Post Vasectomy Pain Forum

How are testosterone replacement therapy guys doing?

Hi Thanks for your reply, I am having a reversal in August, after 26 years vasectomized, I am hoping to get my life back as well, and more so some feeling back after my wrecked life. I might be expecting to much and it might be wrong, but I don’t want to die wondering

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I will keep my fingers crossed for you @Francis, this is not a way to live

How long post vas have you had reversal @etf42? When did you have it done?

I had it done January of this year. 4 months after my vas surgery.

Do you recall what your Testosterone numbers were when they were low?

I had multiple tests in the 300-400 range

If you had pressure issues you had PVPS. PVPS is a spectrum. It can go from minor issues to full disability and pain with most guys falling towards the minor category so I’m not sure why you would say you did not have PVPS. You clearly has some sort of post vasectomy issues going on.

Also, while I agree those numbers are low, they would not be considered clinically low.

What are your numbers now?

Thanks,
Mike

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@etf42

Mine just came back at 320. Doctor said it seemed fine to him and he did not think it was very likely that my low sex drive was related to my testosterone level. It’s hard to figure out what to believe. Since my vasectomy, thinking about having sex is like thinking about food when I’m not hungry. It’s enjoyable, but there is just zero craving anymore.

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Fair enough, I did not have debilitating PVPS.

Those number are not ‘clinically’ low but the healthy ranges for men are absurdly wide and inaccurate and are not created by male hormone specialists or experts. ‘Low’ is also somewhat subjective and specific as I had crippling symptoms in that range while some men will be fine.

I am in the 600-800 range now and feel better but the side effects are bothering me.

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Hi @etf42, what side effect have you got now? Were they as a result of reversal?

One thing I have learned is that most doctors and urologists are clueless about testosterone and male hormones. Its actually a little scary and disappointing and I have lost faith and trust in the credibility of doctors. Your testosterone is low and testosterone is tied to libido. Some men see improvements on TRT, others dont. There is a lot of great information on the testosterone reddit if you are interesting in therapy and honestly those guys know more than most doctors.

The side effects are from the TRT. My body does not seem to be responding optimally. My reversal was pretty smooth.

-Minor hair loss, sleep issues, gained 15lbs of water weight, shrunken testicles and none of the great benefits that many men seem to reap

@etf42 What dose are you taking, how often, and how long have you been taking it? Your reversal surgeon didn’t have you stop the TRT prior to reversal? It has been explained to me that you should stop TRT 3 months prior to reversal to allow your testosterone/sperm production to start back up again and help keep things open.

I have been on therapy for 9 months. Currenlty I am on 60mg of test cyp 2x week and .25mg of anastrozole 2x/week to reduce estrogen. I tried HCG to preserve my sperm and testicle function but did not notice any benefits and it made made me bloated and caused E2 issues.

I dont think I could have survived stopping TRT prior to my reversal as I had debilitating brain fog, fatigue, and depression.

I’m with you on this one @Ethan_Scruples, sex lost its all appeal. Half of the time, I just can’t be bothered with it. My testosterone results came back early in the week, and are absolutely rubbish

TESTOSTERONE 8 nmol/L
FREE-TESTOSTERONE(CALCULATED)*0.177 nmol/L
BETA OESTRADIOL 67.5 pmol/L
SEX HORMONE BINDING GLOB 23.5 nmol/L
PROLACTIN 259 mIU/L

Helpful conversion between ng and nmol units for testosterone: Multiply or divide by 36.1

IOW, your T works out to 288.8 ng/dL and mine works out to 8.86 nmol/L

So we’re both 75-80yo

Yes, but the important thing to keep in mind at a time like this is that your vasectomy is surely NOT RELATED to your low T and any symptoms of low T coincidentally acquired shortly after your vasectomy. In fact, as my urologist patiently explained, not ALL of the the arteries to the testicles are severed by the vasectomy – so that shows that testosterone output is not affected by the procedure.

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“…not ALL of the arteries…”

I was under the impression only the two tubes carrying the sperm were cut and nothing else??? I just read the short mayo clinic article on what is done. Anyone care to clarify for me?

I don’t remember anymore what my urologist said about this, but there is an artery called the “artery of the vas deferens” which some doctors (as I understand it) leave intact, and other doctors ligate (cauterize) during vasectomy.


The main arterial supply to the testes and epididymis is via the paired testicular arteries, which arise directly from the abdominal aorta. They descend down the abdomen, and pass into the scrotum via the inguinal canal, contained within the spermatic cord.

However, the testes are also supplied by branches of the cremasteric artery (from the inferior epigastric artery) and the artery of the vas deferens (from the inferior vesical artery). These branches give anastomoses to the main testicular artery.

https://teachmeanatomy.info/pelvis/the-male-reproductive-system/testes-epididymis/


The blood supply of the vas deferens is from the artery of the vas deferens (deferential artery), a branch of the superior vesical artery that is also important in collateral circulation for the testicle. This artery is easily separated from the vas during vasectomy; however, it may be a source of hemorrhage during vasectomy if it is not separated or ligated.

https://www.glowm.com/resources/glowm/cd/pages/v6/v6c047.html


Now that you got me thinking about it, it would be really interesting to compare outcomes from surgeries where this artery is left undisturbed vs outcomes where this artery is ligated. It would be simultaneously validating and horrifying to discover that such a simple choice could be the difference between testicles that hurt all the time and have no sensation during sex vs. testicles that feel totally normal.

Note from the wikipedia page:

The artery arises from the superior vesical artery or the inferior vesical artery,

Just another reminder that although our bodies are similar, circulatory and nervous system anatomy vary to a surprising degree from individual to individual. No two people, or surgeries, are quite the same.