add iodine to dairy or bread.


Just the man I was hoping for… lol.

I’m 30, 6’5" and 240lbs. Waist is 37.75 around belly button.

ETA - further info
Health issues - former accutane user, occasional hypertension and anabolic steroid abuser.
Facial hair and body hair - both strong
Carry fat around mid section
No hair loss drugs as I have a very full head of hair
Diet can be lacking in amounts at times. Generally eat oatmeal, protein shakes in the morning, meat and rice all other times. Adding in more greens as that is my weakness. I also like my cheat meals, pizza etc.
Training - cardio usually 1-2x per week for 20 mins or so and lifting 3-5 times a week for about an hour
Testes ached prior to adding in HCG
Morning erections like I said earlier are not strong and don’t last very long.

I’m going to increase frequency of injections this week, so I will see.

I will also test the temps for thyroid.

Is 4 weeks the general timeline in which retests for E2 are ordered?

Thanks ksman!


Oddly enough I can relate to your issue, I did a lot of supps for a long time and never once needed an anti estrogen. Now all of the sudden I feel like my hormones (or whats left of them) are always up and down with no rhyme or reason. My research has led me to find a few interesting things, number one adrenal glads that are extremely weak can play a role in hormonal balance, and also look into estrogen dominance when progesterone is low. Its worth reading up on to see if it clicks. Sometimes people forget your adrenals and thyroid are just as critical as your testosterone levels. Also for reference if you check your thyroid make sure to get reverse T3 levels checked. One last thing, a lot of people that dont respond too well to trt get really good libido response out of proviron or if youre willing to get back to the AAS days, masteron.

Thats just my .02 hopefully you find it useful.


Ive thought about it man, but nowadays I’m less interested in physique and more interested in just feeling normal again! Even when a good erection happens for me it can take forever for it to actually occur.


Just a Q as well, what made you jump to thyroid function?


Well a lot of people think T related problems are only test estrogen issues, a dysfunctional thyroid is very possible. Even if your thyroid works well, if you have high reverse T3 thats basically your body hitting the brakes on thyroid thus causing issues, The body is a system and looking in all directions is the best approach. Reason I mentioned proviron and mast is because they are both DHT drugs that dont convert to E and are notorious for increasing sex drive and erections. As long as its high quality stuff obviously.


Getting ‘normal’ thyroid lab results simply means that your doc cannot conceive that anything needs to be considered and that is the typical end of story. - WRONG