I'm 37, and have been having trouble with low libido and ED, and low energy for 5 years or more. When I have sex, I usually lose my ability for a day or two, and my drive for like a week. I thought it was due to psychological issues, but I think that at least part of my trouble has been due to hormonal problems. I finally saw a doctor about it 6 months ago, and the first thing the PA recommended was a Thyroid test. I also had a T test done, at my request. I didn't know much about it, so I didn't ask for other tests like E2, or LH/FSH.
My TSH levels were at 7.6, so I started taking levothyroxine, and they're down to normal (I didn't see that lab, but I think it was around 2).
my latest labs show
Serum T: 387 ng/dL (348-1197)
Free T: 9.1 pg/mL (8.7-25.1)
Prolactin: 4.3 ng/mL (4.0 - 15.2)
I had sex the night before the lab, too, so my prolactin might have been elevated from baseline... not sure.
My PCP said he would prescribe TRT if I wanted to see if it helped with my symptoms, and I actually asked for Striant, which is a ridiculously expensive buccal tab that keeps your levels really even.
Since I'm relatively young, and I still want to have kids, I'm kind of nervous about screwing with my androgens. I asked my PCP about using HCG to keep my testes producing, and he said he was not aware of that therapy, but he would refer me to an endo.
I have no interest in gaining muscle weight, although I wouldn't mind. I'm purely in it for health reasons.
So, I would really appreciate any advice you all have on:
1) What baseline tests I should do before starting TRT.
2) Experience with clomid, especially long term
3) Opinion about whether its even worth doing HRT with levels that are within "normal," even though they're right on the edge.
Thanks a lot for your advice.
Edit: Also, I practice Aikido, a self defense martial art, bike to work, and eat a balanced diet, with plenty of nuts, some meat. I'm pretty skinny. Stress might be part of the issue, but I don't think its the whole story.