T Nation

Who Here Has Had Improved, Consistent Libido with TRT?


Everywhere I look online, it seems libido is the one aspect of TRT that many men never get dialed in. I’ve experienced the same. Curious how many of you have actually had good, consistent libido with injections?


The main issue I had was when injecting once or twice weekly, libido and erections were hit and miss, if SHBG is low inject smaller doses EOD. It can take up to a year or more on some guys to get erections back do to slow venous leakage repair, your E2 needs to be kept within 20-30 pg/ml and your T dosage is right for you. Too much T or to little T and you can forget about libido.


My SHBG is high. It’s at 50


How long have you been injecting and what is your protocol? Like systemlord said it can take some ONCE DIALED in 52 weeks or more for full erectile function.


Large weekly dose are what you need since you hold onto your T well, larger doses will help bring SHBG down to a more reasonable levels and free up some of your T. Some insanely high SHBG guys require T levels over high normal ranges in order to get SHBG down, once SHBG hits 40 it starts taking over FT. Your case isn’t so extreme.


My free testosterone was over the top of the range on my last blood test
despite my high SHBG. I’ve tried weekly injections and they only made me
feel worse.


Everyone feels worse when on a new protocol, it takes 4-6 weeks until things get better and if your E2 is out of range then you should feel bad. It’s impossible to have high SHBG and FT over the range, you aren’t sharing labs so I can’t even see if FT is directly measured which is the wrong way of doing it.

Your E2 levels have more influence on how you feel while on TRT, you’re obviously not working with a skilled doctor. You want to know who has consistent libido and erections on TRT, those who have doctors that know what their doing.

You’re not going to get anywhere with SHBG in the 50’s, hell I see guys coming in here with symptoms at that level.


I’ve been on TRT for four years, started at age 59. After about two to three weeks, libido (which I thought was “OK”) was back at where it was in my 20s and 30s and has been consistent since then. Test dose and AI dose have not changed. Great results for me. Fortunately, my awesome (in every way) wife started HRT when I did, so this works well for us.


I’ve had consistently much better libido on TRT, for 3 years, although it is using Testogel 50mg daily, not injections.

It took about 4 days for my libido to suddenly increase, it was a rapid change. I also got morning wood around that time, the first morning wood in about 15 years!!

I’ve never used HCG, an AI & I only used Nolvadex (from the black market) 4 or 5 times at the start of TRT because my left nipple got itchy.

I’d say I went from sex twice a week (including jerking off haha) to sex 4 or 5 times a week.

My case is complicated by me using antidepressants - venlafaxine & Mirtazapine. I’m confident venlafaxine lowers my libido & lowers the hardness & duration of erections.

I know that, because if I take 2 days off venlafaxine to aid sex, I get almost Viagra hard & duration erections - 7/10 function.

While regularly taking venlafaxine my erection function is 5/10 - so I take Viagra in those cases.

I don’t know how Mirtazapine affects libido & function because I don’t holiday from that med.

Id consider my libido etc a good TRT outcome, given how much antidepressant drugs I currently take.

That good outcome is through chance rather than design however, but it shows good outcomes are possible. I’ve only asked for E2 lab work once - about 2 years ago - and the GP refused it as too costly given “you have no symptoms of high E2”

I do have my Free T, Total T & SHBG measured & they have been good on Testogel.

I will be getting private blood work as recommended on this forum soon.


“The main issue I had was when injecting once or twice weekly, libido and erections were hit and miss, if SHBG is low inject smaller doses EOD. It can take up to a year or more on some guys to get erections back do to slow venous leakage repair, your E2 needs to be kept within 20-30 pg/ml and your T dosage is right for you. Too much T or to little T and you can forget about libido.”

Sorry to bump an old thread but can high testosterone really cause low libido if other hormones are dialled in? I had always been under the impression that higher test always equalled higher libido. This could potentially be the cause of my problem.



It improved with trt but adding 5mg a day of cialis really did the trick.


High testosterone can cause other hormone to be out of balance, when I was above 1000 ng/dL and it caused my bilirubin to get very high and was causing liver issues, lower the dosage and everything balanced out. If you body can’t handle high testosterone believe me it will let you know, you won’t function correctly.

Libido is more than just hormones, people have libido issues who have good hormone levels. Some guys expect to have the raging libido of a teenager at 50.


Ok so seems that lowering test is something I need to look into. I often get heamatology, liver enzymes, etc checked to make sure I’m healthy and things very rarely come back out of range other than creatine kinase due to creatine supplementation.

Something worth mentioning is that last time I got my testosterone levels checked they came back at 2020 ng/dl despite a dosage of about 150mg p/w. Do some guys convert a certain amount exogenous test into higher blood levels when compared with others?



I would say mostly everyone who has followed advice on T and E2 levels. When that does not work, very often the issue is low thyroid function and there is pertinent info in the thyroid basics sticky. Libido is a function of the brain that reflects a state of male health. Part of a good libido is awareness that one’s sexual pursuit circuits are working and been sexually distracted often.


Yes I have read the thyroid posts thoroughly along with other thyroid information online. I made a post about thyroid here some time ago and got some useful help. I have been on T3 50mg ED for about 15 weeks now in hope to reduce rT3 (never tested rT3 but assumed it was an issue due to high TSH, high T3, high T4). Being on the T3 seemed to stop minor depression problems I was having immediately, however has done nothing for libido, which has brought me back here looking for other possible causes


T3 50mcg? 50mg would be lethal.

What are energy levels like?
Feel overheated easily?
Last two can be T3 over stimulation.

If rT3 is high, that opposes T3 medication. But as T4 is depressed by T3 medication, rT3 should be dropping and your effective dose of T3 increases and dose may need to be reduced as lower rT3 allows T3 levels to have greater effect. So this situation is anything but static.


Yes I meant mcg. Energy levels are quite good. Have been getting hot recently but there is a heatwave here in the UK and I’m not sure I have been getting hotter than expected. Don’t think I am jittery. I have recently increased T3 to 100mcg ED as I was losing hope with the thyroid route and thought I would give a higher dosage a try. I was losing hope due to the fact that I had read in many places that rT3 should take 8-14 weeks to clear up and I am past this.

When thyroid levels are finally where they should be, does libido tend to return immediately or should a long wait be expected? If so perhaps I just need to stick it out longer.