T Nation

Very Bad Sexual Dysfunction Issues Despite Ok Levels on TRT


Can someone please help me out, what is going on is despite having seemingly ok levels in everything, i have had some very bad issues with ED and so forth, where even cialis and stuff doesnt really help enough to get the job done, therefore im basically perma-single and its basically making me want to kill myself at times

Note: Since i first started on TRT doing twice a week injections i came up with a horrible case of low SHBG, where it was like in the tiny single digits, ever since i have switched to EOD and now daily injections, my SHBG has been hovering around 19-23… however, i think i have been boosting it by taking 5 mg of Novladex 2 x a week, very small dose… recently i have tried stopping novla and i came back with an SHBG of 10, although i cant say for sure its the novla because i think i havent taken it for times before and i never had it come back that low so it it may have been a freak test, never the less, my SHBG has been around the low 20s, which is not terrible but not ideal, and not clinically “low”, but clearly ive had a few issues with it at some times, despite honestly feeling no different with an SHBG of 8 or 25

every day IM injections now, i have tried both cypionate and prop

get bouts of low libido and ED, whats strange though, is that despite making no changes to my protocol, i get periods, sometimes as long as a month, most recently 1.5 months, sometimes a few weeks, sometimes a few days, etc… where my function and libido goes up and starts “working” to a decent extent significantly. and then again, despite no changes in protocol, and no changes in lab results like E2, Total T, Free T or SHBG, (total t, free t, shbg stayed around the same T 800, FT 23 (2.9%), 22 shbg) same levels at the peak best time and lowest worst time

I NEVER have morning wood, EXCEPT for when i drop my dosage, then it comes for about 1 week, then goes away again, only time i had it consistent my total t was dropped to 450, but sexual function was shit otherwise, also taking an AI doesnt bring it back either

I think i get a bit more gyno like look during bad times than good times, but AI doesnt help my symptoms

Total T and Free T:
(Most recent, low shbg for some reason, )
T: 696, Ft 26.3 ( 3.7%) (SHBG calculated as 8 on Free T calculator based on Albumin 4.1)
(Typical of most tests i have ever gotten otherwise pretty much ever, since a month ago and before, i have tests almost every 2 months as follow ups for last 2 years)
T: 917 Ft 26.4 (2.88%) (SHBG calculated as 24 on Free T calculator)

SHBG: ranging around 19-22 , often taking novla 5mg 2x week, but i think sometimes not, had one test of the lowest range ever last week but really felt no different either way

E2 sensitive: Seems to bounce around between about 32-40, a bit high, but taking AI only seems to make things worse, and people told me its not that high

Prolactin: 8 (range 4-15)

DHEA - S: 254.1 (range 138-475) started taking 25mg DHEA daily after this, seems to do nothing

DHT: 50 (range 30-85) taken last year while on cypionate EOD injections, similar numbers as above , 19 SHBG

Free T3 thyroid : 4.0 (range 2.0-4.4)

TSH thyroid: 2.17 (range 0.45-4.5)

A1C (diabetes test) 5.1 = normal

I am honestly at a loss as to what could be causing these issues and wild fluctuations, other than a couple of very low SHBG results, all the other times i have gotten many many tests done of free t and t ratios over the last 2 years my SHBG has always hovered around 20-25 and i have never felt better,

again, despite having identical Total T, Free T, and SHBG numbers from one month to the next, my symptoms fluctuated from things going well and me thinking “hey i may have this fixed” to after 1 month total crash and burn massive ED zero libido, etc…

I just wonder, is there anything else i should test? what could cause these huge fluctuations ? also there is no consistency to them, i could be doing better for a day, or a month and a half, then i could fall off totally for a week, or 4 months at any given day…

Sometimes Nolva. Sometimes not. Sometimes AI. Sometimes not.

You’re all over the map here brother. What is the most consistent protocol you have stuck to and how long did you stick to it without changing ANYTHING (and this doesn’t mean just changing test dose)? Without changing the sometimes nolva / sometimes AI / injection frequency deviations?

I can not begin to imagine that.