I'll try to keep it short

Hello all. I'm 63, married and my libido and erectile function went into decline about three years ago. For a guy who, for several decades, was always ready to go and had an over the top libido, it hurt. But my story has many twists. My wife and I had always had a difficult marriage, my sex drive was stronger than hers, I have severe untreatable bipolar illness which has caused system wide health problems, specifically the HPTA axis.

My total and free T levels were all over the place over the past eight years, from 325/48 to 668/117. But I also felt old, tired and depressed. When I went on disability I was able to get off my wife's health plan(Kaiser)and switched to Aetna because my ex-primary had gone into private practice. After a couple of bad experiences with endos, this past spring I got the name of a urologist who specializes in TRT. Great doctor and great guy. My TT was 360, LH & FSH normal, so he put me on test cyp shots, 100mg IM, weekly. By week four felt great, then crashed and never rebounded though I stayed on shots for another month. We discussed my situation and at that time, my wife and I were going through some serious marital problems. She went into therapy and so did I and that's where my energy has been focused.

Recently, saw the urologist to discuss low dose sub-q shots. He was fine with that. Last week started 20mg every other day for a total of 60mg, weekly. I think my previous dosing of 100mg IM was too high, too much, too fast and my pituitary couldn't handle it. From my experience, low and slow is a better way. Last night, mood was better, but with bipolar, hard to tell if it's the T shot or mood shift.:confused:

You're right in that it's better to start low. More testosterone (dosing) is not always better. One of the key factors, primary factors is a solid balance between testosterone and estradiol. If this balance is out of line it does not matter how high your testosterone levels are, you will not feel good. Has your doctor checked your estradiol? Too high or too low will render your TRT plan ineffective. That would be the first place I'd look.

Justin,

Last labs(before resuming TRT)showed E2 at 23pg.

That's not a bad reading on estradiol but those don't reflect levels while on 100mg/wk of testosterone. It would be good to know where those levels were when you started feeling bad. Now the 60mg/wk you're taking now, that may or may not be enough, how you feel and labs will tell but you need all the numbers, Test and estradiol.

Sorry to hear you are having such a roller coaster of a time. All of the issues you are having with your testosterone is enough of a pain in the neck, but add marital problems, sexual problems, and emotional turmoil to it and I commend you for being able to keep your wits about you. I hope that counseling will help to iron things out, at least in your marriage if not in all areas of your life. As you already know, the problem with testosterone is in the challenge of finding the right balance of medications and treatment that will allow for you to get the results you are looking for. That is hopefully without tons of side effects that you also have to learn how to cope with.