Join Date: Nov 2010
Location: San Jose, CA
low libido - low T, hi E2 & prolactin, arimidex
I had been suffering from low libido & extreme premature ejaculation, for many years (I am 34 yrs old). I could ejaculate only once/day, & it made me very sore in that region for the rest of the day, my testicles felt empty & loose, & any further erection would feel very painful.
I used to get good erections in the monring, & very low in the evening/night.
Since the past year, I have been seeing endocrinologists & undergoing blood tests & treatments.
I would like your opinions/feedback, based on your experiences in dealing with similar issues, which should help me, as well as, hopefully, others.
My tests & treatment history :
April 2010 (afternoon)
total T : 350 (241-827 ng/dl) // ----> v less, though "within normal"
TSH : 1.45 (0.34-4.82 uIU/ml)
IGF-1 : 264 (106-450 ng/ml)
vit B12 : 470 (211-911 pg/ml)
vit D-25 : 22 (30-100 ng/ml) // ----> v less
I started taking Vit D3 2000IU, once a day.
My earlier doctor was saying T is still "within range" & so he didnt want to do anything. After reading in these forums, I insisted on testing the other components.
july 2010 (morning)
total T : 393 (241-827 ng/dl) LC/MS/MS
free T : 75 (35-155 pg/ml) => 1.89% (1.5-2.2%)
LH : 3.9 (1.5-9.3 mIU/ml) // ----> low
E2 : 48 (10-30 pg/ml) // ----> v high
My E2 was very high, which was causing low LH & low T. (& my testicles seem ok). My Dr wanted to prescribe Clomiphene.
I then went to another Endocrinologist.
August 2010 (morning) - different lab (Quest)
total T : 536 (250-1100 ng/dl) LC/MS/MS
free T : 110 (46-224 pg/ml)
bioavailable T : 217 (110-575 ng/dl)
SHBG : 20 (8-48 nmol/l)
albumin, serum : 4.3 (3.6-5.1 g/dl)
LH : 7.1 (1.5-9.3 mIU/ml) // ----> seems higher?
FSH : 5.5 (1.6-8.0 mIU/ml)
E2 : 56 (13-54 pg/ml) // ----> very hi
Prolactin : 42 (2-18 ng/ml) // ----> very very hi
thyroxine-free : 1.2 (0.8-1.8 ng/dl)
TSH 3rd gen : 2.97 (0.4-4.5 mIU/l)
Alarmed by the high prolactin, he wanted another blood test, where it came lower.
August 2010 (morning)
prolactin : 21 (2-18 ng/ml) // ----> hi, but much lower than 42
Is it normal for prolactin to vary so much over the course of a few days?
After this, I was prescribed Arimidex. I started with 0.5mg/day for 2 weeks, & then continued on 0.25mg/every other day.
After 3 weeks with no change, I felt a hugh increase in libido, & I could ejaculate 3-4 times/everyday (for the first time in years!). However, this lasted only for ~5 days, & then gradually decreased. Assuming my E2 had gone too low, I reduced my dosage further to 0.25mg/every 3-4 days. But my condition didnt improve.
But I did feel my testicles had grown slightly bigger & always felt full.
I recently went for another test.
oct 2010 (morning)
total T : 612 (241-827 ng/dl) LC/MS/MS // ----> improved a lot
E2 : 38 (13-54 pg/ml) // ----> still high
Prolactin : 16 (2-18 ng/ml) // ----> high, but "within normal"
Since my E2 was still high, I increased Arimidex to 1mg/day. It has been 1 month, but I have not seen any improvement in my libido. I do get nocturnal erections, & can ejaculate once/day, but not more (primarily morning).
My evening erections are not good. Is it due to all the T produced in the night/morning being used up/converted by evening?
I have heard that Arimidex is powerful & fast-acting & should see improvement in a few days. I have been on it for ~3 months, but not seen much.
Is the high prolactin causing my libido issues (inspite of normal T)? Should I request a prescription for Cabergoline/Bromocriptine?
Since I have been facing diverse issues - extreme premature ejaculation, low libido, low T, high E2, & high prolactin - I am thinking they are all related, there is one root cause which is affecting everything.
& that I should look for a treatment for the root cause, instead of attacking specific issues like high E2, high prolactin, etc.
Some of my history (dont know if it could be related to libido issue) :
I have always been physically very active, running, hiking, weight training. Though I have good tone on my muscles, I could never really add hugh musculature/bulk/size (guess it is due to low T?). My height is 5 feet 3 inch, & I used to weigh ~130 lbs.
I had hugh extreme acne since age 13-25 yrs; & had taken a variety of medicines. Even now, I still keep getting acne breakups. Dont know if acne medicines could effect hormones, as it was from around the time of puberty.
I have high cholesterol.
The past 5 years, I have been under a lot of stress, & added quite a lot of fat around the belly, shoulders, chest, etc (I hope it is not man-boobs from high E2/prolactin). My weight increased to ~155 lbs.
Since the past ~8months, I have been drastically changing my diet, & have reduced my weight to ~130 lbs, lowered cholesterol, etc.
Thanks a lot in advance.