Hello, all-

I'm a 43 yr old male who recently discovered I apparently have a problem with low T. Readings hover around 190-250. Here's the strange part-other than some ED issues I'm not aware of any other symptoms. Sex drive is still there and then some. I've been level at the gym, but strength is still quite good. I apologize in advance for the length, but didn't want to sacrifice accuracy. Thanks to all who do read this and comment.

Since I'm getting conflicting and perhaps even self serving advice from my local doctors I've expanded my search to see what real people are doing and how they are dealing with this. I've learned more via Google and this board, etc than from my doctors. Gotta say, the thought of being what seems like a eunuch is terrifying and potentially very depressing. I sincerely hope that others here can shed some light on what is going on and offer some tips.

Let's start with a little history.

I'm 43 and otherwise in pretty good health and shape. About 2 yrs ago I realized I had some slight anxiety feelings.Out of consideration for my wife & kids tried paxil. That lasted for about 1 1/4 yrs until I suspected my T may be off as erections just weren't as firm. Initial tests last fall confirmed this, so my GP suggested Wellbutrin. 4 weeks of that made so even a crane wasn't going to get me up, so I dropped it ASAP. Thinking things would get better I waited a month or so. There was no improvement. I then consulted with a local urologist, who did blood work and found low T. He suggested Androgel, which I tried for about a month with minimal improvement. Seems I'm one of those who doesn't absorb it all that well. The urologist was quick to suggest a clinical trial for a stronger version of Androgel now in the works.

I had a feeling there was more to this and started to really research the issue. Quickly discovered that TRT leads to dependency and more, with many Dr's, mine included, inclined to just slap an Andorgel bandaid on the problem, so to speak and be done with it. That's not enough for me, however. I want to fix the root cause, so I consulted with an Endo. Just had an MRI and 24 hr urine test. I await the results.

More research revealed the difference between primary and secondary failures. I learned about FSH and LH and saw to my dismay that my levels are VERY low, .2 and .3 respectively. Prolactin is 5. Collectively, this certainly indicates secondary hypogonadism. The real questiona, however, are WHY and what can I do about it??

Is it possible my 1 1/4 yrs of paxil and 4 wks of wellbutrin could have caused this? Or, was the perceived need for same early T problems in disguise?

I have read with interest here the use of HCG and will be mentioning this at my next appointment. I'll also check for iron as I've taken an iron supplement over the last 2 yrs or so (helps with occasional restless leg syndrome).

So, where do I go from here? I sense my urologist was a "low T = androgel" kind of guy, while the endo is willing to dig deeper. Two guesses who I'll be going back to....

Is there any chance I could actually reverse this? Any other tests/thoughts/ideas? Really not sure what to do- except for ED and an accompanying tendency to ejaculate faster I am not aware of any other symptoms. I was also given Cialis, which I will try this weekend.

Any and all thoughts, comments and suggestions are welcome and very much appreciated.

I know how you are feeling. I am 37 and still trying to figure out what is going on. Doc discovered I had low T back in October, then after being on Testim for three months, he rechecked my T and it was lower than when I started. I am currently awaiting more test results and I get an MRI done today. Like my doctor said, we are too young to be feeling like this. I can tell you I have tried Cialis, Viagra and Levitra. The Cialis worked really well with no side effects. Viagra works but feels like it increases your heat rate and you also feel flushed. I did not like it because it felt like I was having anxiety attacks. I like Levitra the best. I can feel it when it starts to kick in and I had no side effects. Good luck.

Thanks for the post. Wish I get knew what the h*ll is going on. Never felt so uncertain. Still trying to figure out what is going on and what to do. I know it's not helping, but I can't help wondering if I'll end up like a eunuch or something......

The MRI was normal-no tumors. Cortisol was slightly elevated. I mentioned I take an iron supplement (helps with intermittent restless leg issues) and was told to stop, which I had already done after learning that excess iron could be a factor.

I asked about the HCG level and was told it is normal. Not sure how this is so. My FSH and LH levels are in the basement, so I kinda expected HCG to be altered.

Hard not to get rather down over this whole thing. 43 yrs old and I end up with some ***arre ailment of a personally crushing nature I'd never even heard of. I almost wish they'd found something....

Really not sure where to go from here. I don't want to rush ahead with testosterone replacement and end up totally dependent for the rest of my life. I have great problems with being dependent on anything. If I was 75 or so I might not mind so much.

As always, I throw this out there to see what those with more experience can make of it. Seems to medical establishment wants a quick fix and not necessarily to get to the root of the problem, which is exactly what I want to do. Thanks in advance to all for reading and responding.

You're smart to look into this before letting the doc put on the androgel bandaid. First let me say HCG is not something that is normally in any abundance in the male body. HCG is actually collected from the urine of pregnant women and is very high in the female body during pregnancy. It is almost identical to LH though which is why you can take it to get your T back up of you LH is low like yours is.

Getting the MRI was smart. You should also check iron, ferritin, TIBC, saturation % to rule out hemochromatosis. ALso, TSH to rule out hypothyroidism and Vitamin D which can also cause problems if deficient. ALso check total estrogen and estradiol For you this check is especially important because of the anxiety you had which can be caused by high estrogens in males. High estrogen can also cause low T and low LH. I would add prolactin to the list also.

It is possible if one of these is off you may be able to treat the root cause but even so the treatment is probably for life. I hate to say this but I think there is a large number of men in recent years with the same problem I and possibly you have and it is not being recognized by the medical community. Partly because many men dont seek help and mostly because doctors don't know how to treat this and in general just want to put on the androgel bandaid and be done with it.

I know exactly how you feel with the ED and ejaculating faster....in my case it was because I was afraid I would lose the erection. I too still had libido but had the ED issue before treatment. It is hormone related and nothing to do with blood flow like most ED is caused by.

I don't want to be negative but most men with this never find the real reason for it and end up on some type of treatment for life. Some day when I am too old to benefit they may figure it out but I don't think anyone is even trying at this time.

I truly wonder if there are environmental or other factors at play here. Just look around- more and more men are dealing with this, sperm counts are lower across the world (so I hear) and girls are hitting puberty far younger than 20-30 years ago. Something is up-and it increasingly NOT us guys....

Not in the least sure how to deal with this emotional rollercoaster and feelings of self loathing. Always prided myself on being independent and stoic, yet here I am utterly confused and spending hours researching something I never heard of until recently. Glad to see there are others willing and able to share their experiences and knowledge. Thanks--seriously.

I will most certainly ask for the other tests you suggest. The more info I have, the better. I go back to the Endo on 3/9. Until I get more info, however, I'm staying away from Androgel. I tried it for one month, but it only worked "so-so". Seems I don't absorb it all that well. The Urologist wants me to participate in a clinical trial using a stronger version. I'd like to see what the endo comes up with first. The thought of being dependent on a drug for the next 30 or 40 years is a bit tough to bear, hence my desire to find and fix the cause. Wish I could tell for sure who is trying their best and who wants a band aid approach.

As always, I welcome suggestions, thought and input.

I have read post after post after post on this and other forums and I have read of almost no one that is on androgel and perfectly happy with the results, if that helps any. ALso I tend to think of doctors using androgel as uninfomred. That may not be entirely true but if you want to use a topical T you can get a compounded cream for about $25 a month versus over $500 a month for androgel (before insurance). So what advantage does androgel provide? I suppose it may help keep down estradiol since it is spread over a large area but thats about it versus the cream and you could always get the cream in a weaker mix so you can spread it over the same large area as androgel if estradiol is a problem.

I think androgel is perfect example of how we are wasting money in our healthcare when you compare it to the compounded creams.