This might be the key! Androgen function in the spotlight.

Post any data on Treatments and experimentation.
fuckthisisscience
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Re: This might be the key! Androgen function in the spotlight.

Unread post by fuckthisisscience »

Halan wrote: Tue Apr 28, 2020 10:16 pm When you talk about supraphysiological testosterone levels, how much is this? something like 1200 ng/dL?
My levels are 400 ng/dL, not so low but could be higher since I haven't 30yo yet.

The problem with supraphysiological is the risk of prostate enlargement.
First step should be increasing testosterone levels and see, if the symptoms resolve. E.g. doubling your levels to 800ng/dl. But 1200ng/dl or even higher levels might be necessary.

Increasing prostate volume under TRT-Therapy is a myth. Fyi read: https://www.ncbi.nlm.nih.gov/pmc/articl ... ec1-4title


I've read some people writing, that they tried T therapy to cure PSSD. But I cant stress enough, that this kind of therapy is such often done wrong in clinical reality. There are few endocrinologists (and even fewer docs of other disciplines) that can tread hypogonadal patients right! There are quite a few reasons for your therapy not beeing effective, although testosterone therapy itself could be effective.
The most probable reasons I can imagine are:
  • dose too low
  • wrong form of application
  • not waiting long enough to see results
I want to explain the last named reason: TRT in hypogonadal men is known to develop symptom relief at the earliest after 3-4 weeks. But it is quite common that the first symptoms slowly begin to steadily improve after months (6 months and even later)! btw.: Erectional quality beeing the symptom that often times resolves not until you passed the 1 year mark!
For further information read: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3188848/
- Medical Student - finishing in late 2020
- interested in PSSD (and sexual health in general), no sufferer
--> Androgen hypothesis
- wanting to research PSSD
- been reading numerous scientific articles about possible aspects of of PSSD
JP1985
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Re: This might be the key! Androgen function in the spotlight.

Unread post by JP1985 »

vkn1 wrote: Thu Mar 26, 2020 2:18 pm I have had PSSD for 12 years and got it from either a Trazodone or Accutane. I took TRT for 4 years, trying all different methods with T levels set to everything from low to average to high. Never ONCE did I witness any benefit at all. Zero.

The idea that all we have is low hormone levels is not new. The first person who ever got PSSD, PFS, or PAS 20 or 30 years ago probably tried hormone therapy. If it has ever worked for anyone then that person probably simply had hypogonadism and not PSSD at all. Countless people here have tried hormone therapy and failed.
Had PSSD 4 years from citalopram which I was on for 5 years - always had normal sexual function until the last year or so and took me a while to realise it was the citalopram because of that. Once I realised it was that I came off it. I’ve been on TRT the last 13 months and for the first few months I feel like it helped, I had a very high sex drive and sex felt about 80% which I could deal with. The last 6 months or so I’m at about 50% and orgasms are weak. I feel like I was probably better when I was on the citalopram and sometimes think maybe I should go back on it but doubt I ever will as don’t want to chance it getting even worse. It’s just so frustrating, people don’t know how lucky they are to have a normal orgasm, they were the days 😢
Last pill March 2019 - Citalopram for 7 years
Numbed penis and weak orgasm
Fatigue
Slightly blunted
Dizziness (this has improved a lot in the last 6 months)
fuckthisisscience
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Re: This might be the key! Androgen function in the spotlight.

Unread post by fuckthisisscience »

JP1985 wrote: Thu May 21, 2020 3:46 am I’ve been on TRT the last 13 months and for the first few months I feel like it helped, I had a very high sex drive and sex felt about 80% which I could deal with. The last 6 months or so I’m at about 50% and orgasms are weak.
Thats very interesting and a good point to start from! Often times it is necessary to take further adaptions to a TRT regimen in the course of the therapy. E.g. maybe your estrogen levels block further symptom relief. Or maybe you just need a higher dose...

May you write something about:
  • your application form
  • exact medication (+hcq, anastrozol etc.?)
  • dose (history)
  • your labor values then and now? ((free)T, SHBG, E2, LH, FSH, Prolactin, TSH)
  • exact symptom history
- Medical Student - finishing in late 2020
- interested in PSSD (and sexual health in general), no sufferer
--> Androgen hypothesis
- wanting to research PSSD
- been reading numerous scientific articles about possible aspects of of PSSD
wellthatsuckss
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Re: This might be the key! Androgen function in the spotlight.

Unread post by wellthatsuckss »

To be honest, i don't think TRT is a good idea. I am 22 years old male with good testosterone levels. 680ng/dL to be precise. I also tried abstaining from masturbation like 2 weeks to increase it even further. Effect of testosterone is very temporary. It feels like trying to go faster on a car without pulling your foot off the brake. I wouldn't recommend it to anyone unless they have very low levels.
Low response to both sexual and emotional stimuli
I still got nocturnal and morning erections but they are mechanical and devoid of sexual nature.
Almost non existent anxiety.
Koivukovy
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Joined: Thu Jul 18, 2019 4:22 am

Re: This might be the key! Androgen function in the spotlight.

Unread post by Koivukovy »

First of all, you shouldn't be recommending anything to anyone. Second of all, abstaining from masturbation has no effect on testosterone. Third of all the effect of testosterone is not temporary. Please don't comment if you dont know what youre talking about.
JP1985
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Re: This might be the key! Androgen function in the spotlight.

Unread post by JP1985 »

fuckthisisscience wrote: Thu May 21, 2020 7:14 am
JP1985 wrote: Thu May 21, 2020 3:46 am I’ve been on TRT the last 13 months and for the first few months I feel like it helped, I had a very high sex drive and sex felt about 80% which I could deal with. The last 6 months or so I’m at about 50% and orgasms are weak.
Thats very interesting and a good point to start from! Often times it is necessary to take further adaptions to a TRT regimen in the course of the therapy. E.g. maybe your estrogen levels block further symptom relief. Or maybe you just need a higher dose...

May you write something about:
  • your application form
  • exact medication (+hcq, anastrozol etc.?)
  • dose (history)
  • your labor values then and now? ((free)T, SHBG, E2, LH, FSH, Prolactin, TSH)
  • exact symptom history
I‘m not great with all this but I’ll answer as best I can

I take it by injection - 0.3ml sustanon, 0.1 hcg twice weekly, anastrazole 1mg per week (in 0.25mg doses)

These were my bloods the last time (September 2019)
Oestradiol - 96 pmnol
Testosterone - 24 nmol
Free Testosterone - 0.59 nmol
SHBG - 19.3 nmol
LH - < 0.3
Prolactin - 197 mU/L

The first week I started TRT I didn’t know what I was doing as I order it online and do it myself, I live in England and my testosterone was in the low normal range (10.2) I accidentally injected the whole 1ml as I didn’t know what I was doing the first time, after that I did 0.4 per week. At first I was having my bloods taken regularly and had high estrogen so lowered my dose to 0.35 then now I’m at 0.3. The above combination of sus, anastrazole and hcg keeps my test highish and estrogen low. Because of this I’ve realised it’s useless as I’m in the perfect range and PSSD symptoms are as bad as ever. I feel like it was placebo why I had the huge boost at first. I was so excited when I first started TRT after watching YouTube videos of people saying how horny it made them and saw one saying his dick sensation was now amazing. If only it was as easy as taking testosterone to fix it 😫 would do anything to be how I was before!

FYI my symptoms are -
Hardly any sensation when touched by partner but sex feels ok
Masturbation is rubbish, barely feel anything unless major excited by the porn I watch (hard to find videos that mega excite me anymore, used to be easy before this shite)
Orgasm is 50% (At a guess)
Premature ejaculation (even though sensation is shit) 😐
Last pill March 2019 - Citalopram for 7 years
Numbed penis and weak orgasm
Fatigue
Slightly blunted
Dizziness (this has improved a lot in the last 6 months)
JP1985
Posts: 201
Joined: Thu May 21, 2020 3:11 am
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Re: This might be the key! Androgen function in the spotlight.

Unread post by JP1985 »

Is there a way I can start a new thread? I’m new here and new to forums and don’t really get it all yet. Cheers
Last pill March 2019 - Citalopram for 7 years
Numbed penis and weak orgasm
Fatigue
Slightly blunted
Dizziness (this has improved a lot in the last 6 months)
fuckthisisscience
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Joined: Sun Mar 22, 2020 7:03 am
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Re: This might be the key! Androgen function in the spotlight.

Unread post by fuckthisisscience »

I'm 100% convinced, that common form of PSSD is about sex hormone imbalance/dysfunction.

Everyone is experiencing the very same symptoms like hypogonadal patients. The symptom-complex is a mix of T-defiency and estrogen-defiency (gum bleeding, dry eyes/nose/throat, loss of genital sensibility, lichen sclerosus/balanitis are common symptoms of estrogen deficiency commonly seen in postmenopausal women!). If you are not suffering from lichen sclerosus yet, you might be lucky.

The symptoms match so good, that there is no other explanation. But we have to figure out the very cause, and as I said, it might be, that PSSD-sufferers must not orientate towards 'normal' hypogonadal patients. -> so you might not be in the 'perfect range' for your own body and needs!

I've read so often that PSSD patients have had skyrocketing libidos before they got their SSRI cocktail. It is quite possible, that they've had T levels of 1500 (reference 300-1100) or even higher. The same might be true for adequate estrogen levels. But no young man with psychiatric symptoms would ever get their T levels tested. So a previous hyperandronismn would never be noted. Sometimes an hyperandrogenism is seen by accident in clinical managment, but it has no consequences, because other than high libido or acne it doesnt hurt anyone.

How did you feel about that before the SSRI? Did you have high libido? Anxiety? OCD? Panic attacks? Insomia? Might be a sign that you had hyperandrogenism before.

Today it is assumed, that even the balanced ratio between T and E2 plays a role. It is well known, that adequate T levels, with too high or too low estrogen levels lead to certain symptoms.

JP1985: you might not be lost. If anything, be happy that you figured out, that Testosterone helped you! I'm quite sure, that with further adaptions you might get better again.

Regarding your last message:
Every Lab has its own reference, which slightly differ from each other. So please let us now the references for your lab and every value. As far as I can asses the values, there is some room to further increase your T levels! But please check the units: Do you mean 30 nmol/L?

And I would not recommend an Aromatasae Inhib. in the first place. Did you develop symptoms of high E2? A good endocrinologist would never treat numbers, but numbers based on symptoms. You might need high E2 to function! Crashed E2 can lead to the same symptoms like low T.
Might it be, that you felt good without the AI and after taking it you crashed again? That could be one explanation.

Please let me know the exact dosage of your Sustanon. 1ml might be 250mg or even 1000mg.

Let me summarize:
You had a good start. You might need more T, as it is just mid range and you first responded. In addition I would suggest trying without an AI until you develop symptoms of high E2. Increase hcg to 250IU e3.5d (500IU/week).
- Medical Student - finishing in late 2020
- interested in PSSD (and sexual health in general), no sufferer
--> Androgen hypothesis
- wanting to research PSSD
- been reading numerous scientific articles about possible aspects of of PSSD
defmyst
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Re: This might be the key! Androgen function in the spotlight.

Unread post by defmyst »

I had my testosterone tested back in December and was told that it was perfectly normal although I wasn't told specific numbers. Reading about my symptoms (very significant erectile dysfunction problem coupled with very low libido) it would appear that I may have androgen deficiency. However, my question is can I still be androgen deficient while my overall testosterone is within a normal range?

I am getting lab work done on the following hormones next week:

Follicle Stimulating Hormone
Luteinizing Hormone
Prolactin
Sex Hormone Binding Globulin
Testosterone, Free
Testosterone, Total

Fuckthisscience if your theory is right, can you tell me what do you expect the results of these tests to be with respect to each hormone? (i.e. normal levels, or above or below normal).
Thomas
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Re: This might be the key! Androgen function in the spotlight.

Unread post by Thomas »

My two cents.
This theory is interesting, especially because it could explain why symptoms could worsen months after discontinuation. BUT:
1) About the "match" with our symptoms, would testoteron explain such strong symptoms like anhedonia and emotional blunting?
2) I thought other theories (especially about neurotransmitters) could explain every symptoms, too.
3) If it is so slow, why symptoms can appear suddenly after few pills?
4) TRT is the "natural" treatment if you don't know about PSSD and therefore it has been tested...
So test imbalance looks more like a consequence of something else...

Regarding the fact that most sufferers were "super horny" before, I think an alternative explaination would be "the more the difference is visible, the more people report their case". I think PSSD is not binary. When I stopped SSRI the first time, I wondered if my sexual fonctions were as good as before because I felt less horny and had slower erection. But I still had a libido and was perfectly able to have sex so I discarded, thinking I was imagining symptoms (and maybe I was).

To those who read all the studies: was test level checked in previous studies on rats? I guess this would be rather simple to check on rats...
Escitalopram, 10mg/day, Jan-May 2019. Fluoxetine, May-Sept 2019. Mirtazapine 7,5mg/day, November 2019-January 2020. Escitalopram, 5mg/day, Feb-May 2020.
Symptoms: sexual & emotional numbness
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