Full hormonal profile before and after TRT. 8+ years with propecia; 3y off

Hello All:

Weened off clomid in 4 weeks and got tested on last December with the following results:

FSH 2.2 mIU/mL (0.95 - 11.95)
LH 4.5 mIU/mL (1.14 - 8.75)
Oestradiol 118 pmol/L (no range given)
Testosterone 20.80 nmol/L (9.00 - 30.00)

So clomid did its effect of getting me to produce testosterone and it seems my system is awaken in that regards, as I still produce testosterone without having the drug. Will test again to confirm this point.

I feel better in terms of fatigue, but ED persists and so does depression (which leads to fatigue) if I’m off the antidepressants.

Quitted Buproprion and Reboxetine and depression came back. Now I’m on mirtazepine 30mgs. per day, as it has no sexual side effects. Will probably give a boost to dopamine in 1 month with cabergoline if I need help with attention matters.

Only followed during 2 weeks the 5mg/day Cialis treatment, under which I noticed that nocturnal and morning erections were harder and lasted longer. During the day I could feel some activity down there, but never enough to induce an spontaneous or voluntary (manipulation absent) erection. Penis has more vascularity when excited, though. Still have libido issues.

Will test in one month for venous leaks.

Happy New Year to everybody; let’s hope we make significant improvements in 2011 in our issues!
Cheers

mate as i told you cialis won´t help you out with your libido problems and will give you no more pleasure either. My endo agreeded whith that when i told her. In my opinion (just based on my experiencie, of course) there is no point in taking this drug regularly or even when you have sex since i feel stupid having my penis very hard but still no good sensations. It is just awful to make your sexual partner happy but it is not what we need.

Cabergoline will help if your PRL is still high. Mine broght down naturally and still no libido and serious ED so that was not the path i have to follow.

I hope we will get better in 2011 as you pointed out :laughing:

Thanks, reeeff.

I took and may take again cialis to help with erections, not libido. It does help a bit with erections and, in the right circumstances, I can have moderately satisfying sexual intercourse when on it and properly aroused.

I agree it’s no a solution, but absent any, it’s a patch to resort to in some ocassions.

About cabergoline, I may take it under my current doctor’s supervision to help with cognitive side effects, as it will boost my production of dopamine, which may be a better solution than just inhibiting its reuptake (wellbutrin).

Have you ever tried wellbutrim? I read about that stuff but i don´t know if i could get any good from it as there are contrary opinions about its effect. Let me know if you are getting something to tackle fatigue as mine is getting even worse ( i just want to be in bed chating or reading a paper ). Tribulus maybe? Ginseng? (that stuff did not help me in the past).

Did you get your sperma check? I will do it this week as my endo said with those low values of FSH and LH (very close to the inferior border) my reproduction system may be in trouble.

I will post here any updates that might help you too.

:smiley:

Yes, I’ve tried wellbutrin and reboxetine to cope with lack of attention, not with fatigue. As they also seem to lift my mood, fatigue lowers.

I haven’t had a spermogram done, but it’s something I want to do. My ejaculation is poor; sometimes only a few drops and without strength.

Yep, that is happening to my ejaculation lately. Furthermore, i don´t even get a full erection when i am about to ejaculate. I will be posting my semiogram when i get it done.

I am interested in meds to cope with fatigue, almost no libido and severe ed. If only i could find something like that in a pharmacy…

I may buy some wellbutrim. Where do you get it?

Cheers

are you gonna try an estrogen blocker?

you can try some indolplex dim, calcium d glucarate, chrysin with piperine

or aromasin low dose, arimidex perhaps

The doctor didn’t prescribe me any, so I assume I don’t need it.

On mirtazapine 75mgs a day and 0.5mg cabergoline twice a week for one month until my next vdoctor visit.

Well, it seems that Jairus is fighting very strongly against this nightmare. I am glad not only for this good news but also because this can be helpful for all of us.

Jairus mate, i would like to know about you cialis treatment, whether you ended up taking it daily or in a differet dose and how it worked on you.

Well, regarding myself, i took one month ago the reaction test to FSH and LH increment (sorry, im not an expert in this issue so i don’t know the concrete name of the test in English) but clearly the response was very low, which means that even though i got my hormones estimulateD, apparently they don’t react with the intensity which is expected from a “sane” male.

2 years and a half after discontinuation, I can assure that i have been sexually screewed for at least one year and a half. Fatigue, some depression and a bit of brainfog are still there too but my endo is not sure about the path to follow.

Cheers

Thank you, reeeff

I only tried the cialis treatment for 2 weeks. It works to have better erections (or an erection) when manipulated / estimulated. Saves you the date, but libido is missing. I might try the treatment for longer once I test the results of cabergoline, which for the moment are insignificant.

Also, mirtazapine doesn not help with the fuzzyness of the mind, although it relieves depression symptoms to some extent. But lack of motivation for things and of mental focus is still there. Hopefully cabergoline will help with that and if it doesn’t I may go back to edronax / wellbutrin or try ritalin in combination with mirtazapine.

What is the name of that test you took in your language?

i believe he is referring to the clomid stimulation test, which pumps out more LH and thus more testosterone, if your nuts are healthy enough :wink:

thanks!

Well, it is me the only nut over here lol as i forgot the name of the test (due to my lack of memory post-finas side effect, which is quite severe in my case). Its name is GNRH test, very well known on this forum and basically consists of admistering a fixed amount of the gonadrotrophin hormone to kick off your Fsh and Lh production and measures whether your pituitary works properly. In my case the response was very low, I do not remember the exact values, sorry, but i am abroad right now so i cannot check the test info right now. Anyway, my endo said this test revealed a kind of deficiency in my pituitary response. Actually, values were at the botton ot the range, doesn’t it sound familiar?

Therefore, this may reflect jarius’ side effects may come exactly from the same source as me: pituitary lack of response to stimulous. It may be working just at a 25% of capacity so i can sometimes keep weak erections.

This is just my theoric point of view, of course, but my ED persists, so does my lack of libido and quite a few mental problems and fatigue…

thanks, mate. I’ll ask my endo about this test. however, he concluded my axis works fine as i am producing sufficiently enough testosterone after tamoxifen.

So been 5 weeks on cabergoline, 2 or 3 at 0.5 mg twice per week, and one time having 0.75 mg and another 1mg in a week and nothing happened. No sides, no erections.

Seeing the doctor in 3 weeks for maybe am erection test with some drug that makes your body have one even if you don’t want. You could keep it for up to 4 hours, he said, as long as you don’t have venous leaks.

Going back in reboxetine again; feel some more energy in the morning and better concentration, but not ideal.

Hello all:

I want to report an improvement in the sexual side effects:

Last week I had a full erection withou manipulation, just watching some porn and having mental fantasies. It’s been the first such an erection since the last years with finasteride and all the time thereafter; maybe totalling around 8-10 years. I purposedly engaged in such activity to test to which extent I could get an erection. On the previous day / weeks I had been feeling a connection with the penis, I was having stronger and more frequent nocturnal and morning erections and I had a bit of libido and ocassional sexual thoughts. When I tried this previously, the most I could achieve was significant vascularization of the penis and its humectation, but no erection at all.

I discussed this with my doctor and he said that maybe it is the mirtazapine, but we don’t really know.

Nocturnal and morning erections are more frequent and stronger; as many as 3 days in a row and 4 or 5 days in a week, but not every single week. I still can’t mantain morning erections when awaken, though.

During a window of 2-3 weeks’ time and 3 weeks before this happened, I had been weight lifting intensively and having around 18 gr. of creatine monohydrate per day on the first week, then around 7gr per day; plus glutamine after exercising 3-4 times per week, and 5 - 8 IU daily of Vitamine D3. However, I don’t think this is the cause of the improvement as I had creatine monohydrate and high doses of Vitame D3 before and didn’t experience any improvements. I also tried on three ocassions having 20 grs. of L-arginine before sleep to see if I could have better nocturnal / morning erections, but it didn’t happen (actually on those days I had no morning erections).

Also, at the doctors’ clinic I had an injection in my penis to check for venous leaks and it seems I don’t have any, as I had almost a full erection (and artificial and painful) lasting more than an hour. I had a delayed reaction, though, as it took more than the usual time to have the effect.

On the brain fog side, I am on 8mgs./ day of reboxetine, which helps significantly, but is not optimal.
Depression is gone at 60mg of mirtazapine and 8mgs of reboxetine per day.
Good things about mirtazapine: helps me conciliating sleep (haven’t got any issues here anymore); makes me rest well and have vivid dreams that I can recall, which didn’t happen before, and gives me serenity, relieving anguish feelings and making me feel more myself. The only bad thing is that it makes me sleep too much and leaves me sluggish furing the day, so I have to resort to caffeine pills and to teas / coffees to function well at a mental level and have energy. This is a major drawback as it is incapacitating for a normal work / study life, so I am lowering the dose of mirtazapine now and might switch back into buproprion.

Overall energy levels are better than before, but I am still lacking a morning kick that’s sustained during the day.

I had bloodwork done, which I will post when I get it from the doctor. Testosterone came lower than the last time: 14nmol/L vs 20.80 nmol/L (9.00 - 30.00), but I got tested at nearly 4pm, and according to the doctor testosterone levels will be lower at that time. My 14nmol/L would correspond to aroun 18nmol/L in the morning, which is a normal testosterone level for adults.

With all this, the next steps will be:

  • going back on tamoxifen daily during 2 months, to raise my testosterone levels to the upper third of the normal range. Objective: trying to have increased energy levels and an improved sexual function (the latter didn’t happen last time I was on tamoxifen)
  • lowering mirtazapine to 30 mgs. to try to get rid of the excessive sleep and sluggishnesh.
  • potentially substituting mirtazapine with buproprion

My doctor also mentioned that I may try modafinil to improve focus, but that we will assess this later, to act upon one thing at a time. Also, there’s some interaction problems of modafinil with the other drugs, so I will have to quit some of them if I follow the modafinil route.

That’s all for now; will post the test results soon.

Keep on fighting, guys; we have to believe that there will eventually be something that fixes us and meanwhile there’s a number of ways we can explore to patch up some of the more incapacitating issues.

It is good to see that you are seeing some improvement. I haven’t heard of any of the drugs you mentioned apart from Modafinil which I have taken myself (and do not react well too).

Are they supposed to help you with your sexual well being?

tamoxifen induces your body to produce its own testosterone, and that in theory may help with sexual side effects, although it hasn’t worked like that for me so far

mirtazapine is one of the antidepressants that has a lower or null impact on erectyle function. Most of the SSRI’s and other types of antidepressants may cause E.D. So changing to mirtazapine may help with sexual function.

reboxetine does NOT help with sexual function; impotence is one of the side effects stated in its prospectus. I take it to combat depression and brain fog.

buproprion is an antidepressant acting upon dopamine, so it may be helpful with ED, although I didn’t improve in that aspect while on it. I have had it to treat depression and brain fog.

Hi Jairus,

I am very aware of your sexual problems but I thought you had overcome the others. How bad is your brain fog and depression mate?

In my case, my brain fog has been getting better progesively, although i sometimes forget things I should not to. On the other hand, I do feel a bit down ocassionaly, which may be linked to depression too. Actually my last endo told me she had seen me “a bit down” so tested my dopamine, which was “not too bad”. Well, it is not strange im feeling in that way as i cannot have sex when i want and being young is very connected to sexual necessities.

I am having a new appointment in 4 weeks but still suffering from severe ED and almost no libido at all. I might suggest to her that I could start with some TRT treatment, which was out of the table 3 months ago, but as I am still feeling crap I will insist on it very likely. However, as many guys here haven´t had any improvement on TRT, im not very excited to start it either.

I am trying to handle brainfog with the meds. Currently keeping it 70% at bay, but been feeling sluggish probably due to the mirtazapine. I’ve stopped taking it and I’ll get back to buproprion + reboxetine. Even if reboxetine has sexual side-effects; the worse side is brainfog by far, so if it gets somehow alleviated that’s a success.

Glad to hear that your brainfog is improving. Sexual sides are difficult to tackle, though. I am these days back to usual: no libido, few and weak morning erections. I have accepted it as my normal state, so don’t give it too many thoughts.

I thought that dopamine and other neurotransmitters couldn’t be tested for reliably; at least that’s what a psychiatrist told me once. I’m seeing that some people in the forum are getting tested for them; did your doctor commented on testing other neurotransmitters and on the reliability of the test?

Why don’t you propose to your doc to go on clomid / novaldex ? From the experience of many here looks like it’s a first step to explore before going on TRT.