TRT and orgasms

never_again

I haven't had a lot of sexual encounters since I've been on the TRT. Basically 3 ONS in the past 9 months. In each case, I found that I reached the point of O and it just doesn't happen, as in I'm 5 min. or more on the peak before I finally cum, and I have to masturbate to get there. A couple times, including last night, if I wake up from an erotic dream (they're happening more than ever, thankfully), same thing. Masturbation takes forever to get off, and I'm at the peak so long, it's literally exhausting. Anyone else have similar experience?

SkepticalGorilla

Nothing like that. Only time that happened was when I was on SSRI or took tramadol. Are you on other meds?

never_again

As it happens, had my annual blood tests last week, so I asked my dr.  He said it's partly a function of the Androgel, partly age. 

In other news, T level is 10.9 (6.0-27 range), Estradiol 160 (0-172 range) and my PSA - 3.27 (<4.0 is good) and Cholesterol are up a bit.

He's a bit concerned about the PSA with the Androgel, so he's ordered a "free PSA" test as well as total PSA.  Says that Cholesterol is only an issue when combined with other health factors, of which I have none, but the level could be up because I was at hunt camp the previous week and I don't watch my diet at all there.  So we'll recheck both in a month.

JellyBean

Do you take antidepressant medication?

never_again

No. Never have, hope I never have to. Will occasionally nibble the edge of a Viagra pill if I'm feeling self-conscious about my ability to perform, but that hasn't been an issue, given my love life over the last year.

Serenity

Your estradiol level is very high. Ideally, you want that to be in the low 20's. Ask your doctor about using an AI (aromatase inhibitor) to correct it.

Both very-low and very-high estradiol levels have been linked to inability to orgasm, at least anecdotally. I haven't come across any formal studies on it yet, though.

Sorry, can't recall what your porn/masturbation use is like?  That has a strong impact on ability to orgasm. Try giving it up for a few months and see if that helps.

never_again said:

As it happens, had my annual blood tests last week, so I asked my dr.  He said it's partly a function of the Androgel, partly age. 

In other news, T level is 10.9 (6.0-27 range), Estradiol 160 (0-172 range) and my PSA - 3.27 (<4.0 is good) and Cholesterol are up a bit.

He's a bit concerned about the PSA with the Androgel, so he's ordered a "free PSA" test as well as total PSA.  Says that Cholesterol is only an issue when combined with other health factors, of which I have none, but the level could be up because I was at hunt camp the previous week and I don't watch my diet at all there.  So we'll recheck both in a month.

never_again

It's not an inability to orgasm, it just takes forever to.

No porn/masturbation issues.  I've viewed porn maybe 3 times in the last year.  I don't really have an urge to masturbate, except with the erotic dreams, which I mentioned seemed to be happening more often.  Probably 1/2 dozen times this past year, where I went 20 years without having one (at least not waking up from it).

John3

@Never_Again, high estrogen is a problem.  Great article at http://www.peaktestosterone.com/Estrogen.aspx as well as supporting links in the same site.  Your T is still on the low side.  I believe this converts to 319...inside the range of normal, but way below the 600+ that most guys shoot for.   http://www.nebido.com/tools/index.php/en/default/index/conversion-tool is a great conversion tool...very easy to follow.  Androgel has the same impact on internal T production as injection...basically the testicles shut down, which drops your T a couple of months into treatment.  Usually docs up the dosage at this point (same for injection).  For some guys they slowly lose the ability to productively absorb the gel, and the levels continue to drop until they switch to injection. 

AnonJohn

I found that my seminal volume went down a lot on TRT.  

Orgasms are still good though.

Kind of a bummer.

HCG makes it come back but HCG also causes me to hold 10 lbs of water.  No thank you.

never_again

My seminal volume has actually gone up - a lot, but I don't know if it's a function of the TRT or simply not having sex very often.

I'll make sure to talk to my dr about the estrogen level and aromatase inhibitor. I think I'll have a hard time convincing him to up the Androgel (I'm already at 2 tubes/day which is the maximum recommended dose) and he's concerned with the bump in my PSA test enough that he's re-doing it in a month. He's just taken over my old, retired dr's practice (40 years with him) and I've only met him once, so I have to let him get to know me better. My first visit with him went fairly well in that he questioned me pretty extensively on a lot of stuff and my answers seemed to satisfy him.

Pup

@never_again I have the symptoms you describe every time.  I have been having nightly sex with my wife, which is great, but it is becoming almost commonplace that I will require 60 minutes plus to achieve orgasm.  Usually I can get her all excited, and many times she will have an O.  But often I will lose my E before I even get close, then she will have to bring me back to life with  HJ or BJ, and maybe even some dirty talk.  Then it could take 10-15 minutes of that to get me in a state where I can be inserted, and then another 10-15 of working it to get me to O.  The O isn't even that strong any more.

This has been worsening to the point where I will be in her, giving her pleasure and start losing my E right in the middle of the action.  It's puzzling, and it's frustrating because we get started early enough in the evening and almost always end up not getting to sleep before midnight and often 1AM.

As a point of interest, I have been on a statin drug, Astrovastatin (generic Lipitor) for several months.  I have been experiencing worsening symptoms of depression and anxiety.  I had my T tested and it can back in the low 400s, and my E was about 18.  I personally believe that the statin drug has lowered my testosterone and contribute to my depression.  I have also developed a case of wife worship/oneitis, even though I have been with lots of women, I find myself putting her on a pedestal.  I stopped the statin drug Nov 9 and my mood has improved a bit.  Depressive symptoms are starting to fade, but I still have the wife worship problem, and the ED thing is still here.  What makes it worse is that after last night my wife said she thinks the statin is contributing to my ED because she got all sexy/dressed up for me and I still took 90 minutes to O.  That kind of hurt to hear, her acknowledgement of my sexual dysfunction.

never_again

Saw my Dr. for the results of my second round of blood tests. Cholesterol is down (obviously the high test was the fallout from my no-holds-barred eating while on vacation), PSA is well within normal, so he's not worried about them at all.

Asked him about the high estradiol and mentioned aromatase inhibitors. He was surprised at my questions, and frankly admitted that it's completely outside his area of expertise. He's willing to refer me to an endocrinologist, but my questions were so direct that he said he doesn't want to send me to someone else who can't answer them.

So, he's going to do some research and make some inquiries, including his Med School room-mate who now runs a men's health clinic, to find a referral to the right endocrinologist.

He thanked me for the interesting questions, and seems to be taking it as a personal challenge to become better informed.

never_again

Saw the endo today.  Long story short, she doesn't think that there was enough evidence for me to be going on Androgel in the first place, wants me to go completely off for 3 months, then new blood tests and re-assess then.

She went on at length about the new FDA studies linking T-therapy to heart attacks.

Changed_Man

never_again said:

Saw the endo today.  Long story short, she doesn't think that there was enough evidence for me to be going on Androgel in the first place, wants me to go completely off for 3 months, then new blood tests and re-assess then.

She went on at length about the new FDA studies linking T-therapy to heart attacks.

That's funny... @Serenity pointed me to a study that said the opposite with respect to cardiovascular related mortality.

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2834340/

Seriously, get a second opinion.

Serenity

Both viewpoints have validity.

There is a correlation between having low T and poor heart health. That is, guys with the lowest T levels also tend to have the highest rate of heart problems. 

However, if you already have heart problems, starting T therapy can definitely increase your risk. 

There's really not a one-size-fits-all to T therapy. Just like with any other medical treatment, you have to do a cost-benefit analysis. Contra-indications to T therapy include pre-existing breast or prostate cancer, heart problems and being over 60. If you have any of those conditions, you have to decide whether T therapy brings enough benefits to out-weigh the risks.

That's why the single-most important thing you can do before deciding on T therapy is to find a doctor who knows what he's doing. If I could give one take-away, that would be the one. Don't let someone inexperienced muck around with your hormones. 

Changed_Man said:

never_again said:

Saw the endo today.  Long story short, she doesn't think that there was enough evidence for me to be going on Androgel in the first place, wants me to go completely off for 3 months, then new blood tests and re-assess then.

She went on at length about the new FDA studies linking T-therapy to heart attacks.

That's funny... @Serenity pointed me to a study that said the opposite with respect to cardiovascular related mortality.

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2834340/

Seriously, get a second opinion.

Serenity

@never_again  She has a good point. Before jumping into treatment, it's really important to know what's causing your low T. 

Is it primary? Meaning your testes have shut down.  Or is it secondary? Meaning your pituitary is acting wonky.

The answer to that question will determine your treatment plan.

Blog post here and here that go into more detail.

never_again said:

Saw the endo today.  Long story short, she doesn't think that there was enough evidence for me to be going on Androgel in the first place, wants me to go completely off for 3 months, then new blood tests and re-assess then.

Elaine

At the 3 month mark be sure to insist they recheck the E2 along with your T.  If it is still high you need to be on an AI regardless of what they do about the T.  Hopefully it will decrease to the mid 20's range, but if not don't let it slide.

never_again

Had my appt. with the endo yesterday. My T is 11.9 (range 7.9-31 and down from 18.0 when I was on Androgel).  Estradiol is 63 (Down from 160 when I was on Androgel).  She says I'm in range and refuses to provide HRT.  The only thing she would agree to was another blood test in 3 months to see if it changes.

I'm not in a relationship since going off the Androgel, so don't know how this affects me in the sack.  I do know that I'm still interested in women and sex, but I've no urge to masturbate, no nocturnal emissions and rarely morning wood.  But she says that none of that is a problem, even though she asked me those questions.

The_Dude

Deleted because I asked a stupid question. :-)

Northern_Guy

I am experiencing reduced volume and delayed ejaculation too. This is me by myself... no GF or ONS action. Erections are strong and the *sensation* of things is like nothing I've felt before (or have simply long since forgotten). It's strange - it feels twice as good, but takes more to get over the top. Hmmm... will have to research this more and look at the next bloodwork round more closely.

The upshot is the lifestyle improvement. For me, having energy, assertiveness, confidence, a good quantity of "edge"... I need this very much in my life right now for my kids and my career. If it helps one day down the road in a relationship, well, that's a bonus. 8 months into my divorce, "relationship" isn't really on my radar. One attempt at a ONS didn't go anywhere. Meh. Can take it or leave it. The kind of sex I am used to (once-per-month obligatory ovulation sex with the ex) I am not really missing. If it was good, and regular, I'd be missing it like the next guy, I am sure.

In a strange way, it's a blessing in disguise because divorce is hard enough without having powerful desires for sex.

My body said "rest" last night so I did. I watched TV then went to bed, realizing that it was the first time I sat on the couch since starting the Testim gel over 2 weeks ago. I've been going at it hard every day doing pretty much everything plus working out almost daily.

Body isn't in the physical shape to keep up with the energy level yet. That will come.

Mr_Brown

my doc stated being low is a huge issue... Especially with a high body fat percentage. He wants my T levels to be around 600-700. 800 is the uncertain area when it comes to heart issues. He will not treat if your above 400.