New to forum 37 year old with sexual dysfunction from antidepressants

[Markc2008]

Even on low test I convert a lot to e2 but the hcg makes that worse..

[Simbarn]

I was on hcg to keep fertility and it worked as my wife is pregnant but it spikes my e2. I aromatize very highly to e2. My dosage does need to go down some. I’m thinking of going to test only. I’m taking a very small dose of anastrazole that’s being specially compounded so I don’t have to try to cut them. But I still don’t like taking it.

Ok, yes HCG can be enough for some men to remain fertile. Yes correct, HCG can cause estrogenic like effects in the male for some guys, as its not made in the male body naturally. Ovidrel, which is the recombinant version of HCG seemed to have less of this effect on me. I had no nipple issues with this, but I did with HCG. Ovidrel does not degrade anywhere near as quickly as HCG does too.
There was a time when I was taking too much T. It also caused many issues in my body.

If it was me as I cannot give advice, I have in the past gone back to basics. That is reduced my T dose to 80-100mgs per week, split in two injections. I also stopped HCG. I used an AI once and never again; I could feel my E levels plummet and it too weeks to regain sexual function.
It took time for my body to resensitise to a more normal level of T and for other hormones to stabilise and I'm talking months here, not weeks.
When the above has occured and the effects of T can once again be felt sexually, one could reintroduce Ovidrel at a low dose once per week and see how the body responds.
I feel that once the aromatase enzyme has built up in the body due to a reaction to excessive T levels, it takes time for it to reduce.
I have also noticed a big improvement by taking cialis in a low dose daily as opposed to on demand use. This is long term therapy. I have been doing this for almost 12 months now and sexual sensitivity in my penis has improved markedly.

[Markc2008]

Yeah I’m injecting three times a week. I’ve been bouncing around the idea of going back to just test for a bit. Cialis on demand used to work great. I can try the daily. Are you using 5mg a day? You haven’t had any tolerance issues?

[Simbarn]

Yeah I’m injecting three times a week. I’ve been bouncing around the idea of going back to just test for a bit. Cialis on demand used to work great. I can try the daily. Are you using 5mg a day? You haven’t had any tolerance issues?

Yes 5mgs a day, however, every 2- 3days I skip a dose as it builds in the system due to its half life. No tolerance issue yet. This works differently in the body than on demand. You could read some of my other posts where I talk about how long term PDE5i therapy may help erectile function.
The more frequent dosing of T is generally a good idea to minimise peaks and troughs. I found no difference between 2 or 3 shots per week.
I have always been keen on keeping things simple. I found going back to just one medication and getting that right first made a such a big difference. Some TRT doctors keep throwing more medications into the mix and everything gets so complicated, no one knows whats going on anymore.
Its IMO very possible that T receptors get less sensitive if T levels become supraphysiologic for an extended period of time. Everyone has a different genetic set-point for their T levels.
Your doctor has you on 130mgs a week of T (from what I could work out) then he is stimulating your leydig cells in your testes to produce even more T from the HCG and then he has you a T cream!! No wonder you are aromatising T into E! Some men would produce adequate levels of T just from the hcg dose you are currently on. More is just not better when it comes to testosterone.

[Markc2008]

In fairness I asked for the cream to get my dht up to try to help libido. The cream application for some reason converts more to dht. It has seemed to help. I have PSSD If your familiar with that and have a lot of dysfunction with it. I haven’t noticed much with the injections even at these higher levels. My honest opinion is my AR is silenced from the pssd as I haven’t gained any muscle or felt any different. But that’s just an opinion. Yeah I think my plan is—And I’ll discuss it with my dr at Defy Medical— but I think I want to do a lower test only injection, kee the cream if possible, and eliminate hcg and anastrazole. Then maybe every three months do a 3-4 weeks with hcg to jumpstart natural production again so maybe I never fully shut down long term.

[Markc2008]

Even with high test levels my dht is 46 which normal range is 30-85, so I had a little room

[Simbarn]

In fairness I asked for the cream to get my dht up to try to help libido. The cream application for some reason converts more to dht. It has seemed to help. I have PSSD If your familiar with that and have a lot of dysfunction with it. I haven’t noticed much with the injections even at these higher levels. My honest opinion is my AR is silenced from the pssd as I haven’t gained any muscle or felt any different. But that’s just an opinion. Yeah I think my plan is—And I’ll discuss it with my dr at Defy Medical— but I think I want to do a lower test only injection, kee the cream if possible, and eliminate hcg and anastrazole. Then maybe every three months do a 3-4 weeks with hcg to jumpstart natural production again so maybe I never fully shut down long term.

Ok, I understand a little more now. DHT is indeed very important and it is interesting that it is remaining at that level with quite a high T level.
Did you try just T transdermal on its own at any stage?
I am not familiar with PSSD. I had a quick look and am interested in learning more. So will do some reading on the condition.
Also quite fascinating that you have had no muscle gain from that level of T as well. Has this been the case with training with weights in the gym?

[Markc2008]

Yeah I’m thin and I guess slightly tone but haven’t gained any muscle from it. There are theories that ar and er can be silenced from pssd but who knows. I haven’t tried cream by itself but may in the future. The cream has helped some with libido and sensitivity as well as better erections some. Not sure if it’s because of where I’m applying it or not.