Talk About Marriage banner
Status
Not open for further replies.

Dealing with Low Testosterone - Hypogonadism

67K views 184 replies 48 participants last post by  raven2000 
#1 · (Edited)
I have been hesistant to post this thread for some time. While dealing with the dying days of my marriage and then struggling with whether or not my symptoms and issues were a result of stress and coping with the divorce I wasn't sure if my problems were physiological or psychological. But ... testing has confirmed what I would never have suspected were it not once again, for discoveries I made here on this forum. So in that vein, I hope sharing my information will be useful to others.

The website below is a great one-stop resource for learning about all things testosterone. What it is, what it does, what the measurements mean, and methods of addressing and treating the issue of deficiency. Without getting into existential discussion, testosterone is the hormone produced in the testes that basically, defines male sexual characteristics, bone mass, muscle mass, and influences energy levels and feelings of well being.

Mens Hormonal Health

These are other threads on TAM addressing this question - that from a guy's perspective isn't going to be an enthusiastic conversation - but probably is a necessary one, especially if it is having a negative impact on your relationship.

Any man out there having a mid-life crisis?

Could it be low testosterone?

Low testosterone, how to deal

In my case, what I have found most troubling about the diagnosis, is wondering how long it has been an issue. I have shared previously that I was diagnosed with Attention Deficit Disorder in my thirties. I struggled tremendously through college and at times in the work environment with attention and fatigue issues. I took medication for over a decade to treat my inability to focus that led to prostate problems, and utterly crashed my libido, ability to achieve or maintain an erection, or to have an orgasm. Basically the side effects of the medication I was taking increased the symptoms of hypogonadism or low test. To me, the kicker, and hope is the possibility that my ADD symptoms will be resolved by testosterone therapy.

For the benefit of others, in considering low test as a possible issue, my symptoms are as follows:

- Erectile Dysfunction
- Decreased Libido, I still have desire but not that driving urge. And even with desire, my body won't cooperate.
- Decreased penile sensitivity
- Difficulty achieving orgasm, This has almost always been an issue for me. I have the opposite of premature ejaculation.
- Depression, I want to qualify this as feeling more like an emotional trough. I don't feel that it comes anywhere close to clinical depression, although depression still feels like the best word. I feel like there is a damper on my emotions, and at times my energy level is zero.
- Insomnia, I've had bouts of this throughout my adult life. I usually chalked it up to stress - even when there were no apparent stressors in place.
- Fatigue, I'm not talking about feeling a little tired or having a hard time staying alert through the afternoon, I'm talking about a really weird inability to take action in the morning. It's like this low waking state, where I'm aware, but my mind doesn't engage to say - 'time to get up'. I will literally think that I have been awake in bed for 10 minutes or so, and discover when I actually do get up that I had been laying there for close to an hour.
In the evening, between 5 and 8 pm I am exhausted as in want to go to sleep for the night tired, have nearly fallen asleep behind the wheel tired. Occasionally I do doze off and awake a few hours later.

The reason I feel that laying this stuff out there is important, is that so much of it can easily be categorized as other conditions - thus missing the correct one. My physician and urologist never posited the possibility of low testosterone. I asked them to do a screening based upon my symptoms after reading about the subject here, particularly based on contributions and exchanges with Simply Amorous.The screening is a simple blood test.

Testosterone generally begins to drop once a man is in his thirties, the presumption is that the drop is about 1% per year. In my case, my symptoms became far more pronounce approaching my mid-forties. What complicated things in my mind, was this also coincided with the timing of the end of my marriage and divorce. So, based upon the results of my blood screening, I am pursuing treatment on the physiological side. If testosterone therapy doesn't yield any results in terms of the sexual or emotional symptoms, I'll be looking at options on the psychological side.

Frankly, the symptoms and consequences of this condition are humiliating. They are demoralizing. If you feel like crap, it makes you feel crappier. If you are generally confident and upbeat, it's tough to maintain that outlook. All of a sudden the inability to perform one of the most definitive of male traits - becomes the center of anxiety, fear and disappointment - especially if you are trying to forge new intimate relationships. I do want to forge new intimate relationships, and I do want to be back to my confident, upbeat self. So, I have no plans to ignore or deny the issue hoping it will go away, I'm opting for treatment, and would encourage any man on the fence, to get screened and pursue treatment as well.

Treatment takes several forms:

- Pills (Generally considered least effective)
- Transdermal Gels, this is a gel rubbed into the skin where the hormone is then absorbed into the blood stream.
- Injections, intramuscular injections via syringe
- Subdermal Implant, this is the option I chose. The medication is pelletized and inserted beneath the skin where a steady dose of the medication is absorbed for up to 4 months.

My therapy will likely start in early January. Benefits if any, should likely start to appear by February, within 4 to 6 weeks.

I will certainly try to post experiences and progress in the interim, and with ongoing treatment. I'll be happy to answer any questions either on the open forum or via PM.
 
See less See more
#147 ·
Thank you for sharing your story. My husband is suffering from Ed and I am not sure what to do. He was tested, average so did not persistent it further. We had an excellent sex life up to 4 yrs ago. He used to be very affectionate but that also stopped. He never refuses my initiations and always manages to orgasmm but with alot of time and can't always maintain penetration. I am sure what the best way to deal with this is. I don't mind initiating but I know he feels terrible when he can't perform. I assure him that it is okay and we make the mostof it.
Posted via Mobile Device
 
#148 ·
First off , how fit is he?, is he overweight, does he smoke? My libido was going down the tubes, until I lost 22lbs and hit the gym four times a week. ED is often about circulation in older guys, poor health & lifestyle over time plugs up the works and ED happens. My Libido is now back to where it was 20 years ago by simply watching what I eat and regular intense exercise, I'd suggest getting this book for Hubby and following it, "The Four Hour Body " by Tim Ferris.
 
#149 ·
Re: Dealing with Low Testosterone - Depression and Hypogonadism

The following was published by Sciencedaily.com
Here's the reference
Elsevier (2012, April 2). Exploring the antidepressant effects of testosterone. ScienceDaily. Retrieved April 4, 2012, from http://www.sciencedaily.com* /releases/2012/04/120402093750.htm
Exploring the Antidepressant Effects of Testosterone

ScienceDaily (Apr. 2, 2012) — Testosterone, the primary male sex hormone, appears to have antidepressant properties, but the exact mechanisms underlying its effects have remained unclear. Nicole Carrier and Mohamed Kabbaj, scientists at Florida State University, are actively working to elucidate these mechanisms.

They've discovered that a specific pathway in the hippocampus, a brain region involved in memory formation and regulation of stress responses, plays a major role in mediating testosterone's effects, according to their new report in Biological Psychiatry.

Compared to men, women are twice as likely to suffer from an affective disorder like depression. Men with hypogonadism, a condition where the body produces no or low testosterone, also suffer increased levels of depression and anxiety. Testosterone replacement therapy has been shown to effectively improve mood.

Although it may seem that much is already known, it is of vital importance to fully characterize how and where these effects are occurring so that scientists can better target the development of future antidepressant therapies.

To advance this goal, the scientists performed multiple experiments in neutered adult male rats. The rats developed depressive-like behaviors that were reversed with testosterone replacement.

They also "identified a molecular pathway called MAPK/ERK2 (mitogen activated protein kinase/ extracellular regulated kinase 2) in the hippocampus that plays a major role in mediating the protective effects of testosterone," said Kabbaj.

This suggests that the proper functioning of ERK2 is necessary before the antidepressant effects of testosterone can occur. It also suggests that this pathway may be a promising target for antidepressant therapies.

Kabbaj added, "Interestingly, the beneficial effects of testosterone were not associated with changes in neurogenesis (generation of new neurons) in the hippocampus as it is the case with other classical antidepressants like imipramine (Tofranil) and fluoxetine (Prozac)."

In results published elsewhere by the same group, testosterone has shown beneficial effects only in male rats, not in female rats.
 
#151 ·
I have been in the HRT game for almost 15 years. Never had an issue. Most if not all compunding pharmacies will carry it. I have found that Costco, Walgreens, Osco carry it or can order it.

Who is writing the script? a HRT clinic or normal doc? HRT clinics are typically working in conjuction with a compounder already and you buy through them (around $100 - 150 per 10cc vial).

I applaud your efforst to raise test naturally, but it wont happen. At a level of 300, you will most likely feel like crap. A 1cc shot every 7-10 days shoudl raise it to almost 800-900.

Hope this helps

BTW, there are also other esters of test, Enanthate and Proprinate. The Enanthate is a slightly longer acting, while the Prop is slightly less. But, they are all just test. No real difference.
 
#152 ·
My story is a long and frustrating one. My other half has never had a high sex drive, since we've been together, even in the very beginning 3 times a week would have been a lot. Once or twice would be more likely. I would literally have it every day, maybe even more than once. But twice a week I can survive without being grumpy :) so anyway, last May I got nothing at all for a whole month. I moaned about it. He blamed medication he's on - which he's been on during our whole relationship so I disagreed with that. Anyway, I got half hearted effort of maybe once or twice a fortnight for a few months. The. I'd go without completely, moan again then the same again. This went on until Feb this year. When I lost the plot and got really mad. I'd suggested low testosterone 3 times previously and he ignored it. Despite the fact he sees his doctor twice a month. So anyway, we had a big fall out. He said he thought I was joking about the testosterone. As if - this is no laughing matter to me. I literally struggle to cope without sex. I get seriously frustrated and angry.
So he goes to the doc, gets his test done. The results will be back in 2-3 days but he still just waits for his usual appointment in 2 weeks. At that appointment the doc confirms low t and says he needs more tests. Same again, results available in a few days but he waits the 2 weeks. At this point the doc refers him to the hospital to see the endocrinology dept. And there's a 4 week wait on the appointment! 3 days before the appointment it gets put back another 2 weeks.
Last Saturday we fell out as he thought I was being off with him. I was. It had been 6 weeks since we last had sex. I was sad, angry, frustrated, irritable and to be honest starting to get resentful. This scares me as in the past there is a very short timescale from me getting bored to annoyed to dumping him! And my current partner has been a very close friend for 12 years prior to writing together. So I cannot get resentful and just leave him. It's not an option.
So this whole situation stresses me out. I feel like I make him aware how hurt I feel and that he either doesn't listen or doesn't care. Anyway we kinda sorted it out, I think he understands. And his appointment was 2 days ago. The bloody doc took ten more blood tests and he has to wait another 4 weeks to see what the next step is.
And I'm back to frustration again coz it's now gonna be at least another 2 months before I get any.
Sooo the whole point of this is, how long are we looking at before the doc will finally confirm what's happening. And then how long will testosterone therapy take to kick in. And pleeeeeease tell me they'll make his testosterone high to compensate. I don't know how much longer I can cope with this all.
Since he's had the symptoms of low t for years and years every day for him is like normal. It's killing me and that makes me feel so selfish :(
 
#153 ·
I am always struck by how often similar a HD woman's posts sound to that of a man with a LD partner.

It is difficult if not impossible to convey the level of anxiety, insecurity, or pure frustration that one feels intensely ... and your partner is utterly unaware of, or worse, simply ignores altogether.

From the nature of your post, I'm presuming you aren't in the states. I never waited more than 5 days to get my results back from testing and they certainly didn't need to draw multiple vials of blood. I'm presuming his doc ordered another work-up to look for things other than or in addition to Low T.

And I have always encouraged people that if your doctor is unresponsive, then find another doctor.

What were his levels? Do you know? To my knowledge the 'number' that is often referred to here is total T, not 'free' T, and is a number scaling from a low of 200 up to roughly 1100 ng/dl

If and when your partner starts therapy, depending upon the delivery system (injections, vs. gel vs. pellets) a rough estimate is between 4 and 6 weeks before he starts feeling substantial effects.

And in my case, my urologist referred me to a nearby compounding pharmacy. The folks there are great. Very, very helpful and knowledgable.

I am back on 200 mg/ml every 7 to 10 days. Looking forward to being re-tested in early July.
 
#154 ·
The figures are different here. Above 12 is normal. 8 is considered low and his is 5! To be fair I think they're making sure its not a pituitary problem rather than medication he's been on for a while. But I'm so frustrated coz regardless of the cause he still needs testosterone replacement therapy so I wish they'd just kick start it. I'm glad I found this place and have found folk who know what it feels like. I'm walking around with constant anger and it's awful! And yep, I'm not in the states. I'm in the uk. I don't think it's the wait for the results that's the problem, it's the wait for the consultants time. I wish I'd gone to the appointment too - coz I can't cope with the thought that it's at least another 2 months before there's any chance that anything might even start to change! :(
 
#155 ·
Clairey 83

You mentioned he has been on medication? what type and what for?
It has been mentioned by Deejo as well that alot of times doctors treat only some of the symtoms that men may complain about and that the meds actually make the real underlying problem worse. He may be on meds that are doing more harm than good.
You are lucky that you are in the UK because there, you have the same HRT meds that I am on which is NEBIDO, it is a slow ester and only requires one shot every 3 months or so. This is not available in the US yet as far as I know and there it is still required to do weekly shots as Deejo mentioned. I noticed a big difference in a lot of areas almost within the first couple of weeks, and my levels were quite low at the start. seems like he may be around the same as me, quite a ways under the low level. I have gotten my drive back as well as tons of energy now, where before I was quite tired all the time. It does make a big difference. I have a LD wife so now it is quite frustrating for me , not to mention the fact that we are living in different areas and away from each other. Its funny but I never realized that my drive was not that high because of my wife being LD,so the sex was just one of those things we did every once in a while. now its a bit harder for me to deal because my drive is quite a bit higher than hers. which after a few discussions and some very open talking have come to realize is almost non existent! We have actually discussed her going and getting checked out as well!
Anyway, point I am trying to make is, there will more than likely be a big difference once hubby starts on HRT or gets meds to deal with any other real problem they might find. He may have no clue as too what is happening to him because our hormones can control so much of how we feel and think as well. Be patient
 
#156 ·
Thanks so much for your reply. I think that is why it is so frustrating (in part) because every day is normal to him. Nothing is different. He is always sleepy too. He's not got a job at the minute, although he often has work of some kind which helps. His day involves a struggle to get out of bed, his day at work which I imagine also to be minimal effort, then he comes home eats dinner and falls asleep on the couch til bedtime. Then we go to be and he wants to cuddle in to get to sleep - which takes him about 30 seconds but takes me forever. I get so annoyed because I seem to get nothing back. And it's even more frustrating because I know it's not him, it's the whole situation! I just wish they'd hurry up.
At least now I can be hopeful that when he does start hrt that it shouldn't take long to work :)
As for his medication, I don't really want to say what it is other than there is no alternative to it and it's known to be a cause of low t. However, with him I think it's the case that it's always been low and the medication has made it worse. I suppose I should be grateful they're putting such effort in to get to the root of the problem! I'll try to be more patient :)
 
#157 ·
Got a call from my urologist while on vacation. Last T check was a few days after my 47th birthday, first week of August.

T level was 1025.

Oddly enough, can't say I felt much different then when it was 400. No crazy sex drive. No real difference in ED issues. No acne. No noticeable side effects at all that I'm aware of. Although, in the scheme of things I don't know at what 'level' the side effects of being on the high side would manifest. Perhaps in excess of 1200?

Feel pretty good overall. Most noticeable to me has been my lack of aches following workouts, and seem to have a relatively easy time maintaining my fitness level.

Not currently in a relationship, so can't provide any feedback regarding sexuality ... aside from the fact that I have noticed no substantial increase in my drive at all.
 
#158 ·
Got a call from my urologist while on vacation. [..]

T level was 1025.

Oddly enough, can't say I felt much different then when it was 400. No crazy sex drive. No real difference in ED issues. No acne. .
I'm suspecting that you haven't increased your free T as much as it sounds if you are not getting more drive, body hair, or oily skin/acne.

What was your free T level? Maybe some of your total T is the bound type and isn't helping your libido. What is your cortisol and estradiol? It is very important to check those every time too because if they are high it will affect your libido. Did you ever get your prolactin and LH checked (e.g. to check for a pituitary problem)?

If you haven't increased your T dose and yet your level rose this high, it might be a lab error and worth checking again.
 
#159 ·
I suspect an error as well. Will likely get retested in 12 weeks rather than 24.

I may also have to change physicians for monitoring the T piece. Dude just isn't that on the ball.

I already had BPH along with urinating and ED issues prior to starting HRT.

Although, I must say that I have been able to maintain my lean mass, very well, but have also changed up my training routine.
 
#166 ·
warning: graphic moob shot:

(seriously I find it really hard to gauge features in my reflection or in pics, it usually not until years later that I look at a pic and say is that really what I looked like, so in this pic are my moobs showing through? My darn nips poke through several layers all the time and I think I should get more shirts with graphics on the chest to obscure it)

 
#168 ·
That was yesterday... The goatee comes and goes but I prefer clean shaved in summer. Golf shirts used to be flattering not so long ago. Still not sure how much of my moobs are just fat but from what I can tell from feeling the tissue underneath there is breast tissue. I think my best way to find out is to lean out and put on some more muscle, but at lunch time today I was realizing how hard it is especially when the self esteem is kinda low, like my psyche is convincing me I have to look the part too.
Posted via Mobile Device
 
#169 ·
Are you working out? May resurrect my own fitness thread as well.

I've been nearly immobile for 2 days due to issues with my lower back. Slept on a sleep sofa for the previous week while on vacation with the kids and I'm guessing that is the culprit.

As for the nip issue, I do believe they sell things to compress and cover this issue ... kind of like pasties.

I think my testosterone just dropped at the thought of mentioning or wearing pasties ...
 
#172 ·
I had that one time. The pain was such that at times I couldn’t move an inch. What worked for me was to suspend from a bar under my arms and then bring my legs slowly up at the front. Just a few minutes and the pain went never to return.

I think suspension separates the discs a fraction and lifting the legs stretches the back a little more such that any trapped nerve finds its own way out. I mentioned what I did to a sports masseur, he told me it was the right thing to do but the same thing is accomplished by laying flat on a table with legs dangling over the end from waste down and then move them up and down.
 
#170 ·
Yeah I'm not wearing pasties. As for working out, I've "sorta" been will have one good workout then a day to recover then I try again focussing on slightly different part of muscles but usually don't have the will or desire to. Once in awhile I have a workout and the endorphines get flowing and it feels great after, and after those kind I tend to be motivated for the next few workouts, but then I fall off the wagon. I've pushed it pretty hard a few times this last month but not getting any kind of nice feelings, I feel pretty useless afterwards. My typical workouts include shoulder presses, pushups, pulldowns, curls, squats, rows, sometimes forearm exercises. Usually the big pushes like squats make me queezy, those are the really demotivating ones. I try to make enough variety between workouts so I keep it interesting as well as change the motion a bit. But lately I've been quite lazy on these, not doing the full workout, one or two exercises then just give up.

Once in awhile I will do more cardio type sports, like tonight I played squash for an hour and a half.
 
#171 ·
We have some really knowledgeable exercise folks on the boards.

I can offer my personal suggestion. One that has consistently worked for me, when I'm trying to re-establish myself in a workout after a hiatus.

I really like circuit training. Whole body, 3X a week, never more than 30 minutes. Combines aspects of cardio, because you don't rest much, along with resistance exercise.

Definitely helps me build stamina and toning. If I try to jump right in to heavy strength movements and split routines after having not worked out for some time, I get extremely light headed and nauseous when working out.

Circuit training helps me get my metabolism going, and builds up my tolerance if I want to change the routine around.
 
#173 ·
Hi Deejo & Folks,

I'm writing as my husband was recently diagnosed with Low-T. Since you're relatively experienced with treatment plans, i was curious to know :

1. Do you know / have you known anyone who has successfully permanently fixed the low-t problem ? Or is it likely a long-term medication issue ?

2. How long can pellets/ gels / injections be sustained ? Forever ?

3. If trying to have children, should we watch out for genetic conditions due to low-t conditions ?

4. How did low-t affect your relationship with your partners ? Were they understanding ? How do you deal with the worry of staying on top of this issue ?

Your responses to one or all of the above will be greatly appreciated. I'm extremely worried, given how new I am to learning abt low-t (just been 3-4 months). Hope you can help ..
 
#174 ·
For myself, my marriage had already tanked by the time I was diagnosed. For reference, I was very sexually attracted to my ex-wife.

To me, low-T falls under the umbrella of, 'it's not really a problem unless it's a problem.'

HRT is intended to help cope in the event that those problems affect the quality of your life.

It is a long term medication issue. Lots of the men participating in this thread have been on therapy or supplementing for years. I have been on injections for nearly 2 years. I have never 'cycled'.

How old is your husband? Based upon your post, and referencing children, I'm presuming he's relatively young.

I recommend injections. I started with pellets and they botched the dose ... which meant I got no benefit for 4 months. That helped me make my decision for shots, which can be adjusted quite quickly if needed.

I'm revisiting some of my previous posts, but low T in and of itself had little to no issue on my relationships. However ... I was having performance issues that I hoped hormone therapy would help with.
It did not.

In the instances that I shared what was going on, women would always insist, 'it doesn't matter' ... but despite their intended good will ... it did matter. They took it personally.

My input? The more YOU worry about it, you can just about assure it will have an impact on him.
 
#175 ·
Deejo - THANK YOU !!

Husband is 33 & I'm 30. You're right about the part 'It's not an issue unless it becomes an issue'.

In our case, my husband's sex drive was non-existent. For cultural/personal (Asian/Indian) reasons he wanted to wait to have sex until he got married. Never even had a relationship (which I found odd) or crushes in his 20s.

Lacking a relationship reference point, in a way he really doesnt seem to know what a 'normal sex drive' is. I noticed that he doesn't behave like other guys his age. No sexual chemistry. No inclination for making out, No interest in sports, outdoors or general guy things. Lack of ambition, drive for career.

He's not gay but strangely, one of his worries was sex was going to be painful for him and that was a mental block for him for sometime. Bottom line, in the few months we've been married we've never gotten around to doing it.

I mean, I thought a lot of things were off when I got to know him. (We had an arranged marriage). But I had no clue about the problem.

I can't tell which part is caused by the hormonal issue and which part is just his personality. But I'd sure like to know what improvements I can expect because continuing like this is unnatural.
 
#178 ·
Thought I would share my husband's NEW Testosterone LAB results... I was pretty pleased.

Just to mention...when I landed on TAM 3 yrs ago.... I had a little too much worry on my mind over his TEST... an Endocrinologist told me his levels were normal for a 60 yr old man (he was just 45)...& said he may need Treatment in the future....

He WAS a little stressed at work during that time frame...plus I was on a sex high draining him daily...even hours before those tests. I have to wonder now....if this made his results lower....possible ??

His results varied over 9 tests...lowest being 323 - highest being 503, one of the FREE Test results was below the Lab recommendations ~ that freaked me out!

So when he went for a Physical recently.... I asked our PCP to check him again.... it was only 1 test...but still....

(I always get the results sent directly to us...I like to see those #'s in my hand).....

New Results:

TOTAL Test = 487 ....(normal 241- 827)

FREE Test = 583 .... (Normal 250-1100)

Testosterone, FREE = 59.5 ....(Normal 35.0 -155.0 G)
This time around... he wouldn't let us "do it" the night before or that morning....Just in case...thinking that could lower his #'s & I'd be all worried again...

I think he sounds pretty normal for his age - right now... He is 49.
 
Status
Not open for further replies.
You have insufficient privileges to reply here.
Top