Need help with erection quality and libido

[Equipeeler]

For starters, I am new to this forum but very encouraged by the volume of information that has been presented. I am 50 years old exercise daily and maintain about a 13% body fat doing a combination of with training and crossfit. I find the crossfit helps my flexibility and I like its cardio work. For years I have had issues with erection strength and duration even while on testosterone therapy. I routinely take 5-10mg cialis daily with some improvement but not near to my (or my wife's) satisfaction. That being said, I am here looking for opinions on what avenues I can take along with suggestions/experiences on testosterone therapy.

I started Low T therapy a few years ago while being monitored by an endocrinologist. My test levels were
Free test 330
Free T4- 0.84 ng/dl. (0.61-1.12)
TSH- 1.89 UIU/ml. (0.34-5.6)
Prolactin 5.13 ng/ml. (2.64-13.13)
LH. 2.03 mIU/ml. (1.24-8.62)

From the above results, I was placed on Androgel 50mg/day which made no appreciable changes in my testosterone levels. I was then put on a formulated transdermal testosterone at a dose of 100mg/day. This dose raised my test levels to near 600 but lately it has dropped down to the mid 400's and of course my testicles have decreased in size by 50%. I visited another doctor about my issues and brought up the subject of "other options" and did not get much of a response. He stated that since we were not having anymore kids, just stick with the test you are on and leave all else alone. Basically saying the erection issue was age related so get used to it. I was taken aback because this guy is a very well respected urologist. Anyway not satisfied with that, I went back to my original doctor and inquired about injectable testosterone of which he agreed would likely be better.
I got my first shot yesterday of 100mg test cyp. He told me that he likes to give the shots about every month or six weeks because people get to a plateau after a year or so and get minimal benefits from frequent administration. Do you members find this to be true? I also hear a lot of talk about estrogen and I notice that I was never tested for that. To say the least I am a little confused and frustrated. I am not after anabolic cycling programs, just after good strong workouts and a being able to stay hard for as long as the wife wishes. Thanks in advance.

[Iceberg]

I've been researching vit D. Have you had that checked. Might be a stretch but I've had issues and my D is in the tank. I found out yesterday.

[Equipeeler]

I've been researching vit D. Have you had that checked. Might be a stretch but I've had issues and my D is in the tank. I found out yesterday.

What sort of issues are you having and was that considered to be the culprit?

[Iceberg]

I could get erect just takes a lot longer now. Test is on low end but in range. Libido sucks. Wife has to work hard to get me in the mood. I just started on D yesterday so not sure if that is the culprit or not. It's new to me. I'm 36 and it's been about 6-8 months of having this issue. And before that I was like a dog in heat.

[J DIESEL3]

RUN FROM THIS DOCTOR!! "He likes to give the shots every month to 6 weeks because of plateau after a year"

I can tell you as I'm sure others will taking your shots like this will make your problems much worse...Also frequent injections IS what you want!
You should be injecting once or better yet for some 2 times per week.

[2Sox]

OP,

From the information you provided, it's clear that your doctor does not understand how to treat for TRT. Injections should be given weekly - at a minimum. Most start at 100mg/week T Cyp. To keep you stones from disappearing and for a good quality of life, hCG is frequently prescribed. (Read the sticky post on this subject at the top of this forum.) I wouldn't be without it.

It's good to keep in mind that high estradiol can wreak havoc on your sex life just as surely as low T can, so it's a good idea to test for it throughout your treatment, i.e. forever. Get the sensitive assay. But at the T dose you're taking, it's unlikely you're having issues with this at this time. Nevertheless, when guys get this under control erections and libido are improved most often. Most important is to get your Free T to levels to where you feel most healthy - when the symptoms you described are alleviated. And this means getting a good protocol to work for you - testosterone and hCG.

[bullshark99]

Op, this is well said^^^^^^^. Allow me to put it another way, 2+2=10....if I tried to convince you that is correct, you would conclude I am an idiot. The protocol your Dr is suggesting screams 2+2=10.
The half life of T is 7-8 days, how do you think you will feel on day 25???? Or better yet day 40? Curious how your Dr would answer that, would probably be rather comical.

[Beethoven]

Good advice.

[Equipeeler]

Op, this is well said^^^^^^^. Allow me to put it another way, 2+2=10....if I tried to convince you that is correct, you would conclude I am an idiot. The protocol your Dr is suggesting screams 2+2=10.
The half life of T is 7-8 days, how do you think you will feel on day 25???? Or better yet day 40? Curious how your Dr would answer that, would probably be rather comical.

Thanks for your response, bull shark and 2Sox. I appreciate the input and do understand that my I am headed nowhere with the current physician, hence the reason I am here in less than 24hrs. after the appointment! Unfortunately, I live in south central Louisiana and finding the proper physician is proving a daunting task.
I will continue to search for a "qualified " physician to help me out in this area, but I do have some options available. It is very possible for me to have bloodwork pulled and all appropriate tests run as I have a close friend that works in a lab at a local hospital. That would be simple and I could maybe get some input from the boards on directions to take when I visit a physician by posting results here. Being more educated is always a plus. Since I had an injection of test cyp, 200mg yesterday, how long should I wait before doing blood work?

[bullshark99]

Your original post says 100mgs yesterday? Above you say 200, which is it??? Regardless, this will throw your blood work off. There is a sticky on front which will guide you on what blood is needed. Let the more experienced chime in but I would guess you will need to wait at least a couple weeks to clear that shot out of your system or you will test High on several labs.

[Equipeeler]

Very sorry for the confusion, it was 200mg of test cyp. that I received. I am so used to saying 100mg because of the transdermal that I was using at that strength. Obviously that would make a big difference. Thanks for pointing out my inconsistency.

[Lifted1]

+1 on what 2sox said.

400 total is still on the low side of the range so at this point one of two things will happen...your issue will temporarily get better when your total/free levels rise from the 200mg injection or they will stay the same/get worse from the e2 spike. If you can afford $200 per month for an all~inclusive complete treatment from knowledgeable doctors, I would highly recommend clicking on the LowTestosterone .com box up top.

[Times Roman]

I think you could have Titled the thread a little differently..............

......just saying

[Equipeeler]

+1 on what 2sox said.

400 total is still on the low side of the range so at this point one of two things will happen...your issue will temporarily get better when your total/free levels rise from the 200mg injection or they will stay the same/get worse from the e2 spike. If you can afford $200 per month for an all~inclusive complete treatment from knowledgeable doctors, I would highly recommend clicking on the LowTestosterone .com box up top.

Thanks Lifted 1, I appreciate your suggestion. Finances are not an issue in this matter and I will look into the site suggested. I had been paying $200/month for the transdermal test and no assistance from insurance while going no where.

[bullshark99]

Well truthfully I think there is your answer, they will get you dialed in on a proper protocol with no guessing, good luck!

[Beethoven]

OP you've got some quality responses. If you choose Low T maybe mention you already have bloods and just need a proper protocol. Otherwise you would probably have to wait three weeks or so. Good luck to you and welcome.

[kelkel]

Lot's of good advice above op. Listen to it. To expand on what Bull said, the terminal life of test is 14 - 18 days depending on its ester (enanthate or cyp.) That said, it means the last two to four weeks before your next shot you're running on empty. Horrible protocol bordering on malpractice, imho. He simply does not understand hormones. Find a doc who does or visit LowTestosterone.com - $199 All-Included Testosterone Treatment.

[Equipeeler]

OP you've got some quality responses. If you choose Low T maybe mention you already have bloods and just need a proper protocol. Otherwise you would probably have to wait three weeks or so. Good luck to you and welcome.

Agreed, everyone here has been most helpful and it is very appreciated. Preliminary searches that I have done overnight point me to a few options. Top being Lowtestosterone.com but closet location is 4-5 hours away. I also ran across a couple of docs after searching A4M. Choices in the state of Louisiana appear to be very limited. Are there any Louisiana doctors in the works for Lowtestosterone.com? I will do whatever it takes to address this issue. It is hard to believe that there is so much incompetence among our medical professionals in this area.

[Beethoven]

Agreed, everyone here has been most helpful and it is very appreciated. Preliminary searches that I have done overnight point me to a few options. Top being Lowtestosterone.com but closet location is 4-5 hours away. I also ran across a couple of docs after searching A4M. Choices in the state of Louisiana appear to be very limited. Are there any Louisiana doctors in the works for Lowtestosterone.com? I will do whatever it takes to address this issue. It is hard to believe that there is so much incompetence among our medical professionals in this area.

If worse comes to worse, drive the four hours. The rest can probably be done on line or over the phone. Maybe you can use a local lab for BW and have them sent to your Dr. If you find some local Drs, I would first ask if they are familiar with hormone replacement before making an appt. I had to do that once. It can save you some time.

[bullshark99]

Equip,
After almost 4yrs into my journey to this day it still amazes me the incompetence of many Drs regarding HRT. As Kel indicated it boarders malpractice. The scary part is most think because someone has an MD they MUST be right but it truely scares me how these Drs clearly do not know what they are doing but act as if they do.....if they are so "off base" on this, does make you wonder what else they are just "guessing" thru???
Regardless, I think he 4-5 drive is well worth considering the rest should be able to get done over the phone. Worst case, you may need to make the drive once a year.

[Equipeeler]

Equip,
After almost 4yrs into my journey to this day it still amazes me the incompetence of many Drs regarding HRT. As Kel indicated it boarders malpractice. The scary part is most think because someone has an MD they MUST be right but it truely scares me how these Drs clearly do not know what they are doing but act as if they do.....if they are so "off base" on this, does make you wonder what else they are just "guessing" thru???
Regardless, I think he 4-5 drive is well worth considering the rest should be able to get done over the phone. Worst case, you may need to make the drive once a year.

Thanks again! I am so pleased that I came to this site. People taking time out of their day to actually help someone with issues is a rarity in today's world. I plan to search locally (2 hour radius) over the rest of the weekend knowing that I have Houston or Dallas "in the bag" for help. Plan on lots of calls Monday for sure to get the ball rolling. All advice and criticism is welcomed.

[Equipeeler]

Equip,
After almost 4yrs into my journey to this day it still amazes me the incompetence of many Drs regarding HRT. As Kel indicated it boarders malpractice. The scary part is most think because someone has an MD they MUST be right but it truely scares me how these Drs clearly do not know what they are doing but act as if they do.....if they are so "off base" on this, does make you wonder what else they are just "guessing" thru???
Regardless, I think he 4-5 drive is well worth considering the rest should be able to get done over the phone. Worst case, you may need to make the drive once a year.

Actually, I have kids that live in Dallas and my wife and I love going out to the House Of Blues in Houston. Either way a trip is a win-win

[Metalject]

Man, it seems like the doctor stories keep getting worse and worse. Anyway, like everyone's said, you need to try and find a new doctor. Like Kelkel said, give lowtestosterone.com a try, that's who I use as well and no issues.
One thing I didn't see mentioned in the thread (I could have missed it) fixing a LowT problem doesn't always completely fix an erection problem. Even if testosterone levels and other hormones are optimal and balanced, there can still be issues that PDE5 inhibitors like Cialis can only help so much with, especially when we start getting older. If that ends up being the case, you may have to look into things like Trimix. I'm not saying this is absolutely going to be the case, the first step is to address your hormone/LowT issue, and that may very well be the solution to your problems.

[2Sox]

OP,
It's more than likely that at your age, a correct protocol and daily low dose Cialis will address you issues in no time at all. (I take 10mg/night). I'm the poster child for this. My issues started when I was about your age and now I feel almost like I'm a thirty year old again. Okay, so I'm exaggerating - like a thirty five year old. ;-)

My advice: Take it a day at a time and realize you're not alone. Once your start getting the proper treatment, you'll be astonished at how fast you'll feel improvement. It's very important to see yourself as related to countless others with the same issues - many of whom are on this forum. Out of tens of thousands, you're one of the fortunate few to have found yourself here. Stick around. Listen and learn. Then later on you can return the favor.

[Equipeeler]

OP,
It's more than likely that at your age, a correct protocol and daily low dose Cialis will address you issues in no time at all. (I take 10mg/night). I'm the poster child for this. My issues started when I was about your age and now I feel almost like I'm a thirty year old again. Okay, so I'm exaggerating - like a thirty five year old. ;-)

My advice: Take it a day at a time and realize you're not alone. Once your start getting the proper treatment, you'll be astonished at how fast you'll feel improvement. It's very important to see yourself as related to countless others with the same issues - many of whom are on this forum. Out of tens of thousands, you're one of the fortunate few to have found yourself here. Stick around. Listen and learn. Then later on you can return the favor.

I can't thank you enough for the time devoted to my issues. My first step will be getting the proper protocol instituted. I feel confident that erectile issues will be taken care of and if not I will have proven to myself that I need additional steps. While not always the case, the power of positive thinking goes a long way.

[hawk14dl]

I'm with low t also, my Dr is over 2 hrs away. I have only had to visit him once. My initial visit. Everything else was over the phone, and I go to my local lab corp for the blood draws

[Lifted1]

Thanks Lifted 1, I appreciate your suggestion. Finances are not an issue in this matter and I will look into the site suggested. I had been paying $200/month for the transdermal test and no assistance from insurance while going no where.

No problem brotha. After knowing that you're already used to a monthly payment of $199 I think it's a no brainer to get with LowT.com. I use them and had to fly to southern Cali to visit my doc for the initial appointment, but to me it was well worth my time spending the day traveling for quality care. They will also reimburse you for travel (up to $300) if you provide receipts. Bloodwork will be done locally to you (labcorp), you will communicate by phone or email with the doc and all supplies shipped to your front door.

[kelkel]

My advice: Take it a day at a time and realize you're not alone. Once your start getting the proper treatment, you'll be astonished at how fast you'll feel improvement. It's very important to see yourself as related to countless others with the same issues - many of whom are on this forum. Out of tens of thousands, you're one of the fortunate few to have found yourself here. Stick around. Listen and learn. Then later on you can return the favor.

Good stuff right there ^^^.

[Equipeeler]

No problem brotha. After knowing that you're already used to a monthly payment of $199 I think it's a no brainer to get with LowT.com. I use them and had to fly to southern Cali to visit my doc for the initial appointment, but to me it was well worth my time spending the day traveling for quality care. They will also reimburse you for travel (up to $300) if you provide receipts. Bloodwork will be done locally to you (labcorp), you will communicate by phone or email with the doc and all supplies shipped to your front door.

Just an update, on my quest. I found one local doctor about an hour away that seems to treat patients properly, uses test, HCg, and AI products. Unfortunately I can not get an appointment with her for three weeks with the holidays. With my work and travel schedule, I can not get to Houston or Dallas (closest Lowtestosterone.com location) until after the January 1st. With this information, I called my original doctor who wanted to give me test shots every month or so and asked for more frequent injections to tide me over of which he refused to do. He said another four weeks is the soonest he will administer an injection. I could not believe what I was hearing and figured this would be a holiday season I would like to forget having absolutely no test on board. Armed with that knowledge, I called the pharmacist who was producing my transdermal gel (that I was not having much luck with) and he agreed to formulate me some at 150mg/ml in a new alcohol base that has ultra quick absorption. I agreed to this to get me threw the month until I can get to an appropriate physician. Keeping my fingers crossed and will be running blood work locally to get a handle on all that Kelkel suggests be monitored in the sticky. Hope you guys have a happy thanksgiving!

[Lifted1]

good work! somethings better than nothing...

[Low Testosterone]

Just an update, on my quest. I found one local doctor about an hour away that seems to treat patients properly, uses test, HCg, and AI products. Unfortunately I can not get an appointment with her for three weeks with the holidays. With my work and travel schedule, I can not get to Houston or Dallas (closest Lowtestosterone.com location) until after the January 1st. With this information, I called my original doctor who wanted to give me test shots every month or so and asked for more frequent injections to tide me over of which he refused to do. He said another four weeks is the soonest he will administer an injection. I could not believe what I was hearing and figured this would be a holiday season I would like to forget having absolutely no test on board. Armed with that knowledge, I called the pharmacist who was producing my transdermal gel (that I was not having much luck with) and he agreed to formulate me some at 150mg/ml in a new alcohol base that has ultra quick absorption. I agreed to this to get me threw the month until I can get to an appropriate physician. Keeping my fingers crossed and will be running blood work locally to get a handle on all that Kelkel suggests be monitored in the sticky. Hope you guys have a happy thanksgiving!

If you can find a way to make your schedule work, I am positive we can get you into Houston or Dallas much sooner than the first of the year. I know that could be difficult if you're schedule is tight but if there's anything we can do to help with that and make things easier let me know.

[Equipeeler]

If you can find a way to make your schedule work, I am positive we can get you into Houston or Dallas much sooner than the first of the year. I know that could be difficult if you're schedule is tight but if there's anything we can do to help with that and make things easier let me know.

Again, I thank you for the input and assistance. I have too many commitments throughout the country in the next month that it is not practical. That is just the nature of the holiday season for me and many others. January is a good for me. We are going to Jamaica later that month so as long as I get in early, I will be good. Thanks again and Happy Thanksgiving. Eat good but eat good!

[Equipeeler]

Again, I thank you for the input and assistance. I have too many commitments throughout the country in the next month that it is not practical. That is just the nature of the holiday season for me and many others. January is a good for me. We are going to Jamaica later that month so as long as I get in early, I will be good. Thanks again and Happy Thanksgiving. Eat good but eat good!

Sorry for the auto correct
Eat a lot but eat good today!