HomeAnswersDiabetologytestosteroneIs TRT the right treatment for low libido and poor quality erections?

Is TRT the right treatment for low libido and poor quality erections?

Share

The following is an actual conversation between an iCliniq user and a doctor that has been reviewed and published as a Premium Q&A.

Answered by

Dr. Bindiya Thakkar

Medically reviewed by

Dr. K. Shobana

Published At August 13, 2018
Reviewed AtJanuary 4, 2024

Patient's Query

Hello doctor,

I am 47 today. I went to my primary doctor three years ago with low libido and poor quality erections. Blood work came back as total testosterone 381 and A1c 6.9 %. Started exercising and lost weight and inches, 198 lbs to 178, 38-inch waist to 32. Symptoms still persisted. The doctor started me on Clomid 50 mg three times per week. Testosterone shot up to 900's but symptoms persisted although Cialis helped with erection quality, still low libido. Will attach a note with test and A1c results during this time. So, I stopped taking the Clomid in March this year and had my physical last week. The doctor says my testosterone is 570, A1c is 6.0 and everything else looks good. He says since I still have symptoms, that I have testosterone resistance. His analogy was; like diabetics, their bodies produce insulin but just does not know what to do with it. So, his treatment recommendation is TRT along with Clomid. I am hesitant because I feel this therapy is overused nowadays, and I feel pretty good except my libido. Sought a second opinion today from my urologist, he seemed disinterested in me doing that but said if I try a few injections it would not hurt me, then advised me to run this by an endocrinologist. So I guess in summary. Do you believe that testosterone resistance is a valid diagnosis? If I do try the TRT, can I stop after a few weeks or a few injections and get back to the way I am right now with no permanent issues? Should I just start the Clomid again, or just keep using the Cialis and keep working out and trying to clean up my diet more? Any other thoughts and advise would be appreciated. Thanks.

Hello,

Welcome to icliniq.com.

I have a couple of questions for you. Any history of infertility? Any depression? Any sleep apnea? Testosterone resistance is a phenomenon that occurs due to a genetic defect and would have caused problems with puberty and would not appear now in adulthood. Clomid (Clomifene) gave a very good response. I would not advise TRT. The low libido could be due toa variety of other issues and likely not a result of testosterone levels. If the thought is resistance then there would be resistance to exogenous therapy too. Why do we think a chemical would be better than the body’s natural testosterone. You are thinking right, eat better. I would recommend reducing animal food consumption which have high sex steroids and these can act as endocrine disrupters. A plant-based diet is recommended to reduce these endocrine disrupters and lower inflammation in the body.

Patient's Query

Thank you doctor,

Any history of infertility? None. Any depression? Not that I notice, I feel pretty happy. Any sleep apnea? None. So, you recommend not going back on the Clomid? I had the same thought on testosterone resistance. I have not read into it myself. I am skeptical and not willing to jump into trying this quickly. If I do try a few TRT injections, can I stop without permanent damage, or do you recommend that I do not try it all?

Hello,

Welcome back to icliniq.com.

I feel Clomid is not needed at this point. Few weeks is not going to cause any damage but I am not sure what it would achieve. Long-term exogenous exposure does cause your own axis to shut down.

Same symptoms don't mean you have the same problem. Consult a doctor now!

Dr. Bindiya Thakkar

Dr. Bindiya Thakkar

Endocrinology

Community Banner Mobile
By subscribing, I agree to iCliniq's Terms & Privacy Policy.

Ask your health query to a doctor online

Diabetology

*guaranteed answer within 4 hours

Disclaimer: No content published on this website is intended to be a substitute for professional medical diagnosis, advice or treatment by a trained physician. Seek advice from your physician or other qualified healthcare providers with questions you may have regarding your symptoms and medical condition for a complete medical diagnosis. Do not delay or disregard seeking professional medical advice because of something you have read on this website. Read our Editorial Process to know how we create content for health articles and queries.

This website uses cookies to ensure you get the best experience on our website. iCliniq privacy policy