question from a user
How do you address patients that started with low libido and continue to have low libido/worse libido since starting TRT?
AlphaMD's Answer
Libido is one of the hardest hypogonadal symptoms to dial in correctly. Part of this is because libido is not entirely hormonal and is confounded by emotional states and other environmental factors. Also, it is more difficult to dial in because the greatest hormonal factor in libido for men is not testosterone, it’s dihydrotestostetone (DHT). This is created from testosterone by 5a-reductase. Some men convert at higher amounts than others. Those that don’t have much 5a-reductase seem to have chronically lower DHT, and this lower libido.
Medically speaking, using DHT derivative steroid can help, like oxandrolone.
We have found that the peptide PT-141 works like a charm in both men and women as well.
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