HTPA/Testicular Function recovery

Lutalo

New member
Hi Guys

I just wanted some advice regarding long term or permanent shut down on a cycle I ran.

Back in 2011 a good friend of mine suggested that I run a test e cycle if I wanted to gain 10kg to go up a weight class in boxing. I was a solid 88kg but wanted to go to 98kg.

As the guy was a close friend who was in great shape and who was running a test prop cycle I took his advice and followed a plan he set out for me.

12 weeks test e 500mg a week in two 250mg shots. One one Monday one on Thursday. I didn't run any HCG with the cycle as he didn't advise me to. For pct , again on his recommendations I ran nolva along side xlean anti cortisol supplements. He said this was always his pct and he always fully recovered.

Anyway since then I had low libido, erectile problems and premature ejaculation issues. I've seen an endo and my test was low, prolactin was high but LH, FSH, PSA and SHGB were all in range. I got placed on a dopamine agonist and my prolactin went down and test came up. Premature ejaculation stopped, erections were better but still low libido. All ranges were back in the norm.

I'm currently taking 50mg of clomid a day and when I train, eat clean and get good sleep I have a libido, if somewhat lower than before all this. My testicles feel full so I don't think I have primary hypogonadism.

Has anyone ever heard of these problems from a test e cycle? I was under the impression that the cycle I did was relatively mild.

Any suggestions about a pct I should do?

I was considering doing another 12 week test e cycle with some proviron, arimidex and 2 weekly shots of HCG 250mg. Then running a pct of aromasin and nolvadex or Clomid and Aromasin.

But I want to try sort the mess I'm in out before I venture down that road. Any input or suggestions would be much appreciated.
 
My prolactin was in the 700's but now it's 5.

I've been on Clomid for 5/6 weeks at 50mg a day.
Peppers ? Glad I can be of some help.
 
Lutalo said:
My prolactin was in the 700's but now it's 5.

I've been on Clomid for 5/6 weeks at 50mg a day.

Peppers ? Glad I can be of some help.
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Why are you running clomid?

700??? Did you get a MRI?

There are only two things that cause prolactin in the 700s in a male. Pituitary tumor and drugs that increase prolactin like anti-psychotics. Test will not do it.
 
I had an MRI and there was no sign of a prolactinoma. I underwent a metoclopramide test too, to double check. I had previously used finasteride for hairloss I know this drug has caused a lot of continuous negative sides in users.

Since taking Cabergoline my prolactin has been in check and not really a problem. My endo suggested a trial with clomid to help raise test and hopefully my libido. Although from research clomid can be a libido killer. My endo is undecided whether the issues are related to steroid use or finasteride use. He thinks the high prolactin is caused by stress.

The issue seems to be that despite test being in range it's not in the upper 3rd like it should be for a man my age -29.

So should I assume the test e use hasn't been a factor here?

I'm considering trying to convince my endo to give me a trial of proviron. Hopefully more free test will sort me out.
 
Prolactin from stress? Doubtful. I would be very skeptical about that. Did they try stopping the caber to see if your prolactin came bsck up?
 
No I haven't, tbh I'm reluctant to come off the caber because it has helped with the erectile dysfunction and premature ejaculation - which are known symptoms of androgen deficiency and/or high prolactin.

I really want to drop to about 8% bf and pack on 5/10lbs worth of muscle. I think that might help with libido especially.

For that I'd like to do another cycle but want to be sure the gear didn't exacerbate the issues.
 
I would figure out your health problems first. People just don't have prolactin in the 700s. It just doesn't happen. What was your thyroid function? I'd also want a repeat MRI.
 
I've had so many repeat bloods taken. Everything, according to my Dr, was in range including Thyroid Function and the only abnormalities were my prolactin and test. I think it could be from fin use - in which a lot of specialists suggest a htpa restart protocol/pct or drug therapy i.e proviron, clomid or hcg. Failing any of those it's trt. My only issue is I have seemed to complicate things with the test e cycle.

Is it safe to assume that my pct after the test was sufficient? I didn't have any loss to my gains and the only real issues were the high prolactin and low test (and the symptoms they come with)
 
Well I'm not sure on the direct effects of finasteride on prolactin, however the drug has been reported to cause endocrine defects that cause continuous sexual side effects after ceasing the drug. There's a forum called propeciahelp.com if you're interested in looking in to it more. A number of well respected endo's in the US have posted studies and hypothesis but are still unsure of what mechanism causes what has become post finasteride syndrome or pfs.

All I know is that before fin and before my cycle I had no issues what so ever.
 
It has no effect on prolactin.

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There isn't a single reference about pfs on pubmed. The brief web search I did mostly sounds like bs hypotheses. It's more likely your problems are from your cycle and pct. Permanent hpta shutdown is rare but documented. I'd be more concerned about the high prolactin because occult tumor would be on the top of my differential.

Lutalo said:
Well I'm not sure on the direct effects of finasteride on prolactin, however the drug has been reported to cause endocrine defects that cause continuous sexual side effects after ceasing the drug. There's a forum called propeciahelp.com if you're interested in looking in to it more. A number of well respected endo's in the US have posted studies and hypothesis but are still unsure of what mechanism causes what has become post finasteride syndrome or pfs.

All I know is that before fin and before my cycle I had no issues what so ever.
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I agree pfs is widely disputed, but there are plenty of men who haven't taken aas that have taken fin amd experience a whole host of sexual problems despite some having seemingly normal hormone levels.

I don't think my htpa is completely damaged or wholly shut down because I'm still producing in range levels of test and my oestrogen is reportedly low.

Next time I have a full blood panel I'll post tjem along with the ranges.

Thanks for your input. I wonder if doing another pct would help me.
 
I was talking to one of my coworkers he's a endocrinologist and he has seen finastride elevate the prolactin not in numbers such as 700 byAny means.
 
Well you're already doing another pct with clomid.

Lutalo said:
I agree pfs is widely disputed, but there are plenty of men who haven't taken aas that have taken fin amd experience a whole host of sexual problems despite some having seemingly normal hormone levels.

I don't think my htpa is completely damaged or wholly shut down because I'm still producing in range levels of test and my oestrogen is reportedly low.

Next time I have a full blood panel I'll post tjem along with the ranges.

Thanks for your input. I wonder if doing another pct would help me.
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Sorry to bump this over this and without input but MuscleJ I'm trying to PM you back but your inbox is full, sorry this was the newest thread I saw you've posted in!
 
Would suggest, also, that libido isn't purely physical, at this point, mental aspects will enter into it, as in "performance anxiety" etc. Advice on the other aspects by mystere is some of the best posts i have read on a forum, anywhere.

As to another cycle, really? None of this has been enough to put you off?
 
Mystere3 said:
Well you're already doing another pct with clomid.
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Well from the research I have conducted, I was regarding a pct as having more than one element and taken over a short period of time.

At present I take 50mg of clomid ed and will do so for 3 months.

I was under the impression a 4/6 week "power" pct of hcg (250mg weeks 1-3) aromasin 50/50/25/25 and Nolvadex 40/40/20/10 is a much better choice than clomid as a stand alone.
 
simonboyle said:
Would suggest, also, that libido isn't purely physical, at this point, mental aspects will enter into it, as in "performance anxiety" etc. Advice on the other aspects by mystere is some of the best posts i have read on a forum, anywhere.

As to another cycle, really? None of this has been enough to put you off?
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Well I'm not 100% sure it was the gear that's screwed me. I was thinking a light cycle and a good pct might bump start things. I'm also aware it could make matters worse - which is why I joined the forum, advice from guys who might know a little better.
 
Lutalo said:
Well I'm not 100% sure it was the gear that's screwed me. I was thinking a light cycle and a good pct might bump start things. I'm also aware it could make matters worse - which is why I joined the forum, advice from guys who might know a little better.
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Another cycle will definitely not bump start it, at best, you can only hope to be back where you are now, if you're lucky.
Sort your issues first, before considering another cycle.
 
Lutalo said:
Well from the research I have conducted, I was regarding a pct as having more than one element and taken over a short period of time.

At present I take 50mg of clomid ed and will do so for 3 months.

I was under the impression a 4/6 week "power" pct of hcg (250mg weeks 1-3) aromasin 50/50/25/25 and Nolvadex 40/40/20/10 is a much better choice than clomid as a stand alone.
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While hcg might work I don't think the effects will be permanent. Don't think the AI or novla will add anuthing. I am not a fan of that long term clomid use, but who knows maybe it'll work.
 
Mystere3 said:
While hcg might work I don't think the effects will be permanent. Don't think the AI or novla will add anuthing. I am not a fan of that long term clomid use, but who knows maybe it'll work.
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What would you use in my position? I've been looking into HMG. From what I've read it's one of the best recovery compounds there is.
 
Finasteride is a dht blocker.did u have ure free test levels checked?estradiol?test and finasteride have little known effect on prolactin.they can elevate ure estradiol levels.are u using any other drug?if ure free test is low that could be the reason behind ure low libido.stop the finasteride.dont start any cycle before ure libido returns to normal.
 
@ deepthroat

I've been off the fin since before my cycle. I was already having sides from the fin before I did my cycle. I did get a lot of water retention on cycle, so I'm guessing there was some t to e conversion. Since then my endo has tested for it all. My free t was in range as was my test and my e was low. But tbh in range means very little because it might not be the right levels for me.
 
Stop the fina and assess ureself in a month.ure cycle was pretty standard and shouldnt have given u problems.if in a month ure still having libido problems id suggest u use some hcg and see if it will help.are u using other drugs,supps ore are u under a lot of stress?
 
deepthroat said:
Stop the fina and assess ureself in a month.ure cycle was pretty standard and shouldnt have given u problems.if in a month ure still having libido problems id suggest u use some hcg and see if it will help.are u using other drugs,supps ore are u under a lot of stress?
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I've been off the Fin for 3 years, I'm currently taking clomid, Zinc, Vit D and Magnesium as well as cabergoline to counter my high prolactin. I am pretty stressed right now. I'm not sure if the problem is physiological (from the cycle or the fin or both) or psychological.

It was definitely physiological up until taking the cabergoline as that sorted a lot of issues. It's mainly libido that's the issue now. Which is why I was considering running proviron at 50mg a day. It binds to SHBG allowing more free test. Studies have shown at doses up to 150mg a day for isn't htpa suppressive.
 
Lutalo said:
I've been off the Fin for 3 years, I'm currently taking clomid, Zinc, Vit D and Magnesium as well as cabergoline to counter my high prolactin. I am pretty stressed right now. I'm not sure if the problem is physiological (from the cycle or the fin or both) or psychological. It was definitely physiological up until taking the cabergoline as that sorted a lot of issues. It's mainly libido that's the issue now. Which is why I was considering running proviron at 50mg a day. It binds to SHBG allowing more free test. Studies have shown at doses up to 150mg a day for isn't htpa suppressive.
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I am going to sum up everything you've said here: Fin has been known to raise prolactin, and mess with the Hpta, and mess with libido. You have noticed all of these things BEFORE you started your test E cycle. AFTER your test E cycle, you kept your gains, but libido and PE/ED remained.

Brother based on what YOU have said it looks like the fin ****ed with you, not the test. Did you ever have your levels checked before your cycle? You're 29 and that's about the time they start to lower. I think the rest is in your head. I don't know if another cycle would be smart but I don't think test caused these problems. And based on your test results you weren't "shut down" either. Maybe some formeron or aromasin would help. They'd free up test to be used by blocking aromatase.
 
If ure taking cabergoline u should see an improvement in libido.how long have been taking it?hower the caber can also cause depression and if ure already stressed out it may have a negative effect on ure libido.better talk with ure doc see for how long u have to take the caber and tell him if ure feeling depressed.i would advise not taking the proviron cause playing with ure hormonal levels in ure condition is not very safe.better let them regulate by themselves.all aas are suppressive no matter what a lot of people say.after all ure giving ure body synthetic hormones which will shut u down.relax,watch ure diet and take a break from work,relationship.and most importantly dont obsess over it.one day u will wake up and everything will be fine.i think ure problem is psychological more than it is physiological.were u taking caber on ure cycle?was ure libido high on the cycle?
 
SquatsAndOats said:
I am going to sum up everything you've said here: Fin has been known to raise prolactin, and mess with the Hpta, and mess with libido. You have noticed all of these things BEFORE you started your test E cycle. AFTER your test E cycle, you kept your gains, but libido and PE/ED remained.

Brother based on what YOU have said it looks like the fin ****ed with you, not the test. Did you ever have your levels checked before your cycle? You're 29 and that's about the time they start to lower. I think the rest is in your head. I don't know if another cycle would be smart but I don't think test caused these problems. And based on your test results you weren't "shut down" either. Maybe some formeron or aromasin would help. They'd free up test to be used by blocking aromatase.
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I'm inclined to agree with you. I think the fin is the root of the problem. I can get hold of aromasin easy enough, do you think I should run it as a stand alone or with some hcg or possibly hmg?
 
deepthroat said:
If ure taking cabergoline u should see an improvement in libido.how long have been taking it?hower the caber can also cause depression and if ure already stressed out it may have a negative effect on ure libido.better talk with ure doc see for how long u have to take the caber and tell him if ure feeling depressed.i would advise not taking the proviron cause playing with ure hormonal levels in ure condition is not very safe.better let them regulate by themselves.all aas are suppressive no matter what a lot of people say.after all ure giving ure body synthetic hormones which will shut u down.relax,watch ure diet and take a break from work,relationship.and most importantly dont obsess over it.one day u will wake up and everything will be fine.i think ure problem is psychological more than it is physiological.were u taking caber on ure cycle?was ure libido high on the cycle?
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I've been on the dopamine agonist for roughly a year. It's improved my sexual function, better erections no p/e and made my orgasm a litter stronger. But has yet to have any effect on libido.

On cycle I wasn't taking caber, my libido was quite high until there was aromatisation, I gained a lot of water retention and libido dropped.

I read the following abstract with regards to proviron. Also the I'm lead to believe that if aas are kept within natural hormone ratios then shut down is unlikely. I would run it at 25-50mg ed for 7 days then break.


Dr. Crisler was wrong.

25 - 50 mg Proviron a day, doesn't suppress your testosterone production. More recent studies have shown that the suppression begins at 75 mg a day. However, this is an abstract from a study where they used 100 - 150 mg Proviron a day (for 12 months!), and it shows otherwise! As you can see, it suppressed LH by 25% in cases where the level was above the normal range. I recommend 25 mg a day, and I wouldn't use more than 50 mg a day, just to be safe.

Quote:

Abstract

Two hundred fifty subfertile men with idiopathic oligospermia (count less than 20 million/ml) were treated with mesterolone (100-150 mg/day) for 12 months. Seminal analysis were assayed 3 times and serum follicle stimulating hormone (FSH) luteinizing hormone (LH) and plasma testosterone were assayed once before treatment and repeated at 3, 6, 9 and 12 months after the initiation of treatment. One hundred ten patients (44%) had normal serum FSH, LH and plasma testosterone, 85 patients (34%) had low serum FSH, LH and low plasma testosterone. One hundred seventy-five patients (70%) had moderate oligospermia (count 5 to less than 20 million/ml) and 75 patients (30%) had severe oligospermia (count less than 5 million/ml). Seventy-five moderately oligospermic patients showed significant improvement in the sperm density, total sperm count and motility following mesterolone therapy whereas only 12% showed improvement in the severe oligospermic group.*Mesterolone had no depressing effect on low or normal serum FSH and LH levels but had depressing effect on 25% if the levels were elevated. There was no significant adverse effect on testosterone levels or on liver function.*One hundred fifteen (46%) pregnancies resulted following the treatment, 9 of 115 (7.8%) aborted and 2 (1.7%) had ectopic pregnancy. Mesterolone was found to be more useful in patients with a sperm count ranging between 5 and 20 million/ml. Those with severe oligospermia (count less than 5 million) do not seem to benefit from this therapy.

At this stage I'm willing to try anything, but I'll need to be medically monitored. But I think I'll try a few months on the paleo/carb back loading diet, get my bf to sub 10% and see how that fares.
 
I doubt that the fina is the root of the problem since u stopped it 3 years ago.high estrogen levels can cause libido problems and so can low estrogen levels.so if ure taking adex or aromasin be careful as not to decrease ure estrogen levels alot.also taking proviron with caber is not wise because proviron may reduce ure prolactin levels even further and low prolactin levels is also associated with low libido.be careful when playing with ure hormones.are u sure u only took test on ure cycle and not deca?because ure high levels of prolactin suggest that u used deca since test and fina dont act directly on prolactin.
 
Well there are stories of finasteride having long lasting effects even after years of stopping. There's a massive lawsuit in the US again Merk who produce propecia because of these effects.

I'm 100% positive it was test e. It came in the factory vile, from a very trusted source and was marked testosterone enanthate.

Thanks for your advice on the hormone levels, I'll be sure to keep an eye out and be cautious. My last test for estrogen the dr said it came back low. I might spend some time off of all the meds and see how I feel.
 
Lutalo said:
I'm inclined to agree with you. I think the fin is the root of the problem. I can get hold of aromasin easy enough, do you think I should run it as a stand alone or with some hcg or possibly hmg?
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Finasteride doesn't elevate prolactin. Even if it did, it wouldn't elevate it to 700. Prolactin of over 150 in a male has two possible causes; prolactinoma or a non-secreting pituitary tumor that is compressing the infundibulum of the pituitary. A prolactinoma doesn't have to be in the pituitary. If I were your dr, I'd be working this up more.
 
Mystere3 said:
Finasteride doesn't elevate prolactin. Even if it did, it wouldn't elevate it to 700. Prolactin of over 150 in a male has two possible causes; prolactinoma or a non-secreting pituitary tumor that is compressing the infundibulum of the pituitary. A prolactinoma doesn't have to be in the pituitary. If I were your dr, I'd be working this up more.
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Bro I'm not disputing that finasteride has no elevating effects on prolactin, but there are studies, which can been seen on the propeciahelp forum that suggest finasteride effects important neurosteroids and in turn they can cause issues.

Personally as long as I'm on a dopamine agonist my prolactin isn't an issue. I'm only taking 50mg per week in two 25mg doses. I do note the advice that too little is just as bad as too much, which is why I'm going to lay off all meds at some point.

I will chase my endo up about the tumours you mentioned - I do appreciate your input thus far. But after two different tests for pituitary tumours I don't think much will be found.

I have a feeling my dht might be playing a role, but it's difficult getting tested for that in the UK. Unless you pay for the test which I may have to do.

A lot of guys on the propeciahelp website seem to undertake a pct and it sorts them out. I was thinking of doing this;

Hcg 500 iu a week for 3 weeks
Nolva 20 mg a day for 5 weeks
Aromasin 20 mg a day for 4 weeks.

Obviously all meds running concurrent for their duration.

Any thoughts?
 
No need for nolva.20 mg aromasin ed is too much.try 12.5 mg eod.if ure estrogen levels are not elevated u will cause more problems than u fix by taking an ai.hcg might help.but when u stop taking it u will be back where u started.
 
deepthroat said:
No need for nolva.20 mg aromasin ed is too much.try 12.5 mg eod.if ure estrogen levels are not elevated u will cause more problems than u fix by taking an ai.hcg might help.but when u stop taking it u will be back where u started.
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If that's the case would I not be better off using clomid instead? I know like nolva it's a SERM and you said not to use nolva. If hcg is only of use when taking it and not after, would that not make it defunct for a pct? In favour of other compounds like HMG?
 
If ure planning on using hcg then nolva is a must.When used in conjunction with nolva HCG 's suppressive nature is blocked.check this study

Tamoxifen suppresses gonadotropin-induced 17 alpha-hydroxyprogesterone accumulation in normal men.Smals AG, Pieters GF, Drayer JI, Boers GH, Benraad TJ, Kloppenborg PW.
Intramuscular administration of 1500 IU hCG daily for 3 days induced a transient accumulation of 17 alpha-hydroxyprogesterone (17 OHP) relative to testosterone (T) in normal men, reaching its maximum 24 h after the first injection (17 OHP to T ratio, 1.7 +/- 0.3 times baseline; P < 0.01). Simultaneous administration of hCG and the estrogen antagonist tamoxifen (20 mg twice daily) almost completely abolished the hCG-induced steroidogenic block localized between 17 OHP and T (17 OHP to T ratio at 24 h, 1.1 +/- 0.1 times baseline; P < 0.01 vs. hCG alone). These data indirectly suggest that, in man, the hCG-induced steroidogenic lesion might be mediated through its estrogen-stimulating effect.
However using 500 iu hcg per week is only effective at avoiding testicular atrophy.
U must use between 250 and 500 iu ed for 2 to 3 weeks to get the results u want.use it with 20 mg nolva ed.
And if u want to use some clomid u can do 3 weeks clomid after the hcg at 100 mg ed for 2 weeks and the last week at 50 mg.
 
deepthroat said:
If ure planning on using hcg then nolva is a must.When used in conjunction with nolva HCG 's suppressive nature is blocked.check this study

Tamoxifen suppresses gonadotropin-induced 17 alpha-hydroxyprogesterone accumulation in normal men.Smals AG, Pieters GF, Drayer JI, Boers GH, Benraad TJ, Kloppenborg PW.
Intramuscular administration of 1500 IU hCG daily for 3 days induced a transient accumulation of 17 alpha-hydroxyprogesterone (17 OHP) relative to testosterone (T) in normal men, reaching its maximum 24 h after the first injection (17 OHP to T ratio, 1.7 +/- 0.3 times baseline; P < 0.01). Simultaneous administration of hCG and the estrogen antagonist tamoxifen (20 mg twice daily) almost completely abolished the hCG-induced steroidogenic block localized between 17 OHP and T (17 OHP to T ratio at 24 h, 1.1 +/- 0.1 times baseline; P < 0.01 vs. hCG alone). These data indirectly suggest that, in man, the hCG-induced steroidogenic lesion might be mediated through its estrogen-stimulating effect.
However using 500 iu hcg per week is only effective at avoiding testicular atrophy.
U must use between 250 and 500 iu ed for 2 to 3 weeks to get the results u want.use it with 20 mg nolva ed.
And if u want to use some clomid u can do 3 weeks clomid after the hcg at 100 mg ed for 2 weeks and the last week at 50 mg.
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Cheers man, I really appreciate the advice. I'll probably run that, can I still include aromasin 12.5 eod whilst running the hcg? Or would I be better off running it alongside clomid? I preferably want to include some aromasin as I read the libido effects are good.
 
IMO the best way to run hcg is for 2-3 weeks at 500 eod. A serm would be nice with it as well, so would an AI.
 
You need to keep working with your doctor. If the doctor you're currently working with isn't providing you with what you need, get a second opinion. You're discussing medical issues on an Internet forum. Adding additional compounds yourself is likely going to exacerbate the problem.

This is not to discredit any of the advice given to you, it's just that black and white. These are questions for your doctor. You adding **** in on your own isn't going to do you any favors whatsoever.
 
Spaniard said:
You need to keep working with your doctor. If the doctor you're currently working with isn't providing you with what you need, get a second opinion. You're discussing medical issues on an Internet forum. Adding additional compounds yourself is likely going to exacerbate the problem.

This is not to discredit any of the advice given to you, it's just that black and white. These are questions for your doctor. You adding **** in on your own isn't going to do you any favors whatsoever.
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My opinion exactly.if ure planning to use any drug check with ure Dr first.sometimes when u play with ure hormones it can be very difficult to get them back to normal.it can be very frustrating in ure situation but u dont want to fix a problem with another problem.so check with ure Dr before using any drug.
 
I appreciate the concern and all of the advice but here's the thing; I am only here as a last resort. The good Dr's at the National Health Service are useless.

I first went to the Dr about this is 2011 a few months after my cycle. They told me give it 6 months and wait and see, they didn't even take bloods at this stage.

6 months went by, no change so they ordered bloods for test, free test, shgb, lh and fsh. I got a call saying all results came back normal. I asked for the blood test transcript as I wanted to consult a Dr in the US. Upon receiving the transcript in bold letters across the top read ABNORMAL. My lh and fsh were in range but my t and bio t were well below. Surely a good Dr would find this alarming but no. They said as lh and fsh were normal they couldn't see an issue.

Fast forward I finally get referred to a Urologist who also wants to take a wait and see approach, but only after he's given me a prostate exam. More blood is taken and again test and free test are low, although my test has crept slightly back in range. At this point I had begun to do my own research and asked that TSA PSA and Prolactin get tested for.

Low and behold prolactin is sky high - I say let me start a course of cabergoline - no lets wait and see!!!!!! Again tests came back; prolactin elevated and t + free t low. Again let's wait and see.

I decided to go to an Endocrinologist who put me through a series of tests and ruled out a prolactinoma. I literally had to beg for the cabergoline, which was only administered after yet another test came back elevated prolactin decrease t.

Needless to say after a few weeks on a low dose of caber my prolactin came down and test went up and with it came benefits. But by now it was 2013. Two years prolactin had been silencing my testosterone expression and there was clearly still issues. I still complain about low libido and despite staring in the face of abject fact the drs just tell me "you're now in range". I tell them they are treating the numbers and not the patient but it appears they are more concerned about cost than the welfare of the patients.

I contacted a Dr in the US who specialises in sexual medicine. Explained about the finasteride and about the cycle. He was of the view that the fin was the cause. He said he couldn't treat me directly but he advises his patients to take test elevating therapies along side dopamine agonists.

I put this to my endo and virtually had to plead with them to try clomid along with the caber. I literally said my friends are having children and getting married and because of my problems I'm left behind.

I said due to fin there may be issues with my dht and that dht is known to have an impact on sexual function. They won't test for it. I suggested low doses of proviron to bind to shgb to see if that boosts my libido. The endo wasn't keen, not because he felt it was surpressive but because he wasn't in the business of boosting libido.

I saw another endo who asked if I had a medical background because of the way I was talking about my hormones and possible therapies. That is how much research I have done.

I'm not here on the forum seeking medical advice, or because I need to know what these drugs do. I'm here to get the experience and knowledge of guys who have tried and tested these protocols out themselves. First hand knowledge.

The fact is I'm now at a point where I am willing to take a calculated risk. I have told my endo a number of times that if they don't start working with me then I'll need to take matters in to my own hands.
 
U have to understand that Drs dont prescribe hormonal drugs because all the lawsuits that are pending after they gave estrogen to women and were popping them like candy.after a few years guess what?breast cancer.so u have to take it from their point of view.however if nothing have worked for u thus far and u have waited so long then go ahaid and try it.before starting the test cycle and the fina were u ever tested for prolactin?have u used ssri or antipsychotic drugs before?
 
deepthroat said:
U have to understand that Drs dont prescribe hormonal drugs because all the lawsuits that are pending after they gave estrogen to women and were popping them like candy.after a few years guess what?breast cancer.so u have to take it from their point of view.however if nothing have worked for u thus far and u have waited so long then go ahaid and try it.before starting the test cycle and the fina were u ever tested for prolactin?have u used ssri or antipsychotic drugs before?
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I appreciate that, but there's also the possibility of a lawsuit for failing to act. A lack of hormones can cause problems as much as an abundance. It's a double edged sword I know.

Before fin I never once had a sexual issue. In fact I was probably a little too potent - dig a hole in the ground I would have stuck my d*@$ in it. In fact for 18 months on the fin my libido increased then one day crash. Bottomed out. I should have stopped it then but the merk research said the sides went away in those who continued.

That's why this is so hard to take because I remember just how virile I was. Most mornings I was raging. Now days I just wake up. Tbh on the test I was pretty horney in the mornings, despite the aromatase and high prolactin, all at the time I didn't know it.
 
The fina blocks the dht and u get an increase in test levels.this is why ure libido increases at first then suddenly crashes.i agree with u that ure dr should give u something to restore ure libido.but drs will not give u a prescribtion for a drug unless u have a very low test or dht level.if u tried everything and nothing worked then u have to try something new.

Here is a study on kickstarting test production after finasteride.

Dr. John Crisler of AllThingsMale.com presents an update on his protocol of using hCG for this purpose:
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AN UPDATE TO THE CRISLER HCG PROTOCOL

By John Crisler, DO

In my paper “My Current Best Thoughts on How to Administer TRT for Men”, published in A4M’s 2004/5 Anti-Aging Clinical Protocols, I introduced a new protocol where small doses of Human Chorionic Gonadotrophin (HCG) are regularly added to traditional TRT (either weekly IM testosterone cypionate or daily cream/gel). The reasons and benefits of this protocol are as follows, along with a new improvement I wish to share:

Any physician who administers TRT will, within the first few months of doing so, field complaints from their patients because they are now experiencing troubling testicular atrophy. Irrespective of the numerous and abundant benefits of TRT, men never enjoy seeing their genitals shrinking! Testicular atrophy occurs because the depressed LH level, secondary to the HPTA suppression TRT induces, no longer supports them. It is well known that HCG—a Luteinizing Hormone (LH) analog—will effectively, and dramatically, restore the testicles to previous form and function. It accomplishes this due to shared moiety between the alpha subunits of both hormones.

So, that satisfies an aesthetic consideration which should not be ignored. Now let’s delve into the pharmacodynamics of the TRT medications. For those employing injectable
testosterone cypionate, the cypionate ester provides a 5-8 day half-life, depending upon the specific metabolism, activity level, and overall health of the patient. It is now well-established that appropriate TRT using IM injections must be dosed at weekly intervals, in order to avoid seating the patient on a hormonal, and emotional, roller coaster. Adding in some HCG toward the end of the weekly “cycle” compensates for the drop in serum androgen levels by the half-life of the cypionate ester. Certainly the body thrives on regularity, and supplementing the TRT with endogenous testosterone production at just the right time—without inappropriately raising androgen OR estrogen (more on that later)—approximates the excellent performance stability of transdermal testosterone delivery systems for those who, for whatever reason or reasons, prefer test cyp.

But there’s another metabolic reason to employ this protocol. The P450 Side Chain Cleavage enzyme, which converts CHOL into pregnenolone at the initiation of all three metabolic pathways CHOL serves as precursor (the sex hormones, glucocorticoids and mineralcorticoids), is actively stimulated, or depressed, by LH concentrations. It is intuitively consistent that during conditions of lowered testosterone levels, commensurate increases in LH production would serve to stimulate this conversion from CHOL into these pathways, thereby feeding more raw material for increased hormone production. And vice versa. Thus the addition of HCG (which also stimulates the P450scc enzyme) helps restore a more natural balance of the hormones within this pathway in patients who are entirely, or even partially, HPTA-suppressed.

It is important that no more than 500IU of HCG be administered on any given day. There is only just so much stimulation possible, and exceeding that not only is wasteful, doing so has important negative consequences. Higher doses overly stimulate testicular aromatase, which inappropriately raises estrogen levels, and brings on the detrimental effects of same. It also causes Leydig cell desentization to LH, and we are therefore inducing primary hypogonadism while perhaps treating secondary hypogonadism. 250IU QD is an effective, and safe, dose. After all, we are merely replacing that which is lost to inhibition.

In my previous report I recommended 250IU of HCG twice per week for all TRT patients, taken the day of, along with the day before, the weekly test cyp injection. After looking at countless lab printouts, listening to subjective reports from patients, and learning more about HCG, I am now shifting that regimen forward one day. In other words, my test cyp TRT patients now take their HCG at 250IU two days before, as well as the day immediately previous to, their IM shot. All administer their HCG subcutaneously, and dosage may be adjusted as necessary (I have yet to see more than 350IU per dose required).

I made this change after realizing that the previous HCG protocol was boosting serum testosterone levels too much, as the test cyp serum concentrations rise, approaching its peak at roughly the 72 hour mark. The original goal of supporting serum androgen levels with HCG had overshot its mark.

Those TRT patients who prefer a transdermal testosterone, or even testosterone pellets (although I am not in favor of same), take their HCG every third day. They needn’t concern themselves with diminishing serum androgen levels from their testosterone delivery system. These patients will, of course, notice an increase in serum androgen levels above baseline.

While HCG, as sole TRT, is still considered treatment of choice for hypogonadotrophic hypogonadism by many , my experience is that it just does not bring the same subjective benefits as pure testosterone delivery systems do—even when similar serum androgen levels are produced from comparable baseline values. However, supplementing the more “traditional” TRT of transdermal, or injected, testosterone with HCG stabilizes serum levels, prevents testicular atrophy, helps rebalance expression of other hormones, and brings reports of greatly increased sense of well-being and libido. My patients absolutely love it. As time goes on, we are coming to appreciate HCG as a much more powerful--and wonderful--hormone than previously given credit
 
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