Why Did My Erections Get Worse on TRT? (TRT Q&As)
Timeline
The caller says libido remains good, but erections worsened after several months on testosterone despite increasing the dose. Dr. O’Connor says erectile dysfunction should not automatically be blamed on low testosterone and recommends looking at cardiovascular health, medication effects, properly timed hormone labs, vascular function, and other causes before simply increasing testosterone.
The caller asks whether reducing testosterone and starting HCG might improve his erections. Dr. O’Connor does not recommend jumping to HCG and instead emphasizes reassessing the testosterone dose, checking labs correctly, addressing vascular factors, and using appropriate erectile dysfunction treatment when needed.
The caller asks what his testosterone dose should be at 5'7" and 180 pounds. Dr. O’Connor explains that TRT dosing is not determined simply by body weight or size and should instead be individualized according to symptoms, response, laboratory values, and the lowest effective dose.
The caller reports that after only about a week of RAD-140, his ALT rose to around 380 and AST to about 112, so he stopped using it. Dr. O’Connor describes the elevations as concerning and discusses RAD-140 and similar compounds as potentially hepatotoxic, especially when the true contents and purity of the product are uncertain.
A 27-year-old man describes recovering from severe cardiac dysfunction after heavy anabolic steroid use but now has testosterone around 300 with poor libido and low energy. Dr. O’Connor says his heart recovery and current cardiac status must remain the priority, but discusses the possibility of carefully managed low-dose testosterone with close cardiovascular monitoring rather than returning to anabolic steroid use.
The caller asks whether sublingual oxandrolone could bypass enough first-pass metabolism to reduce liver strain. Dr. O’Connor and Omar discuss that sublingual administration may initially bypass part of the gastrointestinal first-pass pathway, but the drug still enters systemic circulation and ultimately reaches the liver and kidneys, so sublingual use does not eliminate potential toxicity.
Video Summary
Participants raise questions about it's it's and related changes while discussing testosterone therapy. The clinician frames the issue in terms of patterns and context rather than one-off impressions. Examples in the conversation clarify what details make a report more interpretable. The opening portion emphasizes what listeners should notice when describing symptoms.
Attention shifts toward practical factors such as i've been and how day-to-day consistency affects interpretation. The clinician explains how timing and communication can change how progress is understood. When participants ask clarifying questions, the answers stay tied to what was actually described. The middle portion reinforces careful observation without drifting into generic advice.
Later questions bring in calcium score and other monitoring topics that arise during follow-up conversations. Discussion of it's just focuses on interpretation and what makes a result clinically meaningful. The conversation returns to what what as participants refine what they are experiencing. It closes by outlining what information about know know is most useful to share before the next visit.
Drug Callouts
Condition Callouts
Key Takeaways
- it's it's is easier to interpret when it is described consistently across time.
- The session links i've been reports to follow-up decisions without relying on assumptions.
- Questions about calcium score are handled through context, not isolated impressions.
- Monitoring conversations emphasize what makes it's just clinically meaningful.
- Clear reporting around what what improves the usefulness of follow-up discussions.