T Nation

Weak Erections and ED


About 3 and a half months ago I got a script from a D.O. for Testosterone Cypionate. I am not really killing it, just 100mg IM/week, but I felt I needed a little something cause I was spinning my wheels in the gym and also getting hurt. My free test was on the low end of normal 139, and my Estadiol was on the high end of normal.

He told me to just try the test and we would check my levels later to see if I needed to get on Anastrozole. I did not get my levels checked yet, but you can bet your ass that I am going in to get them checked tomorrow after a couple of recent issues I have had. Even with masturbation my erections are rather week. I was on Finasteride, but once I noticed the problems I was having I got off it quick.

They are persisting, and I'm wondering if my bodies natural tendency to have test on the low side of normal and E on the high side of normal is the real culprit. If I can't figure this out I am going to have to get off this stuff asap, which would be a shame, because at 35 I am bigger and stronger than I have ever been in my life. Before this keeping it down was my problem...not so much anymore.

Help please. By the way I am new, so if this has been addressed already in another section I am sorry for the trouble.


Hey there, welcome to the board.

Best suggestion is to read through the other stickies and scan the other threads. Your situation is EXTREMELY common and already addressed (for the most part) in the stickies. Just read those protocols and then let us know if you have any questions, comments, or concerns.


Thanks PureChance, I will check them out. It would make me feel a little better to at least know that I'm on the right track with my thought process as I seriously need to get this straightened out. This may seem like a rather stupid question , but where do I find the stickys? I have never been on any forum before at all.


all of the posts at the top of this forum have a yellow 'sticky note pad' icon next to them. That means that they are stuck to the top of the forum and can not be bumped down by other posts. once you have read all of the sticky posts, I would recommend reading through as many other threads/topics within this forum - there are gems of great information scattered throughout.

Also there are no stupid questions (only stupid doctors).


Okay, so I checked out a little more in the forums and have found that I am not the only one who has suffered from this problem. But here is my question; my dosage is so low, that I would think I shouldn't be having this problem. Then again I think that maybe because my dosage is so low I am more susceptible to problems with even the slightest changes in my Estradiol, because there is not enough test in my dosage to counterbalance it out.

I just went back and checked my #s and my total test was 813, free test was 1.37, and E was at 54 before I started the cyp. My feeling is I may be in dire need of Anastrozole as I'm sure it is well above that now, and it seems to be the feeling of most that their libido was in much better shape when they were in the 30 range.

Since I am so new, even though I have read what others have to say about themselves and or their friends experiences it would be helpful to know if those with more experience than me agree with my analysis of this, as I can tell you this shit sucks.


yeah... it is freaking amazing how many doctors are idiots.... it seems like every new poster just reconfirms this fact over and over again...

so your Total T was at 813 (without external medication).... and the doctor figured he can fix your issues by adding in even more T?!?! let's ignore you're at 200% of ideal Estradiol, let's ignore other possible complications such as Thyroid, Vitamin D, Cortisol, DHEA, Pregnenelone, Ferritin, etc. etc. etc.

My guess would be that your E2 is too high (22 is ideal) which is driving up your SHBG which is driving down your Free T, but there are other possible causes.

Simply starting Arimidex may have fixed all of your problems, but now that you are on T-Cyp shots, I don't know. being on shots for 3.5 months - I have no idea what that has done.

are you on anything else?

do you have any other blood test results?


My test results are below. I was actually of the same mind as you about the Arimidex in the beginning. I took the test cause I figured heck, test is good for getting strong and I figured the only thing I had to worry about was the gyno, and I could just take the Arimidex if I started getting BTs.

I wasn't thinking about my dick, which is odd because I think about it and with it for just about everything else. Thanks for your help thus far PureChance, its very much appreciated. I am not on anything else and I don't know what SHBG is. On my way to the lab now for a blood draw.

25 HydroxyVitamin D - 41.6

TSH -1.638

CBC - normal . Hemoglobin - 15.6, Hematocrit - 44.0

IGF-1 - 139 ( range 115 - 307)

Estradiol - 53 ( normal range 5 - 54)

DHEA- S - 338

Total Testosterone - 813 (range 241 - 850)

Free Testosterone 1.37 ( range 0.62 - 2.81)

PSA 0.79


D is low (70-100 is ideal per doctors I trust) - did you start on Vit D supplements?

TSH looks mildly high (.5 is ideal for men - ditto above reason) You may want to ask for free T4 and free T3.

IGF looks mildly low - other imbalances could be driving this lower.

DHEA looks mildly low - did you start on DHEA supplements (25-50mg)

Estradiol is wayyyy out of range.

what are they testing for? are you asking for ferritin, cortisol (8am blood draws are best), SHBG, etc.?


Okay so looks like I need to get on D and DHEA supplement. Check
Free T4 and T3, this is part of the blood test I'm assuming
How do I change my TSH IGF.
my script says to test for Total T, Free T, and E.
So you're saying in addition to this I should ask them to test for T4, T3, ferritin, cortisol, and SHBG.

Looks like I have some more homework to do.


never assume anything. most doctors don't even know that they can test for half of the things you need.

does E = Estradiol? some doctors just run total estrogen which is useless. there is a particular test you need a code to use to confirm the right one.

Per the blood test sticky: For TRT, use the basic LabCorp serum E2 test or Quest Sensitive 4021x. DO NOT USE Quest ULTRASENTIVE! There are some similar issues with other testing labs as well.

If your Thyroid is off (which means suboptimal free t4 and free t3), the you probably will need Armour or Naturoid.

IGF = growth hormone = extremely expensive IF you can get it treated. best to focus on your other issues and keep an eye on this value. if you try everything else and still feel like crap, then maybe look back at IGF.

there is a sticky on suggested blood tests. look at that and compare vs what the doctor order on your paperwork, or call the lab to see what is scheduled.

total iron capacity

I have never had a doctor until this last one run every test I wanted. I have 17 tests in the last two years and all test for different things at different times. This makes it near impossible to see the actual patterns and changes.


sorry missed part of your post.

yes, you should diffenently ask for the other blood tests if at all possible. You need a good solid baseline to go by.

T4 and T3 are helpful, but free T4 and free T3 tell you more. T3 says great you have a good T3 supply. Free T3 says how much of that supply your body can actually use.


PureChance, I think it is pure luck that I found you, pun intended. In any case I am going to have my blood drawn, and when I get the results I will post them on this thread. After which I will likely speak to my doc and get my script for an E inhibitor. and anything else I may need.
Thank you for all your help. It is much appreciated.


I was helped by the same information from here and other sites. Ksman and a host of others have been offering advise here for years now. Without them I would also have been lost. I am only able to post and help out now that I am finally starting to feel better.

God is pretty fricking amazing when you see all that he can do. I am still amazed at the number of "coincidences" that happen in life just by "pure chance" (yeah right).

One example (out of countless stories I could pick from), my wife has thyroid issues, and educated herself about the condition. I then convinced her to join a gym (which was a miracle in and of itself) and get out after suffering from hypothyroidism for so long. While there she just happened to bump into a woman at the gym. They talked and found out that they both loved to play raquetball so they started playing together. As they played, they talked like woman are prone to do, and the other woman had some complaints/issues. My wife thought they sounded aweful familiar and she pressed her to get her thyroid checked out. It took some convincing but she did. The doctors then discovered an extremely rare form of thyroid cancer that is extremely aggressive, but they caught it just in time (another month or so and it would have been too late), and she is now on the road to recovery. I always thought that God was suppose to be a little more subtle then that. I mean what use is faith when it is just so blatantly obvious.

I know that there is a purpose for what I am going through and what I have already gone through, and I am just happy to be able to help when and where I can. Without my faith that there was a reason for all of this, I am not sure I would have made it to the other side (or mostly there anyways).

I wish you the best of luck - keep us updated.

as a side note most doctors can get blood tests results within 7 days of the draw. The two week+ window that I am always quoted is just to make it easier/less demand on the doctors. Call back 5-7 days later and ask them to fax you what ever results have already come in - I always say I want to have the results in hand so that I can do some research and prepare for my dr. visit so I don't waste time while I am there simply reading the results - it has worked great so far.


Get your DHT tested. A lot of guys on Finasteride have their 5AR enzyme downregulated. High testosterone levels aren't enough since DHT is about 7x more potent than testosterone and has a higher binding affinity than testosterone. Low DHT could be a cause of this. Also, if ED is your only symptom, go to a urologist and at the very least have him check out your package to make sure everything down there is working okay. Estradiol could be a problem, too. Also, thyroid should be checked out as PureChance mentioned.


Thanks for all your help PureChance. I'm getting my Blood Drawn tomorrow so that the #s will be accurate. I will get my DHT tested as well.
Mr. Wilson, I am off of finasteride right now and have been for a couple of weeks now. I'm not sure that I understand your post in how DHT can lead to ED.


Test is basically a prohormone in that it converts to estradiol and DHT. DHT is primarily thought to be responsible for libido and erection strength. Most androgenic effects are due to DHT influences. Finasteride users report ED with normal testosterone levels. This is because their 5ar enzyme won't accept DHT or won't convert to DHT. DHT is a good thing. Androgens like DHT help determine blood flow to the penis as well. So, when you block DHT conversion, you can obviously expect to have a lower libido/ED/other low androgenic problems. Test can still bind to the AR, but just not like DHT can. Sorry if this is redundant. I felt like I typed DHT a million times, haha.


Okay, so I think if I am understanding you correctly my DHT may be in the toilet, due to a lack of test which needs to be present to convert to DHT. If I can get my E2 under control then this should help by obviously preventing the conversion of test to E and therefore making more test available to convert to DHT. Or something like that


Haha..no what I'm saying is that you can have all the testosterone in the world but if your body isn't converting it to DHT or the androgen receptor isn't accepting it, you may have ED problems. It's not the actual testosterone that is hurting you but rather the lack of converting it to DHT.


So I had my blood drawn and my numbers for everything are down, even my E2. Granted I had it done the morning before I take my test shot, but here are my #s. I could only get my Total Test, Free Test, and E done, because that is what was o the script. I changed that for the next time.

Total Test 343 down from 813 (This is crazy, and I believe that this is the culprit here)
Free test is 126 down from 137
E2 is 20.3.

So my question is WTF.
I got a script for Arimidex.

Should I ween myself off of the test and simply aromatise? Or do I significantly up my Test and counter it with the Arimidex. Also what are the long term effects of both. I only ask because I really like my balls and want to keep them. Just got the results 2 days ago or i would have posted sooner.


ok, so what do we know?

we know that:
1) 7 days after a 100mg shot, your Total T is at 343 (makes sense since your shots shut down your own natural production, and after 7 days of the rollcoaster ride you are at your lowest point - which is why you see almost everyone recommending EOD or E3D shots)

2) your E2 is down (probably because you have no T to convert)

I would try and find a new doctor. One who will hopefully give you HCG (or maybe Clomid - I have zero knowledge about Clomid - but have read that others have used it to restart their T after a cycle) to try and restart your own T production. Your total T was fine to start with, there were other problems that needed to be researched and addressed, but extra T did not seem to be one of them.

just my 2 cents.