Originally Posted by gregxy
I have been on TRT
for a few months but it has not done much in
terms of sex. (My T level went from 380 - 1000). I have tried estrogen
blockers at various levels (ATD, DIM, Letrozole
) and they help but
not enough. The TRT
did work at first but seemed to wear off after
a few weeks.
The only hormone that was out of the ref range was
Prolactin at 15 [3 - 13]. The Dr did an MRI but found nothing.
The literature says prolactin supresses sex drive by reducing Test
some other mechanism that is not understood, however usually this
is in guys with prloactemia where the prolactin level is over 100.
I'm thinking of getting some cabergoline and trying it. Anyone out there
know more about prolactin?
I've never done steroids but my sex drive always has been low and
now it is getting lower as I get older.
Dopamine controls prolactin levels - reducing prolactin release from the pituitary. Testosterone
increases dopamine levels.
When testosterone is high but libido
is low, among some thoughts:
1. Is enough DHT
being made from testosterone? DHT
) is the active form of testosterone in the brain that promotes libido. DHT
can be increased by using a transdermal testosterone - with the highest amounts if placed on the scrotum. DHT
can also be used directly in a transdermal gel. Some men who genetically have low alpha-reductase activity (who happen to also have a full head of hair as a result), may have low DHT
and low libido.
2. Is there too much estrogen or too little estrogen activity? An aromatase inhibitor or Diindoylmethane or Indol-3-Carbinol can be used to adjust estrogen level downwards until the correct amount is achieved.
3. Is there some unidentified hormone from the testes which improves libido? HCG
treatment often increases libido more often than by using testosterone alone. The testes make more than 17 other hormones, including progesterone and oxytocin, which may have a role in increasing libido.
4. Is progesterone low? This and low DHEA are some of the clues that adrenal fatigue is present. Adrenal fatigue needs to be addressed in order to have adequate energy and hormones for libido.
5. Is dopamine level functionally low despite the increase in testosterone/DHT, since testosterone/DHT increase dopamine levels? For whatever reason (including Parkinson's disease or depression or ADHD, etc.), if dopamine level is too low, libido will be low. Low dopamine results in high prolactin. Some cases of ADHD involve dopamine-resistance. Higher dopamine levels are needed to get the same effect as normal attention people. In these cases, the use of a stimulant or other medication that increases dopamine may be useful.