question from a user
I seemed to have lost libido after being on test cyp and hcg for 10 years it started happening this past year, I get the following labs done which are all normal. Test free, test total, shbg, e2, metabolic panel, lipids, fsh, lh, full thyroid panel, I'm curious what labs you recommend to try and diagnose this issue? I'm HWP eat mostly healthy and haven't really changed much of my habits. My dose is 100mg test cyp twice a week and 500iu hcg twice a week.
AlphaMD's Answer
Libido is one of the hardest things about TRT to dial in, since it has so many factors by physiologically & psychologically. It sounds like you're doing good testing & that regimen also sounds solid. Outside of Testosterone we would normally look at E2 being bottomed out once on treatment with an AI if you're someone who doesn't need it.
Since you've been on treatment for so long & have been doing testing regularly, the best thing to do in that realm would be to compare your results over time. Have your levels in any of those areas adjusted up or down over 10 years?
Given that you've been on treatment for that length of time & not much has changed with your habits or regimen, our first thought if labs are stable would be that it may not just be lab related. How is your personal self image? Confidence? Anxiety/depression & do you take any meds for those (as they can greatly impact libido)? How is erectile function, and has it decreased over time/recently?
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