T Nation

TRT, Need Encouragement

Okay so for about 2 to 3 years I was battling low energy, low libido and poor erectile function. The erectile dysfunction is what finally nailed it for me. After treating “symptoms” with viagra and Cialis I finally went last month (June, 2015) and had my T levels checked, sure enough my T was low (211). I am a fit, very active, 41 year old male by the way. I’m not sure how seriously the Endo here is taking this. He put me on 200mg of Cypionate by injection, I felt great for a week (no improvement in ED), but i had more energy and could focus, then it started to fizzle again, went back about 10 days later and my test was higher (368) but still low, but he refused to give me my next injection early. I waited it out and went for my next pin 3 weeks later (another cypionate 200mg injection). The energy levels are better but still little to no effect on libido/erections.

Being the man’s man I always was my sex life is VERY important to me. The inability to perform is destroying my self confidence and my relationship. Am I expecting to much to soon? is the doc not giving me enough to make a difference (i have read a lot and it seems like 200 cypionate at 3 week intervals is pretty weak)…Help guys!!! am I losing my mind or what!!!

Please read these stickies, then come back with your labs posted with ranges; and other info.

  • advice for new guys
    — note the first paragraph, many here have low thyroid function and many from not using iodized salt
  • things that damage your hormones
  • protocol for injections
  • finding a TRT doc

Your endo should have checked LH/FSH before doing TRT.
200mg T every three weeks is totally stupid and your endo is an idiot [typical].
And that is why you are not doing well.

You should:

  • self inject 50mg T cyp twice per week [use #29 1/2" 50iu insulin syringes] [SC or IM if SC not tolerated]
  • inject 250iu hCG EOD SC [so testes do not shrink or ache]
  • 0.5mg anastrozole at time of T injections

Your low T should be treated as a symptom and then you try to find the cause and fit that if possible.

Many here have thyroid problems, often from not using iodized salt.


Read these, highlight the portions that pertain to you, specifically feeling worse prior to your second injection. Higher doses injected less frequently cause large peaks and then valleys. A more therapeutic approach is a smaller dose more frequently as KSman suggested.

Print those documents and show them to your endo, letting him know that you initially felt better but much worse after the first week concluded and that you’d prefer a smaller dose around 100 mg more frequently, once per week and that you’d like to self inject, in which case you can inject 50 mg twice per week. You may also eventually want to bring up hcg and an aromatase inhibitor.

If your dr won’t work with you, let him know you’ll leave. If it comes to that call compounding pharmacies in your area and ask them for references of Dr’s wh prescribe test cyp, hcg etc. Good luck.

Thank you for the response. He did perform the tests you mentioned prior to placing me on TRT, all my tests came back completely normal, then he preceeded to place me on TRT. I have had a hard time convincing him that I need test at more frequent doses. Beginning to wonder if i could just get the perscrip from my G.P. and dose myself. I guess maybe he thinks he wants to bring my levels up slowly, but what good does it do if, by the next injection my numbers have already plummeted back down? No building can occur because it’s always playing catch up.

You should find a new doc who will work with you on dialing in treatment. A lot of guys don’t get any erection boost from regular T injections until they bring anastrazole into the mix. Adding an AI brought back great erections for me, so might be worth trying in your case.

You need to gain a greater understanding of the effects of TRT. First the benefits of TRT are progressive, some things take longer to than others. Any dose of T every 2 weeks doesn’t work well. Even the higher doses will cause too deep of a troth to feel good. Also with a big T shot (200mg) you could have more issues with aromatization. (T converts to estrogen specifically Estradiol E2) If your E2 goes up you will still suffer with ED, low libido, and a rash of other issues. Your Dr should inject once a week (65mg a week)would basically be the same dose he has you on but your levels will be more steady, also less TtoE2 conversion. Many men do not need A-dex or any AI (aromatase inhibitor).

Guys with higher body fat usually have more conversion issues. I’ve been on TRT 14 months. figure on 3-6 months to dial your sweet spot in, to maximize benefits while minimizing side effects. Read the stickys they will save you a lot. I’ve done injections every 2 weeks, then one a week and then 2 a week (pretty perfect). I convert like crazy and need a ton of A-dex. I now am trying to inject 60mg (.30ml) test Cyp EOD subcutaneous and with 3mg adex a week I’m hitting both perfect, blood work and feel great. I have ed issues and they did not improve with TRT, Libido did… but took 12-16 weeks. But now after a year libido is crazy and ED has improved but I still need medication. Morning wood I can carve marble but I have venous leakage so TRT doesn’t help. You prob. need a new Dr. If its a GP make sure you find one that understands male hormone replacement.

@jimp4155 ; Is there no way to correct Venous leakage?