TRT for congestion pain- please share your experince!


I went to a new urologist last week who, based on my history, thinks I am suffering congestion pain. He wants to try TRT for 3-6 months to see if this brings the pain down. His thinking is that if it does, this will back up the congestion hypothesis and I can make a more informed decision about whether I want to pursue reversal.

I tried papaya seed powder for a month and didn’t notice much difference. I asked him if that means I don’t have congestion, and he said he thinks it just isn’t as effective as TRT in his experience.

My question is for anyone who has tried TRT for a short time. Did it help? Was there any negative side effects? How did you feel when you stopped doing the TRT?

Any input from guys who have been there/done that is appreciated!


I’ve been on it off and on over the last three years. I’m probably not the guy you want to respond because I don’t have congestive pains. I did feel better on TRT. He’d right in that it’ll shut off sperm production. There’s actually a lot of literature in support of TRT for PVPS. It just makes sense. My libido was sky high and I had better energy. Don’t remember any major side effects.

Biggest thing to worry about with TRT is going “primary.” That essentially means you’ve been on T so long that your testicles no longer produce it naturally. Not the end of the world but this world force you to be on TRT for life. They say taking T longer than 6 months increases this risk. It doesn’t happen to everyone.

Personally, this is probably the first thing I would try if I had congestive pains.


@Choohooo thanks for your reply. So although the TRT helped your energy and libido, it didn’t really affect your pain levels/frequency? Is that how you came to the conclusion that you don’t have congestion issues?


I’m still trying to understand how it shuts off production. Seems more logical that male hormones would rev up production.


If you’re on testosterone long enough you will go completely sterile. Your testicles only work as much as they are told to work. If the T is coming in from somewhere else, they shut down as they are no longer needed.

That is one way I realized it wasn’t congestion pain but I knew long before that. I’ve got pretty severe muscle dysfunction in my hip, abdominals, low back and inner thigh. It’s bad enough that some days I struggle to walk. I’ve been in PT for a while now and the differences in strength between my right and left side are extremely obvious. I’m about 30% strength on the side of my spermatic cord damage. Congestion wouldn’t cause that.


Oh, I see. So the testicles are trying to reach a level and back off after that. It’s interesting that it’s tied to sperm production since I always thought that was a separate process from making hormones.


Does TRT shut down spermatic fluid production as well?


It was explained to me that Testosterone and sperm production go hand in hand. When your T levels drop and your body senses this, they are told to kick in and produce more, which brings sperm production with it. If you keep your T levels at or slightly above your normal range (I’m having mine checked prior to starting this), then your testicles won’t sense that it’s time to start making more testosterone/sperm, and production ceases.


I’m not sure. That’s a question I can ask the doctor next week after I get my lab results. I thought that most of the fluid besides sperm was produced by the seminal vesicles, not the testicles themselves…still might be worth asking.


A good portion of my ejaculate is the spermatic fluid. Post vas, ejaculating was uncomfortable because there wasn’t much to push out anymore. My reversal proved this because there is a significant increase in ejaculate. (Plus the skim milk vs whole milk look/feel change…). The doc wants to do TRT but I’m afraid it will shut everything down and cause the reversal to fail. If fluid production stays the same, I wouldn’t worry so much.


Why would your doc want to do TRT if you’ve had a reversal? My doctor said that doing the TRT would be more of a predictor of if I may benefit from a reversal. If I chose to have a reversal, he would not continue the TRT…


My T levels tanked after the vas and continued to decrease even after the reversal. Clomid and anastrozole did not restart T production. That leaves only TRT. The reversal relieved a great deal of my PVPS, so I’m scared to do anything that might cause the reversal to fail.


Gotcha. That makes sense. Did you ever try TRT before your reversal to see if it affected pain levels? How long ago was your reversal?

I can see the dilemma in your current situation…does your doctor think replacing Testosterone now would put your reversal at risk of failing? How well versed are they in PVPS issues?


I had both nerve damage and massive congestion issues. My story is here. My sex drive was off the scale prior to my vas. It was instantly gone post vas. When the PVPS struck about four months post vas, I had to deal with the nerve issue first before moving on to the congestion problem. My intuition told me that TRT wasn’t going to solve my problem at that time, so I had the reversal. To be honest, low T wasn’t even on my mind at that time with the problems I was fighting.

The doc thinks most reversals close off within 10 years so he isn’t worried about the TRT causing it to fail earlier. (This is from one of the PVPS doctors at the PUR clinic in Florida.) However, I’m very worried because the reversal provided most of my PVPS relief.


I 've been on TRT for six months now. Tostran 2% 80mg/day. After reversal in feb 2013 my condition improved a lot. But still episodes with pain and dayly discomfort. With TRT my testicles are smaller in size and most pain is gone. I presume the pain after vaso vaso is because of inflammation due to autoimmuno reaction against spermcells. TRT lowers the spermcount so less spermcells less inflammation and thus less pain. For the long term maybe the vas will close, doctor says it won’t. No side effect of whatsoever so happy till now.

Greetz from Holland


Thanks for the input.


Hello @slowrain. I read your story, absolutely dreadful, and unfortunately mirrors most of our issues. Can you tell me if your vas is still open? How’s your pain level those days?


Hi @Geerts, what kind of pain were you getting? Was it inside the testicles?


I would say the usual pain. In the groin area, depending on physical load. After lifting, a long car ride, cycling, sex, the pain could be really bad. These pains are almost solved with TRT. Traction on my testis, scrotum and penis does still hurt. I think that is the nerve damage part and there is no solution imo. So congestion/inflamation pain is (almost…) gone by TRT.