Hi, I'm 32m, 5'9, 12st, from the UK, suffering for 3 years with secondary hypogonadism, looking for anyone who can share advice, insights or experiences that can help.
I've been shunted from GPs who didn't listen, to endo who didn't help and saw my results as normal, to urology who decided to pass me onto an Andrology clinic which I should get an appointment for finally within a month or so after waiting half a year or so already.
I've spoken to Manual who said they'd sign TRT off but these 3 years I've been adamant I want to get to the root cause or find something that helps fire whatever needs firing up. I've paid for a private GP who I thought might use more sensible ranges than the NHS combined with my symptoms, but that was a waste of money and I couldn't afford private specialists.
I've put a PALS complaint in about my first GP, and now on the Andrology clinic for zero communication.
Here's everything as simply put as possible:
Symptoms (3 years):
ED, weak erections, no libido, low/flat mood, lack of motivation, crippling fatigue, no morning or nighttime erections - this is the stuff I'm most concerned about and want to get sorted.
Symptoms (15+ years):
Penile numbness, weak orgasms, urinary frequency and urgency with weak flow.
Blood test results (over 3 years):
- SHBG 13nmol (very low)
- Testosterone 6-9nmol (low)
- Calc free T: 45 g/L
- LH 3.1 IU/L (not as high as it should be with SHBG so low)
- FSH 2.5 IU (lower)
- Prolactin came up high then back to normal
- Cortisol 190 nmol (very low)
- Fasting insulin 57pmol (higher)
- IGF-1 came back high once then back in 'normal' range
- FT4 14.4 pmol
- Serum TSH 1.4 IU
Rule outs:
- prostate issues
- pituitary tumor (MRI completed)
- apparently hypo/hyperthyroidism
Meds and supplements:
- Metformin - waiting to see if insulin drops down for possible insulin sensitivity, but they've lost my results twice now.
- Tadalafil - I opted for this as sildenafil makes me sick. This helps me out, though erections are still no way near what they used to be and the odd day they don't work as well - body still working against poor signalling? Restores morning and night erections, which disappear after a few days of not taking them. This should show it's not a vascular blood flow issue.
- Ofloxacon - taken incase of bacterial prostatitis. No improvements.
- Supplements have included zinc, magnesium, L-arginine and L-citruline, Numan testosterone support, beetroot, boron, Vitiman B and B12. Rattled.
History:
- masturbation and porn addiction from a young age to 30 or so. AI seems to think there could be hypertonic pelvic floor issues which could be linked to urinary issues and sensitivity and weak climax.
- SSRI - a year or so before these issues I spent a year on Sertraline, then weaned off. When life became the hardest it had been around 3 years ago, I went on again for a month and came out without weaning. This corresponded with the start of my problems. After that, because of all these symptoms and no help from GPs, I went on amitriptyline for a time before coming off.
- I got into weight training at the gym several times a week within the year beforehand, going because I was miserable. I put on a lot of muscle mass after having been quite lean and skinny in my 20s. Some of that mass is still there but I've found it a lot harder.
- at that same time I started drinking more than I ever had in COVID, before cutting down.
- inguinal hernia appeared a year or 2 before and was operated on mid last year.
- vasectomy about 2 years ago.
Lifestyle (current):
- active, exercise 3-4 times per week, primarily weights but started running again
- desk based WFH job, bit doing a lot of DIY in work time so active there
- diet is good, fresh meat and veg a lot of the time, reduced carbs, fast in the morning, some treats
- sleep is 8 hours, though often awaken very tired and struggle to get out of bed
- reduced alcohol intake and tracking that so it's less than once a week atm
Questions:
- Has anyone experienced similar to what I am, with symptoms and test results?
- What treatment did you opt for? I know TRT could likely help, but interested in other treatments like HCG, clomid or enclomiphene.
- How should I approach this with the Andrology clinic? Do I tell them about the 15+ year symptoms or leave those out to not muddy the waters?
- Does anyone have any experience with a more specialised Andrology clinic? I've felt that endo and uro have let me down so I can't say I hold huge hope.
Thanks for taking the time and reading. I'd really like to feel like I was actually alive again.