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12-25-2013, 12:23 PM #1New Member
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New and looking for some sound advice and recommendations
I am new to all of this so my questions/comments may appear lacking.
I am 52 years of age. This past June I was diagnosed with Low T (256). I was put on 200mg of Test Cypionate every two weeks. After 6 weeks (early Sept) my blood was re-tested. My T-level went up to 479. The doctor did not recommend a change to the dosage but did allow me, after I asked, to take 100 mg each week.
In late October, still feeling tired and lethargic, plus what gains I had to increase my libido then dwindled, I increased my cypionate to 150 - 200 mg/week. I know that some of you will say that I am not helping myself by not following the doctor, who knows more than I. Still, I remember him saying that he wanted to get me to the point where I felt not just good, but great.
I did see an increase in energy and libido, the latter almost animalistic which brought back memories of my earlier years.
In late November, I decided that I should have my blood levels checked again because I was concerned about my overall T-level, Free T, PSA and Estradiol. My doc was not pleased with me when I told him what I had done and actually refused to run the blood work. He then asked me to stop all injection of the cypionate. He decided that I should be in contact with an endocrinologist. I am fine with that. I was not pleased with his not agreeing to re-run the blood test since it was a legitimate concern.
I decided to seek out another doctor. He ran the blood work. My suspicions were warranted. Here are the results:
Test Serum 1301 ng/dL
Free Test (Direct) 30.2 pg/mL
WBC 10.1
RBC 5.54
Hemoglobin 18.0
Hematocrit 51.5
MCH 32.5
RDW 13.1
Platelets 315
and the kicker.......
Estradiol 73.6 pg/mL
I did a follow-up to discuss these results. Doc has no problem with my taking 150mg - 200mg per week of Test Cypionate. I asked if he could prescribe me an AI since by then I had discovered that my endocrinologist could not see me until March 4, 2014. He said that he did not have the knowledge about AIs and would have to defer it to my endocrinologist.
I have joined a gym in hopes that I can work out some of my elevated numbers. I've lost 5 pounds of the 30 that I have gained since July. My total BMI is 32 from 25 a year ago. I have not been very physical for a number of years but believe that since I have to be on this stuff for the rest of my life, I might as well make it work for me. My biggest concern is the conversion to estrogen which from what I have been reading has very negative consequences. But until I see the endocrinologist (1st time) in March, I am on my own.
What are any of your knowledgeable comments and/or suggestions to my dilemma?
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12-25-2013, 02:05 PM #2
Welcome to the forums. I've gone through the same as you. The minute your libido and the rest dropped off is probably the time your estradiol went up. That's just what has happened with me. I just started an AI but kept my test at 100 mgs ew. Whenever you post labs on this forum, you should post the ranges also as so the more knowledgeable members can properly give their opinion. At this point your estradiol is doing a number on you as well as your hematocrit is high and should consider donating blood. Also you should consider cutting your test back to about 100 mgs ew divided into 2 50 mg injections. The more knowledgeable folks should chime in soon. Post your ranges and testing lab.
Last edited by Beethoven; 12-25-2013 at 02:08 PM.
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12-25-2013, 03:57 PM #3New Member
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Thank you, Beethoven.
Here are my labs with their respective ranges:
Test Serum 1301 ng/dL H 348-1197
Free Test (Direct) 30.2 pg/mL H 7.2-24.0
CBC With Differential/Platelet:
WBC 10.1 x10E3/uL 3.4-10.8
RBC 5.54 x10E6/uL 4.14-5.80
Hemoglobin 18.0 g/dL H 12.6-17.7
Hematocrit 51.5 % H 37.5-51.0
MCV 93 fL 79-97
MCH 32.5 pg 26.6-33.0
MCHC 35.0 g/dL 31.5-35.7
RDW 13.1 % 12.3-15.4
Platelets 315 x10E3/uL 155-379
Neutrophils 59 % 40-74
Lymphs 29 % 14-46
Monocytes 9 % 4-12
Eos 2 % 0-5
Basos 1 % 0-3
Immature Cells Comment %
Neutrophils (Absolute) 6.0 x10E3/uL 1.4-7.0
Lymphs (Absolute) 2.9 x10E3/uL 0.7-3.1
Monocytes (Absolute) 0.9 x10E3/uL 0.1-0.9
Eos (Absolute) 0.2 x10E3/uL 0.0-0.4
Basos (Absolute) 0.1 x10E3/uL 0.0-0.2
Immature Granulocytes 0 % 0-2
Immature Grans (Abs) 0.0 x10e3/uL 0.0-0.1
Hematology Comments: Comment
PSA Serum 2.0 ng/mL 0.0-4.0
Estradiol 73.6 pg/mL 7.6-42.6
Nothing noted where "Comment" is written.
There may be more lab results than is needed here, but these were the tests run.
My concern is with my first appointment with the endocrinologist not until March, what can I do in the meantime to try and regulate the spike or high E2.
I should clarify that I take 200mg of Test Cypionate every 5 days. I like how I feel at this level. To reduce it will only take me back to feeling and performing just so-so. Does working out at the gym help out in any way.
My current weight is 224 lbs. A year ago I weight 175 lbs. I saw the lethargy build in February of this year as well as about 20 lbs of weight gain by June. I hadn't planned on telling my doctor about this, but I was tired of feeling the way that I was and did not want to just brush it aside giving it the excuse that I should feel like this at my age. I'm not ready to grow old just yet.
I did work out years ago, but when the children came I focused my attention to their needs and did not give much regard to taking care of myself quite as much. I still have a waist size of 34 in. with a mid-section which no longer shows any sort of packs except for what I've packed on if you know what I mean.
And finally, I don't want to wake up one morning and find out that I need to start wearing a D cup. Does gyno happen quickly? HELP! No signs of it yet and I would like to keep it that way.
Thanks.
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12-25-2013, 04:33 PM #4
I agree with what Beethoven advised. He is spot on. I'm relatively new to this but I rarely have heard of anyone needing as much Test Cyp as you are injecting. And in my opinion, you are dosing WAY more than you need. Lower, more frequent dosing keeps aromatization lower. This protocol doesn't stop it but you may get to the point where you don't need an AI.
First move should get your E2 under control - and I'd advise you NOT wait until March. You'll feel like crap. (That's when you tell yourself to up your T dose, but don't do it.) I'd also advise you lower your dose IMMEDIATELY - as Beethoven suggested. In fact I'd suggest you not take another dose of Test until at least two weeks after your last dose. Then do the protocol described in post #2 above by Beethoven.
Get you hands on some anastrozole as soon as you can - like yesterday. Start low - .25mg every 3 1/2 days. See how you feel. If you keep to a low dose, more frequent T dosing schedule, you may in time do away with an AI altogether.
Donate blood a.s.a.p.! I wouldn't be surprised to see your hematocrit even higher on your next lab report, so don't put it off. You can make an appointment with The Red Cross online.
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12-25-2013, 04:42 PM #5
Hi. I'm 52, as well. I agree with beethoven. Honestly, 200mg every 5 days is quite a large dose. With that large of a dose, it's not surprising your e2 is high. You probably don't want to get an ai on your own, so cutting your dose might be the way to go. There was a time that my level got to where yours is at. I didn't feel right. I cut my dose and things were better. Also, regarding your thyroid; has it been tested. Your weight gain and lack of energy could be an indication of an underactive thyroid. I was diagnosed 15 yrs ago, so I am familiar with weight gain, lack of energy, libido, etc... It was a rough time until Doc got it straightened out. The endo will probably check that out for you. So, cut your dose and donate blood to get the HCT down would be my un-educated opinion. Also, not to be Debbie Downer, but endos are great for thyroid and diabetes, but most are lacking in the trt dept. I know one of the savvy bw guys/girl will give you a response.
Edit: 2Sox beat me again
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12-25-2013, 05:49 PM #6New Member
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Thank you 2SOX.
How do I get anastrozole if my PCP doesn't want to give me a script because he admits it is not his area of expertise?
Excuse both my ignorance and impertinence but can you explain why the urgency to donate blood? Am I in danger?
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12-25-2013, 06:07 PM #7New Member
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Thank you, Rusty11.
My thyroid was found to fine. It was tested in June and then again in Sept.
When I received the BW results, I did take a two week hiatus from taking the testosterone . I will reduce the amount I inject.
If the Endo is not as specialized in the TRT area, where can I go where they are?
Also, if once on an AI can I increase my dosage back up? I am trying to increase my muscle mass as well. My post readings seem to indicate that 200mg/week would be a benefit.
Appreciate your feedback.
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12-25-2013, 07:25 PM #8
If your dr. won't prescribe an ai, you can get it from ar-r (banner at the top right of your screen). I don't need one, but many members use it with good results. Every item I've purchased there has been good. Regarding high hemocrit, many guys on trt have this issue. The higher the number, the thicker the blood. The thicker the blood, the harder your heart works to pump that blood. I was at 54.5 and donated. I also lowered my dose.
As far as the endo, I would wait to see what he says before trying to find a new one. Who knows. He may be great.
Are you on your own until the appt? Or are you still seeing the original dr.?
One last thing...I noticed no decrease in the ability to gain muscle since reducing my dose. I'm on a gel, not injections. Matter of fact, since getting my training and diet in check, I've gained more muscle in the past six months than I did with a much higher t level. More is not always better. At 52, I don't need or want super high levels.
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12-25-2013, 07:58 PM #9Associate Member
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Google the a4M physician webpage, use their search engine and find yourself an A4M doc close to your area. Good luck!
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12-25-2013, 08:01 PM #10
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12-25-2013, 08:23 PM #11
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your test injection of 150mg does not seem extreme to me. That is what I am on (doctor prescribing it).... 150 mg Test C every 7 days. When I do my own injections, I am breaking it down to 75 every 3.5 days
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12-25-2013, 09:11 PM #13
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12-26-2013, 05:31 AM #14New Member
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Thanks Rusty11,
As I mentioned, I am now seeing a new doctor. That being said, yes, I am on my own until my appointment with the Endo in March.
I intend to have BW tested again in 6 weeks time.
I appreciate your candidness regarding to ar-r . One never knows whether these links are reputable or not.
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12-26-2013, 05:50 AM #15New Member
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Thanks for the input 2Sox.
The anastrozole with ar-r is in liquid form. I presume you knew that. My injection syringes are 22 gauge 1 1/2 in. Being new to all of this, can I use the same for this med? How much does that equate to in dosage if my current syringe calibration is 1ml = 200mg? Or, do you recommend a smaller sized syringe? Does injecting intra muscular matter or not?
Clearly my questions indicate my "newbie" status, but I would prefer to lean on the side of caution while I try to understand all of this. Wow, that last statement seems more like an oxymoron based on my dosage of T that I am giving myself.
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12-26-2013, 08:15 AM #16
I believe that is not injectable. It doesn't say but I believe the guys that take liquid CIA have talked about that.
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12-26-2013, 01:27 PM #17
Ar-r's product is Liquidex and is NOT injectable. Comes in a 30mL bottle with a syringe (no needle). 1mg/mL. Squirt the desired dose into the mouth of you best "lab animal". ;-) As others have suggested, wait for your lab results. Then start low at something like .25mg every 3.5 days.
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12-27-2013, 10:01 AM #18New Member
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Oh, okay. I've gone ahead and ordered that.
I noticed, for the first time this morning, that my right nipple area has a small lump just beneath it and is sensitive to the touch. I presume that is a sign of the onset of gyno. Would that be an accurate assessment?
For the record, my 200mg every five days was just implemented last week, so I have no problem reducing it. I will break the 100mg into two 50mg injections per week starting tomorrow.
I'll keep you all apprised of my progress.
It is interesting how the body builders stress taking 300mg per week as a starting point to get some good bulk on. That was my premise for increasing the dose, which my current PCP has no problem with. Once on the AI, that will reduce the E2 so does that mean that as I am ramping up my gym workouts that if I were o increase the dose, that it would be safe? I know this is a re-hash of what has been discussed earlier, but the higher dose actually makes me feel better and that is really the issue here for me.
Thanks.
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12-27-2013, 10:39 AM #19
It's common knowledge that in all areas of nature, a dynamic equilibrium - balance - is the goal. The same goes for testosterone and estrogen in our bodies. We can up our T dose but estrogen catches up. We increase it again, E is close behind. I'm learning that the ideal is to find that dynamic balance within our bodies. I'm presently in the middle of REDUCING my dose because I want to do away with using an AI and I want to keep my hematocrit at a safe level.
I can't speak for others but this is what happened to me when I first began TRT about a year and a half ago. I felt great in the beginning but then the feeling faded and I didn't understand why. (That was before I joined this forum and learned more about the T-E balancing act.) I thought upping my dose would do the trick. It didn't. And I'm glad I paid attention sooner rather than later.
It's been said many times on this forum: Go slow and be patient. (Advice I did not heed.) My guess is that if you keep taking high levels of T, you'll need to continually take an AI and be very concerned about hematocrit. I predict that if you follow the advice given to you here and reduce your dose - and start with a low dose AI - you eventually will feel rather good.
Others much more knowledgeable than I can contribute more to this discussion regarding the health risks of continuous high dosing T.
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12-27-2013, 10:52 AM #20New Member
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Thanks, 2Sox.
Your advices is a sound one. I intend to follow it.
Best.
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12-27-2013, 03:38 PM #21
Lib, we've all been there. The body builders' dosages are for cycling and not trt. The difference is you can't keep those dosages for an extended period of time without damaging your body. 100 mg is a starting dose, you might need more or less depending on what you and your Doc find during the dialing in process. 2soxs' analogy is spot on. Be patient it takes time. I'm still getting dialed in so I feel your situation. I would not start an AI until you have BW. You may not need it. If you keep your dose low and keep the shots more frequent, that would be a good start.
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12-27-2013, 07:39 PM #22New Member
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Thanks Beethoven.
I think with my most recent BW of 12/4, showing Estradiol levels at 73.6, I will need to start a small dose of AI. I will start with .25 mg as was suggested every 3-4 days. I will re-run BW end of January and hope that by reducing the amount of T that I am injecting and the intro of AI that I will be at more healthy levels.
Will the AI help in reducing some of my weight gain which I believe is 90% water retention?
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01-01-2014, 06:25 AM #23New Member
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2Sox,
I received my liquidex and had a some questions. Will it take away the bloat? Will it eliminate the water that I am/have been retaining? How soon will I notice the effects?
I realize that we are all different and results will vary. I'm just looking for approximates.
Happy New Year everbody.
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01-01-2014, 09:00 AM #24
You need to figure out a dosage that gets you 700-900 consistently on injection day. You say you switched from 100 to 150-200mg, that's a huge gap. Your either taking 150mg a week or 200mg a week. Whatever dosage you were taking it was to much, 1300 is to high. I know 50mg E3d (120mg a week) only puts me at 550, so I don't think 150mg a week is extreme but be consistent and don't change anything untill you have bloodwork to confirm. If your getting bloodwork in January id say don't start the AI. Just lower the test dosage and see where it puts you so you have accurate numbers.
Edit: it should reduce the bloat,how much no one can sayLast edited by Machdiesel; 01-01-2014 at 09:06 AM.
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01-01-2014, 09:59 AM #25New Member
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Thanks, Machdiesel, that is good information.
When I first started test cyp, I was at 100mg per week. After 8 weeks my T level was 459. If I didn't mention previously, my doc did not want to change the dosage after I had requested an increase. Again, that was based on his quote that he "don't want you to feel just good. I want you to feel great."
Since I was not feeling much improvement other than a slight increase in libido, I increased the dosage to 150mg. I found that I was experiencing the lows at the 5th or 6th day, even knowing the half life was 8 days on cyp. The doc was aware that I was injecting 100mg every 5 days and had no problem with that. That is why I continued that regime at the higher dosage.
Since getting on this forum and getting good advice/recommendations, I purchased the dex and have reduced the frequency to once a week.
I have found that 72 hours after injection, I find that my breathing seems somewhat more labored. I've also found that I have sleep apnea issues during my sleeping. I tend to gasp a lot. Like I might be stopping to breathe. I am attributing this to my high hematocrit of 51.4. I have not donated blood as of yet.
I am working out at the gym 7 days a week. I do 45 minutes of cardio first and then weight machines for an hour. I am not doing free weights yet or bench press. I lost quite a bit of muscle mass before realizing I was low T. I am slowly building what I have lost. I believe within the month I should be ready.
I've lost 8 pounds since starting this original thread post. Keeping in touch with my food consumption, types and amounts. I'm in a learning curve but already I see how one can get addicted to wanting to workout. It has been years since I was working out and physically fit (30).
I'm excited at the possibilities this 52 year old body may have to give.
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01-01-2014, 10:17 AM #26
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01-01-2014, 10:29 AM #27New Member
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Thanks 2Sox, I'm a firm believer that positive encouragement is key to anyone's betterment.
The AI dose that I took this past Monday (first one) was .25mg as was suggested. It was advised that I repeat every 3.5 days. With my Estradiol so high, do you think the dosage and frequency should be different?
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01-01-2014, 10:34 AM #28
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01-01-2014, 01:12 PM #29
If you were injecting once a week again the BW doesn't tell the whole story. 24 hours after injection you may have been at 1300, but when you did bloodwork 7 days later you were in the 400s. The fact u felt the trough means the dosage was Atleast giving u something. I have a feeling That same 100mg a week split up twice a week would increase your numbers. As you are probably finding out its a lot of trial and error, and it takes time. Ya It sucks changing your protocol and having to stick with it for 3 weeks until you get BW, and then that may not be right so you try something else. But in the long run you'll have a protocol your 100% confident . I think the constants should be inject twice a week, an Atleast try to not use your AI untill uou get BW on your new protocol( lower dosage a/frequent injections will lower e2) . As far as your breathing I have this also. It kicked in about week 3 but it's slowly getting better. My bro science opinion is your body will eventually adapt to these new hormones and it will get better over time, mine has. Maybe it takes time for the body to figure out how to run on this new hormonal enviorment , idk but it does scare me alittle. I will prob get an EKG done along with my yearly BW to closely monitor my heart
Edit: I'm alittle confused . You said you switched Drs. So the old doc wouldn't prescribe an Ai or the new one. If ur new doc is wiling to then 100% don't use the AI. BW will show high e2 and you'll get a scriptLast edited by Machdiesel; 01-01-2014 at 01:16 PM.
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01-01-2014, 02:47 PM #30New Member
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The reason why I changed docs is because I made the appointment with my first PCP because I was concerned about what my blood work might show. Since it had been 8 weeks since the last. He refused. So I paid for an appointment with no results. Being self employed, I did not see where the doc was listening to the patient. Plus having to pay for nothing doesn't sit well with me.
This 1st doctor of mine has not only written books and articles, but he is also a TV personality. Each time I saw him, while friendly, he always looked at his laptop when talking to me. When I would begin to let him know of my concerns, he'd often cut me off as though he knew where my question was headed. Many times he was incorrect. He had an ego and I was tired of his responses. The refusal to listen to his patient when I suspected something was the last straw. I was right in the end.
My new doctor did not want to give me a script for an AI because he said that his knowledge of that area was limited. Since by then, I had an appointment to see an endo we both agreed to leave it as it was which is how I came to purchase the liquidex via this forum.
I think the higher hematocrit might have something to do with the breathing since the possibility of polycythemia is a concern at high levels.
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01-01-2014, 03:46 PM #31
Ok Gotch ya . Since you have an apt with an endo but already takin an AI bring your test results to show him you had high E. If he asks to redo BW which he prob will id say something like the sides got to bad so you bought an OTC AI and would like to try arimidex .25mg on injection days(2x a week) and go from there.
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01-22-2014, 06:36 AM #32New Member
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2Sox,
This is in reply to your comment to me on another thread about libido.
Your comment referenced that unless medically necessary, you still were of the opinion that I was still injecting more T than was necessary.
I value the knowledge that all of you have given to me. We have but one body and one life to live so far be it for me to play with this "one shot deal" that I have been given (pardon the pun).
I spoke to my doctor after I got the feedback here as well as when I received the dex. I am on T for medical reasons. My doctor thought a reduction was not unreasonable and so suggested that I reduce to the 2 injections of 100mg per week. He too agrees with finding that balance. He also agrees to my request in having new BW drawn which will be done the last week of Jan or 1st of Feb. From there we'll discuss what and if any changes need to be made.
In the interim, I have seen the improvement in reducing my dosage. I feel great. Libido is amazing however performance is not quite there yet with my wife. This should be in another thread but since I am on the subject, it's more of an issue with the fact that she herself could be taking something to enhance her own libido. Nothing is more "deflating when you're banging and your partner is clearly not into it. She is only 50. But went through full-end menopause at 38. She takes minimal hormone replacement and should, in my opinion be on more. Needless to say I have had to take care of it myself which is psychologically demeaning to me.
Sorry to have gone off track.
Best
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01-22-2014, 08:50 AM #33
Ljb,
Regarding the details you describe: Whatever the case, your next set of labs should give you the full story. Libido is an interesting thing; always a relation of the objective and subjective. IMO, a good libido is not spending a good amount of your waking hours thinking about when you're next going to have sex or having sexual fantasies constantly. That to me is a disturbing libido. I know because I've been there. It was my signal that my dose was too high and my blood work showed it; both total and free T were considerably out of range - and I was only injecting 140mg a week. Now I'm injecting 112mg a week (32mg EOD) and I feel better. I'll see what my BW says in a few weeks, but regarding libido, I feel more grounded; not as frantic. And I don't need an AI. On another thread, I posted that I get labs every month. I feel comfortable with this frequency since I don't consider myself dialed in yet. But that's me. Others may consider it excessive. I joked that it may save me a few trips to the Red Cross to give blood.
I (and I'm fairly certain, others) understand what you are feeling when you speak about intimacy with your wife. My wife began HRT shortly after I did, she felt better, and things improved fairly fast. She is on a compounded cream of estrogen, progesterone AND testosterone and still in the process of finding the "sweet spot" of dosing. We're coming closer to being in the same place. Be assured, you and your wife will too.
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01-22-2014, 11:09 AM #34New Member
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Good post 2Sox. I am encouraged with the latter comment regarding relations with my wife.
I would not say that my libido is at the "disturbing libido" mark. Instead, I think that I went so long with the slow downward progression that getting an erection just by brushing up against her while reaching for the toothpaste is a huge positive in the right direction. Like anything the novelty will wear off. IMO it would be then that what one does from that point is where one could find themselves in that zone that you referenced.
If nothing else just the fact that I am not alone in what I am or have been going through makes me feel a lot less of an oddity. It's interesting but when I look back to the days of my youth, I realize that no matter the age, we are all still having similar concerns albeit more in depth due to our level of experience for having actually gone through them.
Much appreciated.
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