# Importance of Progesterone? Libido Issues on TRT.



## Koalocelot (Nov 27, 2020)

My biggest struggle by far on TRT and Hormones is a total lack of libido and ED.

I am wondering how important the hormone Progesterone is for those of us on TRT. I ran a more extensive lab panel, and my progesterone came back completely undetectable for the second time. 

A while back I ran 30mg pregnenolone for about a week, and this raised my Pregnenolone to 90, Progesterone to 0.2 ng/ml, but I was so groggy from it that I stopped after a couple of weeks.

I know supplementing DHEA with pregnenolone is usually recommended, but I didn't do so given that my DHEA levels are normal.

Current Protocol is 70mg Enanthate 2x per week. 

(Related Hormones: Pregnenolone is 31 ng/mL, DHEA levels are 311. Prolactin is near the top of the range at 12.9 ng/mL (range is 4.0-15.2), but sometimes it creeps up to 16. Test is at the high end of the range at 950, and E2 sensitive is 34. Thyroid panel is excellent, DHT is above 60. Salivary cortisol came back normal.) These are all trough readings, immediately before the next injection.

I have heard HCG raises these hormones, although it didn't show up in my bloodwork when I tried it, and HCG triggers a gyno response no matter the dose. It does slightly increase desire and sensitivity for me though.

Clinic is pretty stumped. They recommended continuing the pregnenolone and using .125mg caber once per week.

I can post more extensive labs if necessary.


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## Koalocelot (Nov 27, 2020)

Also should add that HCG tends to double my E2 into the 60s, if thats relevant.


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## Joliver (Nov 27, 2020)

I doubt you will want to hear this, but the simplest solution would be to add a SERM like Nolva, or Raloxifene for the gyno with the HCG treatment and bump your AI as needed.

Exogenous HRT isn't doing very much for your intratesticular testosterone levels. Unscientifically, and pure observation on my part leads me to believe that most of the HRT guys that have libido issues have low ITT, but think it's an E2/progestin/etc ssue. A dose as low as 250iu a week can significantly increase ITT. 

 Finding a happy medium with progestins, the hormone that effectively castrates pedos, is extremely difficult. And while animal studies show some positive bullshit correlation with a low level progestin goldilocks zone in regards to libido, I'd say it's like chasing a ghost. 

In summary, this is a case where fighting the symptoms is easier than trying to chase the chemical cascades of progestins, etc that may or may not help. 

What I'd do: 

HCG 250iu a week. Add the SERMs to rid the nipple itch. Adjust a bit of AI to accommodate for the increased aromatization (which hcg causes increased rates in everyone--its not an individual thing). See where my libido stands in 3 weeks. Add cialis (or any pde5 inhibitor of your choice) for dick issues. 

All else fails, add some bremelanotide (pt141). That stuff is pretty libido friendly.

Godspeed, sir.


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## Koalocelot (Nov 27, 2020)

Joliver said:


> I doubt you will want to hear this, but the simplest solution would be to add a SERM like Nolva, or Raloxifene for the gyno with the HCG treatment and bump your AI as needed.
> 
> Exogenous HRT isn't doing very much for your intratesticular testosterone levels. Unscientifically, and pure observation on my part leads me to believe that most of the HRT guys that have libido issues have low ITT, but think it's an E2/progestin/etc ssue. A dose as low as 250iu a week can significantly increase ITT.
> 
> ...



Appreciate the response. I am not against hearing anything at all that may help. Totally open to the idea of nolva on TRT as I have some on hand. As far as a dose, 5mg, 10mg a day? 

I'm not currently taking an AI but I have anastrozole on hand as well.

I understand what you mean about the balancing act with progesterone. 

I have considered PT141 but I have read that you can only use it sparingly because of tolerance, so I'm trying to find a long term solution before using that as a boost. 

Also not excited about caber recommendation by my clinic with my prolactin already in range.

Thanks for the help.


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## Joliver (Nov 27, 2020)

Koalocelot said:


> Appreciate the response. I am not against hearing anything at all that may help. Totally open to the idea of nolva on TRT as I have some on hand. As far as a dose, 5mg, 10mg a day?
> 
> I'm not currently taking an AI but I have anastrozole on hand as well.
> 
> ...



With the nolva, I'd say you'll be "titrating by tit." Which is to say if you have issues, dose accordingly. I'm not trying to avoid the question, but everyone will respond differently to SERM administration. The half-lives are fairly long on some SERMs, so you may find you don't need daily dosing. If I we're going to do it, I'd suggest 20mg when I felt an issue with my nipples. Dose till it's gone. Then back the dosage down to something manageable, like 10mg eod as a preventative thing. 

An AI is fairly common with HRT administration. No reason not to keep it around. It will not prevent HCG induced aromatization in the testes. Not sure why...not a doctor. Something I read on pubmed. That's good news to some degree seeing as how studies do show some positive libido and erection markers for E2. I'll post that study...

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4854098/

I know you don't want to fix a seemingly permanent situation with band-aids, but for right now it's going to have to work. Seems like hormonal changes in response to HRT protocols runs in 3 week cycles. So whatever you need to do to survive for those weeks, may just be the best way forward. So if pt141 gets you through the weekend, cialis scrapes you by date night...while the hcg fixes your ITT issues (if that's the case) I'd embrace it... temporarily, at least. 

With the caber: I've seen a few guys that had some success with it. Some I attributed to placebo, some may have legitimately worked. But on the whole, I've seen few doctors stay the dopamine agonist course for HRT dudes. The good news is that the problem I'm suggesting is much simpler....and dopamine agonist withdrawal (DAWS) is an absolute bitch.


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## Koalocelot (Nov 27, 2020)

Joliver said:


> With the nolva, I'd say you'll be "titrating by tit." Which is to say if you have issues, dose accordingly. I'm not trying to avoid the question, but everyone will respond differently to SERM administration. The half-lives are fairly long on some SERMs, so you may find you don't need daily dosing. If I we're going to do it, I'd suggest 20mg when I felt an issue with my nipples. Dose till it's gone. Then back the dosage down to something manageable, like 10mg eod as a preventative thing.
> 
> An AI is fairly common with HRT administration. No reason not to keep it around. It will not prevent HCG induced aromatization in the testes. Not sure why...not a doctor. Something I read on pubmed. That's good news to some degree seeing as how studies do show some positive libido and erection markers for E2. I'll post that study...
> 
> ...



Excellent advice man I appreciate every bit of it. I'll start with the SERM, HCG, and low dose AI and go from there. Thanks.


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## Joliver (Nov 27, 2020)

Koalocelot said:


> Excellent advice man I appreciate every bit of it. I'll start with the SERM, HCG, and low dose AI and go from there. Thanks.



Yessir. Keep me in the loop. I'll help in any way I can.


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## Sicwun88 (Nov 27, 2020)

Hcg and cialis!
Works for me


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## dragon1952 (Nov 27, 2020)

Koalocelot said:


> A while back I ran 30mg pregnenolone for about a week, and this raised my Pregnenolone to 90, Progesterone to 0.2 ng/ml, but I was so groggy from it that I stopped after a couple of weeks.
> 
> I know supplementing DHEA with pregnenolone is usually recommended, but I didn't do so given that my DHEA levels are normal.



I take my pregnenolone and DHEA about an hour before bed. If you were taking it daytime you might try this instead.


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## Koalocelot (Nov 27, 2020)

dragon1952 said:


> I take my pregnenolone and DHEA about an hour before bed. If you were taking it daytime you might try this instead.



I have tried preg before bed also I still wake up groggy for most of the day. Do you think Dhea would counteract that in any way? I haven't taken dhea since my levels are good.


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## dragon1952 (Nov 27, 2020)

I take any supplement said to make you sleepy or improve sleep at night. Pregnenolone, B6, taurine and dhea, which is said to improve REM sleep. You'll read some say DHEA in the daytime to improve wakefulness but I have been sleeping the best I have in years lately with this regimen, esp. since adding the taurine for some reason.


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## Koalocelot (Dec 21, 2020)

dragon1952 said:


> I take any supplement said to make you sleepy or improve sleep at night. Pregnenolone, B6, taurine and dhea, which is said to improve REM sleep. You'll read some say DHEA in the daytime to improve wakefulness but I have been sleeping the best I have in years lately with this regimen, esp. since adding the taurine for some reason.



It's funny how different two people can respond to the same thing: b6, taurine, etc all completely destroy my sleep if taken before bed.


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