Male libido advice

by DarrenB
(Birmingham,UK)

Hello there, hopefully, you guys can help a little here. I'm sorry this will be a long one, I'm trying to give you every piece of information I can think of to help, I just need to be 'normal' again.

I have been suffering from what I assumed were low testosterone/andropause symptoms over the last 3 years. I finally got to see an endocrinologist who said it wasn't, so I booked a private endo who also agreed it wasn't low T. So now I'm stuck in limbo with no direction.

My libido (sexual interest and drive) is virtually absent, I can get an erection (about 60% hard) with stimulation but these go fairly fast, within about 20 seconds with no physical stimulus. I often need to use Cialis just to be able to have sex on the odd occasion I get 'frisky'

I'm male 44 not overweight and in reasonable condition. My bloods are as follows:

Serum testosterone 16.2 nmol/l
Free test (calculated) 0.214 nmol/l
SHBG 62nmol/l
LH 8.1
FSH 8.8
Prolactin 247
Testes are 15ml bilaterally
Pulse averages 78
Blood pressure is around 120/78
Thyroid just says normal
Cortisol is 455 nmol/l
IGF-1 37 nmol/l


I am on carbamazepine 600mg morning and 400mg evening. I am also on fexofenadine 120mg evening. These are my only prescription medications. I have been on B12 injections for over 1 year but I have decided to take myself off them as I don't have pernicious anemia and the last few I have felt better in the weeks before the injection, but not so good after it.

I have been on a very long term of oxytetracycline (18 months!!!) for head acne, but I decided to come off those in January 2018.

Since that blood test was taken I have been taking the following supplements daily

Zinc 30mg elemental morning
DHEA 25mg morning
Magnesium oxide 200mg morning
Vitamin D 10,000 IU weekly
St John's wort 3x daily (only last 2 weeks)

I used to take a multi vitamin (Centrum MEN) and add a B complex to it but have stopped those over a month ago. I have taken tryptophan for about a week over 6 months ago then stopped it. Also previous to that I have taken theanine, rhodiola and taurine.

I drink coffee regularly, but not daily. I walk around 5-10 miles daily. I probably don't eat enough, I think it's between 2,000 and 2,500 calories daily. I have lost a lot of muscle tone so think I probably need more protein??

My symptoms:

Brain fog
Language skills are terrible
Memory issues
Poor concentration
Always tired
No motivation
White coating on the tongue
General fatigue
Low-grade anxiety - I sometimes have difficulty waiting on things I feel are important.
Don't dream any more
Sweat lots, more than I ever have
Don't fantasise sexually
Skin itching at night (hence the fexofenadine)
I have found I am quite pessimistic these days unless it's something that interests me.
I do sometimes have mood swings that are uncontrollable

Sleep; I can't remember the last time I had a refreshing sleep. I can usually get to sleep no problem, but staying asleep is much harder. I usually wake around 3 times at 2:30, 5 and 7:30 am. I don't feel refreshed when I wake.

Muscle loss; I have had quite a lot of muscle loss since January (since I started walking). I can put it back on, but struggle to keep it. I think I might not be getting enough protein and/or food in general?

Low/zero libido; I can't even fantasise about sex, it's like a switch has been turned off inside my brain

Erection; much softer erections. If I were a 10 before they are more like a 6 now. There's no 'pump' and it doesn't 'stand' on its own when lying down, just rests on my stomach, even with Cialis. I no longer get spontaneous erections either. Doesn't seem to have as much sensation and is always flaccid and unresponsive unless masturbated. I have been thinking about eating more nitric oxide rich foods to try and 'pump' it more when erect. However this doesn't seem to do a great deal on the occasions I have done this.

Orgasms; sometimes I can reach orgasm easily, but probably 75% of the time I struggle to reach orgasm and often can't. It's as though I don't enjoy it as much, I assume because my erections aren't as hard as they used to be, the pressure is different.

Loss of joy; things just aren't enjoyable for me right now. I still have a laugh and a joke with friends etc.. but the little things aren't enjoyable

Joint pain; recently my joints are hurting, my thumbs and shoulders especially. this came on 3 days after my last b12 injection.


As you can see, all of the symptoms point to low testosterone, but both endocrinologists say no and after finding out that it's a lifetime thing since it shuts your own production down, I don't fancy trying it privately. That and the prostate cancer issue as my father has literally just been diagnosed.

The private endo did suggest that the symptoms were sympathetic with depression but he also stated that based on my interactions and that we were having a giggle that he didn't think I was depressed and I agree, I don't feel depressed, just frustrated that I'm broken and my Dr can't or won't help.

Now here's the part that is interesting:

I mistakingly used my girlfriends progesterone cream (22mg per pump) and had half a pump. Within about an hour I actually felt things in my penis again for the first time in ages. My erections are a little better when I use it but there is a caveat; the sensations stop quite shortly, I would say around 4 hours after using it.

I have since taken a full pump twice a day with the same results. Although I am sleeping longer now but still not refreshing :(

So, here's my question, should I be using more progesterone? Maybe couple the pg with a dopamine agonist like DLPA??

All help will be gratefully received.

Any help or insights greatly appreciated, I really need this fixed soon.

Thank you for your input in advance.

Comments for Male libido advice

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Sep 13, 2018
Correction
by: DarrenB

Sorry I was meant to type Cetirizine Hydrochloride 10mg instead of Fexofenadine. I no longer take the fexofenadine.

Sep 13, 2018
Male libido advice
by: Justine

Hello Darren

Thank you for writing in. Unfortunately Wray is no longer with us and she would have been the one who would have answered your questions and given the best advice on your subject.

What I can suggest is that you please read the pages on this website that she has written (that I will list below) as well as the references and the forum pages that all relate to similar topics as your own. You will find Wray's answers to other men on the forum pages and I am sure your questions will be answered somewhere within them.

Progesterone for men

Question about progesterone for men

Prostatitis and libido

Progesterone boosted my quality of life

All the best.

Sep 13, 2018
Male libido advice
by: Justine

P.S - Another way of finding information on this site, (which is vast!) is to type your question into the google search bar at the top of the home page, this will bring up web pages and forum threads with related information (Just look for the 'progesterone therapy' links ;)

Sep 13, 2018
Thank you
by: Darren

Thank you Justine, I've been browsing for around 3 days now lol and just decided that things that are similar aren't close enough to warrant a decision.

Never mind though, I'll just soldier on and see what happens :)

Sep 13, 2018
Male libido
by: Rachel

Has anyone interpreted your hormone results?
Some of your symptoms sound a lot like low testosterone to me.
Particularly muscle loss. Depression, crappy sleep etc. I have the exact same symptoms and my T is low (I’m female).

Sep 14, 2018
Male Libido Advice
by: Justine

Hello Darren

Oh dear, I am sorry I could not be of more help. There is so much info on this site though people rarely seem to do their own research so it is refreshing to find someone who does! I hope you find your answers.

Incidentally, I am sure you came across this, though I will just point it out here again, Wray suggests men to take anything up to 100mg of progesterone a day depending on symptoms, see this page here:
Progesterone dosage

Her philosophy behind taking progesterone is that it is the precursor to the sex hormones the body makes, so taking progesterone the body can then use it to convert to testosterone or estrogen, whatever it needs to create balance.
Quote from the home page: "Progesterone is an essential raw material from which your body makes many of the other hormones vital for good health"

See this chart from Genova Diagnostic on the Steroidogenic pathways

If you were feeling better on the progesterone, then perhaps listening to your body and trying it out would be a good way to go. Perhaps increasing the dosage may help?

I am not sure what make of progesterone your girlfriend has, do you know the percentage of progesterone it contains? and is it a bio-identical progesterone cream?

Sep 14, 2018
Testosterone
by: Anonymous

Hi Rachel, thank you for the reply. As mentioned in the original (rather long) post I have seen two independent endocrinologists and both concur that it isn't a T issue. One giving no further idea and the other (privately paid endocrinologist) saying that depression or my medication could be the culprits.

To be fair the meds do have very similar known side effects and I have been on them for 32 years now :( but I do have an appointment with a neurologist scheduled to see if this is the case.

Justine, many thanks again for your reply. Please don't feel that you have been little help, you have been far more help already than my GP over the last 3 years!

I've read many times about the dosage on here, I noticed that, sorry to be crude, my penis was having the pre-erection feelings, and seemed fuller and thicker with around 8mg of pg.

Then read elsewhere that 8mg should be considered a half dose for men so upped it, well did 8mg twice daily, and did have better results. I was able to get an (almost) erection without manual stimulation.

However, these results were short-lived so I decided to try 20mg (a full pump) of the cream twice daily, this was yesterday.

The original feeling of pre-erection tingles wasn't as strong.

While the initial response was about the same, it didn't seem to last as long so I can only conclude from this that either

a) my body is adapting to the dose by producing more estrogen

b) my body needs more pg as it's responding to the initial pg surge

c) the pg is raising my SHBG even further and binding more testosterone

The cream she has is a 'now' brand which is bio identical paraben free etc.. One pump of 1.3g of cream has 20mg of pg in it. So not a huge amount but enough to experiment with lol

Beause I have never had my estrogen or progesterone tested (for some reason DR's here have trouble testing a man for female hormones, I had to pay privately to get my prolactin!) I have no idea if my estrogen is high or not, however, I can say I scored 51 on the questionnaire. I'm assuming this is higher than most.

Sep 14, 2018
Inverse response
by: Anonymous

Forgot to ask if its common for the body to respond well in the beginning then has a 'relapse' of results if there isn't enough pg in the system? Iv'e literally only been taking it for a week yesterday (thursday 13th Sept 2018)

Sep 14, 2018
Response
by: Justine

Hello Darren

In my mind, taking the medication is definitely the cause of your symptoms, though I am not a physician so I probably should not comment and cannot advise you on how to proceed. Any chemical we put into our bodies will have an effect and if you have been taking something for so long then I would presume that could be the root cause, though there are so many other factors that come into play, it is almost impossible to root out one issue, everything is connected isn't it!? Environment, diet, lifestyle, stress levels, body chemistry, thoughts, behaviours, beliefs, the list goes on!

I am not an expert on hormone levels in men, again that was Wray's field of expertise so I cannot give you feedback on that though I do not believe progesterone can do harm so I think experimenting with it, with the cream you have access to, is a good idea (seeing as your body has responded well so far to small doses). There can definitely be a period for some where the body may 'relapse' once one starts taking it, the advice on the website is to keep going and try increasing the dose, (applying half in the morning and half in the evening) to find the level that suites you best... and to persevere, it can take 2-6 months before the balancing comes into full effect.


It is strange that doctors think progesterone is a female hormone!


All the best!

Sep 14, 2018
Meds
by: Justine

Hi Darren, are you taking carbamazepine for epilepsy/seizures? I know progesterone can help with this, please see the page on this site for Epilepsy Treatment

I found this when I put carbamazepine into the search bar on this site:

Epilepsy treatment references

PubMed: Effect of carbamazepine therapy on vitamin D and parathormone in epileptic children.

Perhaps you should take more VitaminD (daily?)

Sep 14, 2018
Epilepsy
by: Anonymous

Yes I'm taking 1000mg daily which when I was put on it at age 12, I was told it was a fairly low dose, now a few weeks ago my new GP said it was fairly high lol

I have an appointment with the neurologist booked to discuss it because I have been seizure free for over a decade and not even had the feeling of pre-seizure so I honestly believe I may no longer need it.

The reason the dr's think I became epileptic was I grew 12 inches in 7 months and my body just couldn't cope with the extended stress.

Dr's here think all manner of annoying things, for example I had to literally beg to have my testosterone levels checks despite showing so many symptoms of low T

Sep 14, 2018
Epilepsy & doctors
by: Justine

There are some brilliant doctors and then there are some not so brilliant, many of whom just seem to follow the advice of the drug companies and don't do their own research or develop their practice further.

At the end of the day, doing one's own research is the best way to go, be informed and then know which questions to ask. It seems some doctors don't respect our requests, we have every right to get the tests we want done, regardless of their opinion.

There is so much information and there is a lot of conflicting information, I know it can become difficult and daunting and confusing knowing what to believe and what to do! Personally I believe the body knows best and the less we interfere with it the better, and if we do need to interfere, then approaching it holistically and integrally is key.

I wish you well and trust the right decisions will be made and the right answers will come!

P.S - you may find this page interesting, its about the role of progesterone in treating brain injury, seizures etc.

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