[Hyde12]

found this study....interesting

http://www.ingentaconnect.com/conten...00003/art00009

[Megazoid]

Nice one hyde. I seen that study before when i was doing research way back, good article.

I believe varicocele causes "dysfunction" rather than failure. My theory is that the actual secreted T takes longer to get into the blood stream due to the weak blood flow. This in turn leads to lower total T. LH will only elevate when the leydig cells suffer from atrophy or the leydig cell array is reduced (due to tissue death).

I need to go back in and get a venogram done (to check for leaking veins) as the varicocele is still causing pain for me and i am getting reflux/back flow in the veins.

I had a doppler ultrasound done and it showed back flow on aspiration which could be causing my problems. The good new's however was that the testicles were both intact with regards to the echo texture or "meat" of the testicles themself. The urologist said i had shrinkage but NOT atrophy. He described atrophy is as being actual tissue changes and death of the testicle cells/tissues.

How are you progressing yourself? No pain or anything from the varicocele? You need to your get your LH up to 3.9, i don't think you've recovered properly.

[Hyde12]

Originally Posted by Megazoid

Nice one hyde. I seen that study before when i was doing research way back, good article.

I believe varicocele causes "dysfunction" rather than failure. My theory is that the actual secreted T takes longer to get into the blood stream due to the weak blood flow. This in turn leads to lower total T. LH will only elevate when the leydig cells suffer from atrophy or the leydig cell array is reduced (due to tissue death).

I need to go back in and get a venogram done (to check for leaking veins) as the varicocele is still causing pain for me and i am getting reflux/back flow in the veins.

I had a doppler ultrasound done and it showed back flow on aspiration which could be causing my problems. The good new's however was that the testicles were both intact with regards to the echo texture or "meat" of the testicles themself. The urologist said i had shrinkage but NOT atrophy. He described atrophy is as being actual tissue changes and death of the testicle cells/tissues.

How are you progressing yourself? No pain or anything from the varicocele? You need to your get your LH up to 3.9, i don't think you've recovered properly.

Well, right after the surgery I started feeking good and then my libido took a nose dive again.So, I started taking 6-oxo, ZMA and fenugreek and Im starting to feel much better. I even had some morning wood this morning My left testicle was hurting really really bad this morning. I dont know if its a good sign (like maybe its coming back to life) or a bad sign.

[JanSz]

Originally Posted by Hyde12

Well, right after the surgery I started feeking good and then my libido took a nose dive again.So, I started taking 6-oxo, ZMA and fenugreek and Im starting to feel much better. I even had some morning wood this morning My left testicle was hurting really really bad this morning. I dont know if its a good sign (like maybe its coming back to life) or a bad sign.

Describe what fenugreek does in this context.

[Megazoid]

Difficult to say. Is the pain coming from the veins or spermatic cord or the actual "ball" itself?

[Hyde12]

it seems like the actual ball itself

[Hyde12]

Originally Posted by JanSz

Describe what fenugreek does in this context.

Helps with libido and semen quantity. Fenugreek is also reported to increase testosterone. Yeah, I know that it raises progesterone but that is only in women.

[Hyde12]

Well, they did another ultrasound and said that it looks like I may have epididymitis! This sucks if its not one thing its another!

[sammowise]

I finally got my second set of tests back (a week late... they somehow lost them the first time I went in ) So here thery are:

testosterone, total 273 ng/dL 250-1100
testosterone, free 47.7 pg/mL 35.0-155.0
% free testosterone 1.75 1.1-2.8

LH 1.9 mIU/mL 1.5-9.3
FSH 1.4 mIU/mL 1.6-8.0
Prolactin 8.4 ng/mL 2.0-18.0

Based on my (admittedly limited) understanding of the hpta, low LH and FSH probably means my testicles probably aren't the problem, corrent?

The urologist I was seeing said he didn't want to prescribe testosterone replacement since it was still in range. However, he seems to realize that there definately is something wrong, so he's sending my to an endocrinologist instead. (At least he can admit he doesn't know enough about it...)

I'm guessing I should now be looking into the possibility of either 1) pituitary problems of some sort or 2) elevated estrogen levels.

thoughts?

[JanSz]

Originally Posted by sammowise

I finally got my second set of tests back (a week late... they somehow lost them the first time I went in ) So here thery are:

testosterone, total 273 ng/dL 250-1100
testosterone, free 47.7 pg/mL 35.0-155.0
% free testosterone 1.75 1.1-2.8

LH 1.9 mIU/mL 1.5-9.3
FSH 1.4 mIU/mL 1.6-8.0
Prolactin 8.4 ng/mL 2.0-18.0

Based on my (admittedly limited) understanding of the hpta, low LH and FSH probably means my testicles probably aren't the problem, corrent?

The urologist I was seeing said he didn't want to prescribe testosterone replacement since it was still in range. However, he seems to realize that there definately is something wrong, so he's sending my to an endocrinologist instead. (At least he can admit he doesn't know enough about it...)

I'm guessing I should now be looking into the possibility of either 1) pituitary problems of some sort or 2) elevated estrogen levels.

thoughts?

1. It would be helpfull to start with more complete test, post what you have, you have mentioned of having extensive test done.
2. Add the E2, DHT, SHBG, Albumin (at least), possibly thyroid and adrenals info.
3. You may want to look into HCG alone first, possibly plus DIM.

[KSman]

Originally Posted by sammowise

I finally got my second set of tests back (a week late... they somehow lost them the first time I went in ) So here thery are:

testosterone, total 273 ng/dL 250-1100
testosterone, free 47.7 pg/mL 35.0-155.0
% free testosterone 1.75 1.1-2.8

LH 1.9 mIU/mL 1.5-9.3
FSH 1.4 mIU/mL 1.6-8.0
Prolactin 8.4 ng/mL 2.0-18.0

Based on my (admittedly limited) understanding of the hpta, low LH and FSH probably means my testicles probably aren't the problem, corrent?

The urologist I was seeing said he didn't want to prescribe testosterone replacement since it was still in range. However, he seems to realize that there definately is something wrong, so he's sending my to an endocrinologist instead. (At least he can admit he doesn't know enough about it...)

I'm guessing I should now be looking into the possibility of either 1) pituitary problems of some sort or 2) elevated estrogen levels.

thoughts?

The T is very low. The low FSH and LH are probably the cause as the testes are not been told to make T. You probably need T and HCG. The HCG will put the testes to work. 250iu HCG injected SQ/SC EOD might be tried alone. It will take a while for the testes to get back up to speed. Then a test for T levels would indicate if you need more T. But you doc may go right to the T.

Future tests will need to also get E2 estrogen levels.

[Hyde12]

Well, Im going back to the Urologist Friday becase it seems like the Varicocele is still there and the surgery was about 2 months ago. I dont know how long it typically takes to heal.

[Megazoid]

The varicoceles never actually go away hyde. Once you have it, it's always there, surgery or not. Basically the surgery does improve matters (this is known) with regards to pain and sometimes sperm/testosterone levels but other times it makes it worse. It's usually best to get it fixed though to out-rule it.

I would request a color doppler ultrasound and also more recent blood work to see how thing's are going. Have your testicles increased in size at all?

[MuscleBound1337]

I had the surgery in the end of august.. Doc told me it was pretty big and had to remove some vessels.. and that there would be scar tissue left.. Now I think I can feel another varicocele forming so I'm going to make an appointment with the urologist tomorrow.. Should I ask for bloodwork to check test levels? What else should I have checked? last time I didn't know how it effected test and the doctor never said anything and never did bloodwork to check my testosterone.. I had a pretty bad one my left testicle was atrophied so I probably had some lowered test/sperm production..

[Hyde12]

Originally Posted by Megazoid

The varicoceles never actually go away hyde. Once you have it, it's always there, surgery or not. Basically the surgery does improve matters (this is known) with regards to pain and sometimes sperm/testosterone levels but other times it makes it worse. It's usually best to get it fixed though to out-rule it.

I would request a color doppler ultrasound and also more recent blood work to see how thing's are going. Have your testicles increased in size at all?

Yeah, it seems like they have increased in size, but the wierd thing is is that they dont hang as low as they used to. I'm using some clomid right now and that seems to be helping a lot. I do feel a marked improvement now as to before my Varicocele ligation. My Urologist says it will go away in time. I dont really see why a Varicocele should'nt go away because you are redirecting blood flow to another vein.

[KSman]

Originally Posted by Hyde12

Yeah, it seems like they have increased in size, but the wierd thing is is that they dont hang as low as they used to. I'm using some clomid right now and that seems to be helping a lot. I do feel a marked improvement now as to before my Varicocele ligation. My Urologist says it will go away in time. I dont really see why a Varicocele should'nt go away because you are redirecting blood flow to another vein.

The size and hanging are both LH related. Clomid will raise your LH and that should do the trick if your hypothalamus and pituitary are up to the task.

The testes are also responsive to DHT and that depends on T to make that. So that is a time delay. The levels of T inside the testes are around 100 times that of serum. So there will be more than enough T inside the testes.

HCG could be used to hurry things along, but that is repressive and would set back your own LH response.

As E levels do create a negative feedback on LH, E can impede your progress. While you are taking clomid, you are blinding your hypothalamus to the E levels and the LH levels will raise. There will be increased E and T. Note that the increased E will create increased interference at T receptors.

Note that the T levels will also raise and the E & SHBG levels typically then increase as well. If you stop the clomid suddenly, the hypothalamus will suddenly be exposed to all of that E and again you have a setback in your progress. So you will need to taper off of that clomid just like someone on PCT. One could use an AI to manage that transition as well.

Some guys get emotional from clomid from its estrogenic side effects, something common with some estrogentic SERMs. There are SERMs that do not have those sides. The increased E from a SERM can improve arterial endothelial function and skin tone. But I suspect that the increased E will promote or retain female-like fat patterns that many can shed with effective TRT. E is also now considered the major culprit for prostate enlargement and inflammation.