Should I stay on clomid or try to start TRT?

[Justlooking5]

Brief background: I'm almost 35 y/o, did multiple but reasonable AAS cycles from age 19 to 25. Crashed after last cycle (taking OTC anti-e supp not clomid) and have had significant hypogonadism symptoms since, causing large decrease in QoL, and chronic anxiety, ED, fatigue, depression that I did not have prior (except for moderate ED).

Currently I'm on clomid 25mg/day since last week prescribed by my urologist after test came back at 369ng/dl despite very good nutrition/sleep/exercise regimen. I have noticed a pretty significant reduction in anxiety, fatigue (both basically gone), and depression since starting, and I think some mild improvement in erectile function w/ some nighttime erections returning. Still no morning wood. Libido is decent but only slightly higher than pre-clomid. Last cycle was in 2005 and I was treated w/ clomid previously but my test went from 1100 on clomid back to 300s off it so my HPTA will likely not "restart."

I am currently debating whether to continue clomid longer term (say at a reduced dose of 12.5mg ED or EOD) or to start TRT and would just like some opinions. The ONLY two choices are clomid or TRT though. I will never go back to chronically feeling like I have been. Even my family agrees (mom etc. knows about AAS history and has been worried about how down I have been for years now urging me to go into Dr.)

Mitigating factors: Due to what I do for work/school I may have to move to a place I cannot control in the future. It could be a semi-rural area or may be a larger city, but I will likely have to move in 4 years (so I cannot be sure I will be able to get TRT in the new city - how available is online TRT?)
Also, I worry that starting TRT could label me as having a pre-existing condition and we don't know how that will affect insurance with it in flux right now in the US.

Health risks: What's more risky? Long term low dose clomid or TRT? I think really no one knows, clomid has the vision issue and negative mood sides whereas TRT will make you dependent on it in a way that clomid does not.

Any thoughts? Anyone go from clomid for low T to TRT and have better results with one or the other?

TLDR: Currently on clomid 25mg/day rx'ed by doctor due to AAS induced hypogonadism (test in 300s). Seeing some improvements mostly in anxiety, fatigue. Debating whether I should continue clomid long term or start TRT. 35 y/o. Interested in experiences comparing clomid only vs. TRT in terms of mood, motivation, energy, libido, gains, overall well being.

(Originally posted in anabolics section but I thought it would be better here.)

 

[GreekTheBrick]

First of all you should take bloods to see where are you with the clomid therapy. In my case clomid raised test just over borderline -360- and when I started TRT I felt a new man, finally functioning as I should.

A serious thing to consider, the most serious IMO, is about having kids. If your HPTA is damaged and clomid or hCG cannot bring you to normal levels, then TRT will shut you down completely and you will have a hard time having kids in the future.

Cant comment of health care in USA as I live on the other side of the sea..

Here, there are many people with a lot of knowledge on TRT, I hope they see it and offer their help on your matter

 

[Justlooking5]

Thanks. One thing I should add that has been influencing my decision a bit. I DON'T want to have kids anytime soon, and likely ever. I was also thinking TRT could be a kind of birth control (I know not necessarily 100% effective) as well, while allowing me to hold off on a vasectomy right now.

 

[bad rad]

Have you tried hCG with the Clomid? Sometimes the testes get very unresponsive from being suppressed for so long. Even after elevating the LH/FSH signals the response is fairly poor. hCG action is much stronger and tends to pull the testes out of their coma. I previously found improvement after one 5000iu injection on a few occasions. The injections were months or years apart. Eventually I stopped responding and ended up on TRT.

 

[Justlooking5]

Thanks, I haven't found a doctor to prescribe me hCG also and these days I can't order anything illegal due to possible professional repercussions. Last I checked hCG is scheduled in my state.

Also, I did respond well to clomid in the past (got my levels up to 1100) but they still fell back to 390 after clomid cessation. I'm guessing the problem is with the hypothalmus/pituitary.