What Regimen for Medication-Induced Low T?

Some of you may know me from a previous post about my pre and post-clomid results. Well, despite getting good results on paper from clomid (minus the high e2), I hated the side effects. I mainly took the clomid for low libido, and it definitely did not help my libido.

A little bit more about my situation. I am on a long-term opioid for chronic pain, and over time the opioid has reduced my testosterone and caused me to have practically zero libido. My test results after 6 months on the opioid are below. Before taking the medication, my libido was perfectly normal and a testosterone test a few years ago put my total T at around 500. After taking clomid to treat my low-t, my T-levels significantly increased, but so did my e2.

My question is this: If you were me, what regimen would you go on if you were planning on having children in a few years? I am almost certain I do not want to take “real” testosterone, as that would reduce my chances of having children. I heard nolvadex is a better option than clomid, but I really have no idea. I have a urologist that is essentially leaving the decision up to me as far as what medication to take, so I would love to get some of your opinions. Thanks!

Test Results While On Long-Term Opioid Medication:

TESTOSTERONE, TOTAL, LC/MS/MS: 271 ng/dl (RANGE: 250-1100 (ng/dL))

TESTOSTERONE, FREE: 29.1 ng/dl (RANGE: 46.0-224.0 (pg/mL) )

TESTOSTERONE,BIOAVAILABLE: 53.6 ng/dl (RANGE: 110.0-575.0 (ng/dL) )

ESTADIOL: 29 pg/mL (RANGE: < OR = 39 (pg/mL))

LH: 1.7 mIU/mL (RANGE: 1.5-9.3 (mIU/mL))

SEX HORMONE BINDING GLOBULIN: 41 nmol/L (RANGE: 10-50 (nmol/L) )

ALBUMIN,SERUM: 4.0 g/dl (RANGE: 3.6-5.1 (g/dL) )

PROLACTIN: 14.2 ng/ml (RANGE: 2.0-18.0 (ng/mL) )

TSH: 0.98 (RANGE: 0.40-4.50 (mIU/L) )

FSH: 2.5 (RANGE: 1.6-8.0 (mIU/mL) )