In the absence of success in treating my hormonal health through Dr's I am now looking to call on this pool of collective knowledge I see in this thread. There is still hope!?
OVERALL PROBLEM:
I'm 25 - supposedly at an age where my sexual function should be at its peak, and yet I've very little sex drive, and find myself struggling to drum up the energy to pursue real sport and career interests - VERY frustrating for someone who at age 12 was up there with the strongest and most determined people in class.
PHYSICAL PROBLEMS:
Minimal physical arousal around attractive females even with full stimulation/contact.
Inability to sustain a proper erection in all but the rarest occasions
No or poor morning 'wood'
Easily stressed at work or in social situations involving argument/conflict (noticeably resolved when I first started taking Hydrocortisone)
Gynecomastia (Along with elevated estrogen AND progesterone levels (both slightly above reference range)
Acne and slow wound healing or slow recovery from gym sessions
BACKGROUND:
At almost 24 years old I met a 'progressive' Dr in March 2005 who suggested Wilson's book, and arranged me a 4 point salivary cortisol/testosterone/DHEA/Progesterone test along with a Synacthen Stim test and Thyroid tests. (After hearing my problems listed above)
Did these tests with the following results:
- Salivary Cortisol was in the very low end of the range for the wakeup, late morning, lunch and afternoon tests, but on their way back up to low/normal levels by late evening.
- Progesterone levels were slightly above the reference range (exactly as per numerous previous blood tests)
- Estrogens were at the very high end of the reference range
- Testosterone was low/mid range
The Synacthen test came back with a very strong response, and I recall that day feeling on top of the world and with loads of energy for at least half the day.
Based on the consistently low salivary cortisol, and the bad rhythm (going higher in late evening) the Dr arranged me to go on a combined T3/Hydrocortisone pill of 20mg cort and 30mcg T3 which I took daily in the morning starting late March 2005. The effects were immediate - Within a day I found myself far more tolerant of arguments (they didnt leave me feeling weakened as usual) and physically stronger. Sex drive however, remained relatively unchanged to pre treatment levels.
After about 6 weeks I noticed physical changes. My neck started getting thicker and I generally was a more outgoing and stronger person. The increased energy was a relief, but sex drive was still relatively unchanged, which really frustrated me, however the Dr said that the process of recovering the adrenals was a slow one that would likely take many months, so keep going. I did.
In early July I restarted Gym which I had been doing consistently/seriously for all of 2004, but then stopped at start of 2005. I quickly improved my weights and within 2 months I had returned to the weights I was once lifting at my peak end of 2004. Workouts were much less debilitating now that I had the Cort/T3 supplement. Again though, sex drive improved slightly, but was really still inadequate. HOWEVER, in late August something changed. I found I was getting quite sexually excited about some new females that were in our office. I would come home, have a shower and noticed I was producing pre cum just at the thought of them, and my erections were stronger, with the penis feeling ironically more 'numb' in a good way. Over the coming nights I would find myself waking up at 2am (usually about 4 hours after going to bed) with a proper erection and it actually felt like I was getting relief when I masturbated, and for once the climax really felt good! instead of a tense sort of feeling. I also noticed that if I took magnesium tablets and ate a banana before going to bed it increased the likelihood of these 'nocturnal erections'
It was also about this time that I started to have real acne problems and a lot less able to handle alcohol. The Dr suggested it was because my liver was struggling to dispose of the cortisol/T3, so he pointed me to a supplement - Calcium D-glucarate which helps dump these end products from the liver. This improved the acne and made me more tolerant to alcohol. I have taken them religiously to this day.
Over the following couple months I became more sexually interested, but couldnt return to the situation I found myself in there in late August with the 'wakeup calls' Proper erections were still a rarity. About September, 6 months after starting my T3/Cort treatment the Dr gave me a reduced dose T3/Cort in the belief I was well on the road to recovery (10mg Cort and 40mcg T3). This was fine - I did notice a bit of a drop in energy, but it was negligible
Followup salivary tests were arranged similar to those I had the first time. Ironically my morning cortisol was even lower than pre treatment, however the pattern was 'normal' with the lowest cort being the evening reading. Testosterone was MUCH higher, and actually in the high end of the range. Progesterone was as usual just above the reference range (HIGH) and Estrogens were also higher than pre treatment (now definitely above ref. range) Thyroid tests indicated higher than ref range levels of T3, but normal T4 levels. Note that I ensured I took not treatment on the day I did these tests so levels would indicate pure endogenous production.
By the start of 2006 I still had not reached any kind of acceptable sexual function (despite that brief joyous period in late August 2005) but at least I had near acceptable energy levels to pursue my gym and career goals. In my frustration I was referred to an endocrinologist for the first time that sent me for a barrage of blood tests and advised that the salivary tests were inaccurate and not to be used as a guide for any treatment. As usual the Cortisol levels were at the high end of the range, T levels were low/medium, Thyroid was sky high, Progesterone was high, and Estrogen too.
So I tapered off my T3/Cort supplement completely on his advice. In my frustration over the previous months with the Gynnecomastia I researched medical journals on progesterone. I thought that its quite possible my adrenal function is fine, (as supported by the synacthen test, and numerous blood tests) and that the real problem must be something to do with my elevated progesterone and to a lesser extent, estrogen. Sure enough I found out that high progesterone in the presence of estrogen stimulated breast tissue growth, and there was some animal studies that demonstrated less mounting behavior when progesterone was high (might explain the poor libido) As a result I tried bromocriptine for a couple weeks to try and suppress progesterone production and promote dopamine. After 2 weeks I noticed no real change, and so stopped taking it. Having said that, it was a low dosage, and the pills were about 2 years past expiry date (I got them informally)
So at the start of Feb, 2006 I had almost completely tapered off the T3/Cort, only taking it on gym days so I could do my workout without feeling destroyed. I took a herb called 'Rhodiola' that seemed to help a little bit, but of course nothing like the T3/Cort. To be frank, I felt like rat sh1t for the following 2 months. Every day felt like a struggle. My neck started to lose its once thick/strong look. The upside was the acne reduced after the first few weeks, but then it actually came back worse than during treatment levels! and I noticed I was producing massive amounts of sebaceous fluid, often finding I had a thick greasy sheen to my forid by late afternoon at work.
Finally, in early April I returned back to the original 'progressive Dr' who I had lost hope in. However I knew that at least getting back on the hydrocortisone would make me feel human again. And so I did - but he agreed that I had plenty of thyroid, and so I would just take pure hydrocortisone - 20mg a day divided in 2 taken morning and lunchtime. The relief was enormous. I had energy again. I was outgoing again at work, I could work harder at the gym and noticed I actually gained more muscle (ironic given I'm taking a catabolic agent) Sex drive was definitely improved, but only for a few weeks after restarting treatment. Then it was back to the usual crappiness. Again, it never reached the 'acceptable' levels I experienced in August 2005.
The gynecomastia, developed slightly after resuming the cortisol, however I countered this by following a lower fat diet, and have managed to keep it from developing further, though its a big struggle and even having a night of heavy drinking leads to them being bigger almost over night.
The latest development for me has been taking my first course of SSRI's that were prescribed to me by a GP who I saw just to get a mole scan. I explained to him how frustrating it has been that after 1 year of treatment I still dont have adequate sexual function, and poor energy, and how I'd rather have bitch tits and some energy than no bitch tits and feeling like crap all the time. He was of the belief that I had depression, and that the cortisol was just alleviating some of the end symptoms but not addressing the underlying problem, and that it was in fact causing secondary problems in the form of the gynecomastia.
I could see his reasoning, and in spite of my self belief that I didnt have depression, I gave the SSRI's (Cipramil) a try. Within a couple days I noticed I was far more outgoing at work, and getting wood around attractive females. It seems he was right! My hopes were further boosted by the knowledge that apparently it takes 2 weeks for them to really become effective. I thought that this could be the answer.
I've since found its not the answer though and now, 6 weeks since starting the Cipramil I'm only slightly better sexually and energy wise than pre treatment levels.
So - whats wrong. Why do I have elevated progesterone levels. Why is my sex drive still inadequate. Is the progesterone level the primary problem causing my lack of libido and lack of erection power?
I'm 25. I need to find a solution soon. I want to have a sex life and I want to have the energy to pursue my ambitions. Things that most people take for granted.
Keen to hear your thoughts...