Testosterone replacement therapy and decreased libido?

[pseudonym]

I went in to my doctor to have some blood assays performed to determine what my testosterone levels were since I had - and still have - many of the symptoms of low testosterone (i.e. low libido, low energy, low motivation, scrawniness, small bones, depression, decreased penile sensitivity, etc...). The symptoms, though, that I most wished to resolve were low libido and decreased penile sensitivity. Sexual pleasure - sad as it is to say - is about the only thing I have in life and without it I have almost no reason to live.

So, the tests showed that I did indeed have low testosterone levels as I had guessed. I took my testosterone home, so happy that I would have a good orgasm for the first time in years - or so I thought. I took it for a few days and... nothing, but I figured that the effects of testosterone were cumulative and might take a number of weeks to manifest themselves in a salient, ostensible way, as with many other medications. So I kept taking it, but over the course of about three weeks, the only effect I noticed was dramatically decreased libido and increased stupidity, of which I already have more than enough, thank you very much testosterone! I stopped taking it and after a week or two I had at least some sex drive again, but my libido never returned to the level where it had been just prior to testosterone supplementation (and it was already very low - to the point of being almost non-existent.)

Has anyone else experienced this?

Based on what I knew of some of the body's hormonal metabolic pathways, I came to the conclusion that my problem was excessive levels of aromatase, which I figured was converting all of my testosterone away into oestrial, oestrone, and oestradiol. Assuming this to be the case, I went to my doctor and begged him for a prescription for Letrozole. I ordered it online about a week ago and have been feeling fairly hopeful since then, believing that soon this nightmare would be over - that is, until I happened upon this website and found a very large number of people complaining that letrozole had utterly obliterated their libidos.

This surprised the hell out of me to say the least. I am a dilettante in all areas of biochemistry, I must admit - whether neuropharmacology, psychopharmacology, endocrinology, etc - but everything I have learned thus far has taught me that an increase in oestrogens is responsible for decreased libido; that a decrease in oestrogens produces increased libido; that an increase in androgens increases libido; and, finally, that a decrease in endogenous androgens decreases libido. A very simplistic picture of the activities of the biological substrates of and genesis of human libido, evidently.

Do I need to increase my oestogen levels? Or what? I'm feeling quite hopeless here.

 

[Big_Joe]

Before you start taking anything for your problem get more blood work done. Get back get your blodd estrogen levels checked before you start your trt and the again a couple of months after you have been taking your test. See if you really do have elevated estrogen levels.

If this is your problem it doesn't mean that letro will do the same thing to you that it did to others. But if it worries you you coukd always use a different aromataze inhibitor. Something like exemestane sold as Aromasin.

One thing, among many, that you didn'e say was what was your test levels and what is your dosage schedule? And your age, fitness level and body fat level. One thing that many people don't know is fat in men produces estrogen. So if you have a lot of body fat this might be your problem.

I would recommend getting you backside into the gym and lifting weights. This will put more lead in your pencil the just shooting juice into your butt.

 

[tomw]

what are your estrogen levels? you posted no numbers sounds like a joke?

 

[Nelson Montana]

Yeah bro, you're just guessing and taking a shotgun approach. Sounds like your e is too high but Letro can decrease libido. Use arimidex -- 1/4 mg EOD. It's about finding the right balance.

 

[pseudonym]

Before you start taking anything for your problem get more blood work done. Get back get your blodd estrogen levels checked before you start your trt and the again a couple of months after you have been taking your test. See if you really do have elevated estrogen levels.

If this is your problem it doesn't mean that letro will do the same thing to you that it did to others. But if it worries you you coukd always use a different aromataze inhibitor. Something like exemestane sold as Aromasin.

One thing, among many, that you didn'e say was what was your test levels and what is your dosage schedule? And your age, fitness level and body fat level. One thing that many people don't know is fat in men produces estrogen. So if you have a lot of body fat this might be your problem.

I would recommend getting you backside into the gym and lifting weights. This will put more lead in your pencil the just shooting juice into your butt.

The test results showed that my testosterone levels were around 200. I didn't have my doctor check my oestrogen levels because I have no insurance; I am self-pay and don't have enough money to buy an aromatase inhibitor and have my oestrogen levels tested. I figured that the the obtention of an aromatase inhibitor would be a better use of my limited funds because I was under the impression that it would simultaneously be a test and cure for low libido caused by excessive oestrogens, whereas the bloodwork would simply show whether or not my oestrogen levels were high without having any potential to provide remediation of the problem.

I am 23, at a height of 5'10'', and weight of 160 lbs. I have a very small amount of flab on my stomach.

I did actually happen to know that fat contains more aromatase than other bodily tissues. Knowing this I always made sure to apply my testosterone on the least fatty areas of my body.

You're right about exercise improving libido but I have very low motivation and energy levels. It's very difficult for me to get into it.

Thanks for the response.

 

[digit0x]

The test results showed that my testosterone levels were around 200. I didn't have my doctor check my oestrogen levels because I have no insurance; I am self-pay and don't have enough money to buy an aromatase inhibitor and have my oestrogen levels tested. I figured that the the obtention of an aromatase inhibitor would be a better use of my limited funds because I was under the impression that it would simultaneously be a test and cure for low libido caused by excessive oestrogens, whereas the bloodwork would simply show whether or not my oestrogen levels were high without having any potential to provide remediation of the problem.

I am 23, at a height of 5'10'', and weight of 160 lbs. I have a very small amount of flab on my stomach.

I did actually happen to know that fat contains more aromatase than other bodily tissues. Knowing this I always made sure to apply my testosterone on the least fatty areas of my body.

You're right about exercise improving libido but I have very low motivation and energy levels. It's very difficult for me to get into it.

Thanks for the response.

Did he explain the other chemicals in your blood that may effect libido, body mass etc, how TRT would effect you or your other options? Did he explain that severe depression can destroy libido also? Has he/she tested you for anything else?

And what prescription did your doc give you for TRT that you rub on your body? Most HRT patients I know (which admittedly isn't many), use intramuscular administrations carefully prescribed by a doctor.

You need to give more info. From what is posted here, this sounds like BS.

 

[goin on 4T]

Are you applying a cream or injecting the real thing? It reads like you have the cream, I thought that was way more expensive that injects?
If so how much and when, days and times?

 

[digit0x]

Are you applying a cream or injecting the real thing? It reads like you have the cream, I thought that was way more expensive that injects?
If so how much and when, days and times?

Yea, the gels are substantially more expensive.

 

[njmuscleguy]

Wow, I have a TON of advice that I could give you...

First, when you see a doctor about hypogonadism (low test levels), as others have suggested, you need to get a whole set of tests to get the big picture... total testosterone won't tell you necessarily what's wrong with you... here's what you should get tested on your first go-around:

· Total Testosterone
· Free Testosterone
· SHBG
· DHT
· Estradiol (specify “ultrasensitive” assay for males)
· LH
· FSH
· Prolactin
· Cortisol
· Thyroid Panel
· CBC
· Comprehensive Metabolic Panel
· Lipid Profile
· PSA (if over 40)

Next, even when you go on testosterone therapy, it isn't a cure-all from the get-go... especially not within a few weeks. It takes ALOT of tweaking with your doctor's supervision (not just willy-nilly try this and that). Which leads to my next point: FIND A GOOD DOCTOR... if your primary care doctor doesn't have experience with hypogonadism or sounds like he doesn't know much, then ask him to refer you to a specialist, either an endocrinologist or a urologist.

(btw, I know you said that finances are an big concern, but this is your health... eventually, you'll find a way to make it a priority... and I'm not gonna lie, these tests *are* expensive).

Also, if you have tried the Androgel or cream, some people don't respond too well with them, others do very well... you don't necessarily have to use an injectable though. In fact, Androgel will raise DHT levels more so than injectable because of its absorption through the skin, and DHT makes you FEEL GOOD.

Next, a good doctor will be able to prescribe ancilary medications along with test, for example an anti-estrogen/aromatase inhibitor.... arimidex is your best bet... you don't need anything stronger, certainly NOT letrozole.... too much estrogen is no good... not enough is just as bad... it's all about BALANCE... other things that a doctor might prescribe are HCG or DHT. You should do some research on HRT protocols.

My last point.... don't start something, then stop ... then start... you're sending your body into a tailspin... give yourself some time now to re-adjust....save some money for bloodwork, see a good doctor, and it couldn't hurt to ask guys around here who have long-term experience with HRT, just as guidance.

Good luck man!

 

[pseudonym]

Wow, I have a TON of advice that I could give you...

First, when you see a doctor about hypogonadism (low test levels), as others have suggested, you need to get a whole set of tests to get the big picture... total testosterone won't tell you necessarily what's wrong with you... here's what you should get tested on your first go-around:

· Total Testosterone
· Free Testosterone
· SHBG
· DHT
· Estradiol (specify “ultrasensitive” assay for males)
· LH
· FSH
· Prolactin
· Cortisol
· Thyroid Panel
· CBC
· Comprehensive Metabolic Panel
· Lipid Profile
· PSA (if over 40)

Yes, these are all tests which I wished to have performed (with the exceptions of PSA and CBC; I didn't know about those), but, as I said, I don't have medical insurance. There's no way I could ever afford that. (I did have a comprehensive metabolic panel peformed, however, which showed that everything was normal, with the exception of bilirubin levels which were slightly elevated due to dehydration.)

The only reason I can afford testosterone cream is that the pharmacy I use mixes their own and sells it at a reasonable price of $30, far better than Androgel which is about $230 without a prescription, which I could never afford.

Suspecting that my low libido might be due to low thyroid hormone levels, I tried synthroid (which increases sex hormone binding globulin levels, by the way). That did nothing.

Suspecting that the melatonin I was taking might have precipitated hyperprolactinaemia, I tried cabergoline, dextroamphetamine, phenylethylamine, tyrosine, levodopa (with a peripheral aromatic l amino acid decarboxylase inhibitor, of course). Nothing.

Cortisol levels should decrease with the use of testosterone.

Sex hormone binding globulin levels should decrease with the use of testosterone and with the reduction of oestrogen levels, which in turn can of course be achieved with an aromatase inhibitor (I still haven't tried that yet, if it's not clear. I should be getting my shipment of letrozole in a few days.)

Luteinzing hormone and follicle stimulating hormone levels are probably normal since my testicles are of average size. At any rate, the function of these two hormones is to increase testosterone production. If my problem of diminished libido were ultimately due to low LH or FSH levels, you would expect that I could redress it through the use of testosterone (which did not happen).

It happens that I had my human growth hormone levels checked at the same time as I had my testosterone levels checked; the results showed that both were low. I won't be able to use human growth hormone any time soon, though, on account of its cost, and l-arginine truly seems to do nothing to increase HGH levels, despite claims to the contrary. (It's true, correct, that low HGH levels can give rise to low libido?)

(btw, I know you said that finances are an big concern, but this is your health... eventually, you'll find a way to make it a priority... and I'm not gonna lie, these tests *are* expensive).

I don't think you appreciate just how poor I am. My health is my priority; I spend every last cent of my disposable income on improving my health. Yet, even so, I really can't afford even the cheapest of therapies without taking out loans with my parents, who themselves have little money to spare.

certainly NOT letrozole.... too much estrogen is no good... not enough is just as bad... it's all about BALANCE... other things that a doctor might prescribe are HCG or DHT. You should do some research on HRT protocols.

What if I broke off a tiny piece of a 2.5 mg tablet. Would that have the same efficacy as anastrozle? (I was able to buy generic letrozole for $70, by the way, the cheapest of all aromatase inhibitors if I am not mistaken.)

Good luck man!

Thanks for the reply, the good advice, and, not least of all, the well-wishing.

P.S. I find it odd that anyone would think this to be a joke... If it is a joke or a troll it certainly isn't very funny or provocative.

P.P.S. Do you know what's bizarre? Opiates increase my libido! The reason for this is probably that my depression is the result of low opioidergia and that endorphins mediate liking. There is a very high density of mu opioid receptors in the pleasure centers of the brain, and these pleasure centers are most certainly involved in sexual pleasure and desire. What's more, these areas of the brain have been shown to be underactive, defective, and/or deformed in individuals suffering from anhedonia (which I do), a condition always associated with sexual dysfunction and low libido. It seems that insufficient activation of mu-opioid receptors diminishes libido just as excessive activation does. (Does all of this sound like a cogent and reasonable hypothesis? It's the best I've got.)