Diagnosed Low Testosterone - Doctor has options - Seeking Advice

[JockItch (imported)]

He could put you on Clomipheme along with the testosterone to keep ur balls working to avoid shrinkage, as mine did. I lost my balls about 4 mo ago so this is no longer a concern. Also, I am taking anastrozole, which is an anti estrogen, and basically makes my estrogen level unmeasureably low. So I can eat all the tofu and drink all the beer i want without getting bitch tits.

[Wellesley (imported)]

Totally agree with this,

TRT is not a switch, one must wait 10 to 14 days to "flush" it out if one adds too much. The other side too is dangerous and I was depressed addicted to benodiazapine and sleeping pills with too little.

Atrophied testicles likely as not should be removed. Atrophied parts tend to have other issues.

I found that I can't get a "maintenance" dose. 0.4mL is too little and 0.5 is enough but gives me a sex drive.

Technically 0.6 is perfect for my feeling but bad as I become aroused too easily.

Finding something that works for the individual is key I think.

Testicles that atrophy are subject to tumor development. Maybe benign, maybe cancerous. Tumor development is treated differently in different places and by different doctors. Some will recommend removal, some will recommend biopsy. There are inherent dangers in biopsy. If the tumor is cancerous taking a biopsy punctures the shell of the testicle and can permit cancer cell(s) to escape and be set free which could perhaps move about and cause cancer elsewhere. Each case of course is unique.

TRT is not a light switch and does not just activate and deactivate sexual drive. Hormones in the body are interdependent, and their interaction have a cascading effect.

If you start tinkering around with T level and making it go up, and go down, and go up, there will be consequences. It would depend on your age, health, and other factors, but basically, IT'S NOT NICE TO FOOL MOTHER NATURE.

Then, lastly, if you let your T level remain low for long enough you will of course start to lose body mass, be impotent, perhaps develop confusion, loss of mental clarity, gain body fat, and a whole host of other things. That;s the down side. On the plus side you will gain a feeling of peace, calm, loss of agitation, and possibly lose any interest in tinkering around with T. Once thoughts and cravings for sex diminish you start to realize that there are more important features in life than sex.

There are no clear answers, other than, not choosing to keep your T up all the time, or down all the time, you very likely will reap more problems than benefits.

Why do I say this. Well, been there, done that. Seemed like a neat idea in advance. Turns out, not so much, and unnecessary.

Now I just use a maintenance level of T. Low enough to remain sexually neutral, high enough to not suffer low-T side effects.

What level is that? Well, I experimented on my own to find the level that worked for me. I doubt that any doctor could possibly predict this.

[Woggler58 (imported)]

Yeah, with my current low level of T, my libido is actually lower than I prefer. But I like being able to play with it. The idea of being able to get on T and have it kill my bodies ability to produce even the small amount of T that I now have and then at some point in the future if I want to try to see what it would be like to be chemically castrated, it would (in theory) be as simple as stopping my T dosage.

I've been on TRT (via MD-prescribed daily rub-on compounding pharmacy-made crème) continuously for 3-1/2 years, following a crashing to 210 of my natural T production due to radiation treatment 5-1/2 years ago for prostate cancer. I now have T levels at least double my pre-radiation level of 360-410, and enjoy the pep, mental sharpness, and largely restored libido. This exogenous (external) T source continuously satisfies my hypothalamus's T-detection and regulation "setting" (in the manner of an air conditioner thermostat's setting or a car’s voltage regulator) such that it no longer emits the GnRH hormone that would stimulate my testicles into T-making activity.

An Explanation Per Kristoff's sticky Castration Primer post of 12-27-2006 in the Eunuch Central Forum:

"Production of testosterone is controlled by the release of luteinizing hormone (LH) from the anterior lobe of the pituitary gland, which is in turn controlled by the release of GnRH (Gonadotropin Releasing Hormone) from the hypothalamus. LH is also called interstitial cell stimulating hormone (ICSH). Thus: Hypothalamus --> GnRH --> Pituitary --> LH --> Testes --> Testosterone.

"The level of testosterone is under negative feedback, that is, a rising level of testosterone suppresses the release of GnRH from the hypothalamus."

Accordingly, my testicles have not been getting any LH for 3-1/2 years and presumably have not been producing any T during that time. They have gradually shrunk to about 75% of their former dimensions, meaning to about 43% of their former volume. I have noticed that they hang from shortened cords so that they don't rest on the bottom of my scrotum, which in turn now hangs slack in its underneath part as well as not being filled out along its sides.

Subjectively, I enjoy every effect of my TRT-supplied high T level compared to my natural level and especially compared to my low, post-radiation level. And I’m indifferent to my testicular shrinkage or whether I even have testicles any more, at age 70.

Because my PSA results have risen over the last year to the point that suggests prostate cancer is returning, I may soon have to discontinue TRT and then maybe undergo a process to eliminate T from my system thereafter, permanently or in lengthy intervals separated by spells of having normal T levels until PSA again rises. Thus I have the same question posed: what will my testicles do if I stop long-term TRT?

I asked my hormone-prescribing doctor and he said without hesitation that my testicles will come out of hibernation and resume T production in accordance with what my hypothalamus wants of them. How fast and how well they would perform he didn’t get into, but it matters if I have to drop to and maintain a castrate level of T in the future to stall prostate cancer. Any returning T production would be too much. Info on this Board mostly says that the time I’ve been on TRT is too long for my testicles to return to productivity. Other info from the bodybuilding world, where T-like steroids are taken in much shorter cycles than a full year, seem to agree that taking certain drugs is necessary to stimulate prompt return of testicular output when the T-suppressive steroids are about to be stopped. HGT and Nandrolone or Clomid were mentioned, I think. Thus it’s not clear what the answer is. Perhaps I’ll be finding out in real life for myself in the coming months.

[dancinggizmos (imported)]

May I ask what medications and dosing you are using for your HRT?

[dancinggizmos (imported)]

After long term Therapy of TRT, you would really want to stay on it for life. I would slowly taper off though, see if your Physician will provide you with with Arimidex and some HCG, this will restart your system.

You can goo off of the HRT, the natural levels are not the worst if your testicles were not small then perhaps it may be better to use hemopathic things such as Tribulis Terrestris or HCG.