Post Vasectomy Pain Forum

Testosterone Therapy Thread for PVPS

I was told to start a thread about TRT, so here I am.

First and foremost, I am a member of TRT and Hormone Optimization on Facebook, which is a group that holds about 5800 members, 12 of which are doctors. This group is founded and moderated by at least 5 of them.

In the files section, you will find dozens of medical studies about its use, and will disspell alot of myths you may have.

I would highly recommend their YouTube channel as well for any videos that interest you.

Any questions, please feel free to ask, I’ve been on TRT for just over a year and have done a ton of research and reading on the subject. I will try to follow this thread the best that I can.


Thanks for starting this thread @Daveydealz.

There are several men that have posted on this site - or will visit this site in the future - that do entertain similar or the same thoughts as you regarding TRT.

I’m guessing the YouTube channel below is the one you are talking about?

Believe it or not - some people don’t have a Facebook account and don’t want one. In my case, I won’t be able to view all of those files on the Facebook site you previously mentioned.

For those who aren’t aware - this thread spun out of the thread below around post ~206. The thread was in the verge of being completely derailed and I suggested starting a dedicated thread pertaining to the risks and rewards - all of the in’s and out’s, and so on - regarding the use of testosterone replacement therapy - TRT.

What are your thoughts on the FAQ page below @Daveydealz?

How about what the website below has to say?

TRT -Some men undergoing TRT experience testicular atrophy. This is because TRT can stop the production of gonadotropin-releasing hormone (GnRH). Without GnRH, the pituitary gland stops making luteinizing hormone (LH). Without LH, the testicles stop secreting testosterone, leading to smaller testicles.

Hopefully this is a decent beginning to a useful discussion that reflects on where we left off at in the other thread. Anything pvps TRT or related, relevant, etc, is welcome.

Please share your thoughts - and please try to provide some link/s to reference/s wherever you can.

Yes as stated, you have provided links to 1 medical provider and a healthline link, which can be written by anybody and search optimized on Google. That “TRT mill clinic” you posted, their prices are atrocious and that should be illegal. Especially considering they have no idea what they are talking about.

Testicular atrophy can actually be counteracted by a drug called HCG, which leads to keeping your testicle size, and its an LH mimmicker. But, I would assume this is actually opposite of what you want with PVPS, you want to lower your sperm production. I will inject a round of HCG every few months just to keep my balls somewhat alive.

Going on TRT will do just this, and there is actually a way to get prescribed luteinizing hormone to keep your natural production going, incase you want to keep it. There are also other drugs that do the same.

As stated, you can restart your natural production with drugs, you will be left with the level you had before, minus the many years your body aged since going on.

TRT can prevent alzheimers, diabetes, treat depression/anxiety, help libido, give energy, lose fat, to name only a few. I can provide literature for all of this.

Estrogen and its aromatization is actually just as beneficial to men as it is to women. It follows testosterone and is a paracrine hormone. Thats why they dont block estrogen in teenage males with high testosterone. Benefits include heart health, cognition, bone formation, to name only a few. There are many forms of estrogen, both good and bad. TRT increases the GOOD hormones.

All the research studies of the benefits of estrogen can be found here.

Aromitization is important to Cognition in older men

ALL estrogen studies, this google drive should still work:

This leads me into risks of prostate and cardiovascular problems, which is now considered a myth. Here is are some very interesting MEDICAL STUDIES.

Amazing study on prostate cancer in rats. They divided rats into a few groups - a control group, a medium-dose T group (that achieved high-normal levels) and a high-dose group that achieved levels well into the supraphysiological range. Then they injected the rats with cultured LNCaP cells to induce prostate cancer and studied tumor indicidence and growth.

There was no significant difference in tumor incidence between the control group and the medium-dose T group (same in humans - multiple studies show no difference in PC risk between people with low and high T levels) but here is the interesting part - the group that received a very high dose of T (achieving supraphysiological levels) had a 100% lower tumor incidence!

Not a single tumor developed when TT was maintained 2.4 times above average

“Serum T levels of 5 to 11 week old control male nude mice were an average 1.0 ng/ml.”

“none of the tumors appeared in less than 35 days after LNCaP cell injection in 5 mg T arms (0%, 0/12) when the serum T level was maintained above 2.4 ng/ml”

When it comes to tumor growth - the higher the Testosterone level was, the longer the tumor doubling time was (slower growth). The high-dose group had by far the longest tumor doubling time, followed by the medium-dose group and control. As testosterone levels fell (further away from injection) the tumors grew faster

In summary, supraphysiological levels of testosterone markedly reduced prostate cancer risk in mice and inhibited PC growth

Long-term treatment with testosterone undecanoate injections in men with hypogonadism alleviates erectile dysfunction and reduces risk of major adverse cardiovascular events, prostate cancer, and mortality


Better yet, heres another whole Google drive of files on TRT and prostate cancer:

As well, in your link it says there is a risk of POLYCYTHEMIA. THIS IS FALSE. Polycythemia is a separate condition which causes the blood to thicken. TRT is more of a secondary Polychythemia. TRT is no more than what its like when an endurance athlete trains at higher elevation. It causes your red blood cells to go up so you can carry more oxygen. You DO NOT have to donate blood in most cases on TRT, and most of the time this can be remedied with more frequent injections, and well, drinking more water.

This is outlined in this video

As well as this one:

I can also provide more literature if you’d like.

The problem is, most doctors are not up to date when it comes to TRT. Its only a small section covered in medical school and we have found that most doctors are very ill-informed unless they do their proper homework and research.

There are also very many “TRT mills”, like the link you posted, who obviously are in it for money and have absolutely no clue about what is is they are actually giving their patients.

Any more questions, feel free to ask. You can lead a horse to water, but you can’t make them drink.

As I suffer from testicle shrinkage on my right side its marble size what is the h something other drug you refer to to keep testicle size and is it available in all countries

HCG, but the problem is why is it marble sized? Did you lose blood flow to it? I’ve maybe experienced some shrinkage on TRT, maybe to 3/4 their original size. Not a huge difference

The dr destroyed the blood flow through an epididectomy. I will admit man that I am bitter and twisted over the vasectomy but it did stuff my life. I could write a book on why you shouldn’t have one but it would have to be censored


This is interesting, but I’m still struggling to see the pros and cons of TRT in regards to PVPS. It sounds reasonable in theory that testosterone injections should suppress spermatogenesis and thus lower congestion pain?
As far as I can gather, there’s a case study or two where one guy had effect of three months of testosterone injections.
@Daveydealz You’ve been on TRT for over a year, how has it worked for you? What were your original symptoms, and how are they now?

About the cons - it seems there are conflicting opinions on whether TRT poses an increased or lowered risk of cancer? Is that it, or are there other cons?

Thanks for all of that @Daveydealz.

Yes, I posted that and I am fully aware of who or what healthline is - why their results are generally near the top of the majority of any search engine results, etc. Yes, obviously the other link is to a TRT clinic, TRT mill, etc. I find it interesting that you shot both links down just like that. There is a slew of information online - websites, etc - that echo pretty much everything that both of them links covered and then some.

I didn’t see any point in mucking up this thread with a slew of links that would be considered opposition to your argument - that TRT is relatively safe, everyone that knows something negative regarding the risks and side effects of TRT is wrong, the internet is wrong, my GP is wrong, and so on.

BTW - I am fully aware of what Google is up to, how their search engine works, etc. I don’t use Google search unless I have to. It’s not just Google either.

This is simply amazing if it’s actually true. Testicular atrophy can be completely reversed by HCG? I wonder if that includes the most severe cases where the man requires TRT for life because his testicles simply atrophied past the point of no return.

Yes, that’s correct. The whole idea behind TRT or papaya seed powder for PVPS is to reduce sperm production - not to increase it.

I hope this thread will be helpful to others. There are numerous posts in random places on this site that cover some of this stuff already, but I was hoping to see it in one place, one thread, etc - so the information could be found with ease.

And BTW - as I posted in the papaya seed powder thread already, there’s a lot we don’t know about it. I’m not sure if it carries the risk of testicular atrophy, although the question has been addressed on this site in the past. My guess would be that it doesn’t, and my guess is based on how papaya seed powder works vs how TRT works.

I’m just trying to provide people with evidence-based medical knowledge. If anybody else has any questions, please feel free to ask :slightly_smiling_face:


No problem my friend.

I’m absolutely certain that anyone can post evidence based medical knowledge about TRT that would sway a person’s thoughts, opinion, etc, one way or another.

Whatever the case, the risk vs reward factor is very real, and the use of TRT gets quite complicated.

Keep the posts coming guys.


BTW @Daveydealz - I want to hear the details about this too.

Did TRT help you? I don’t recall hearing anything about what brought you to this website - ie - pain, side effects, etc. Please elaborate when you get a chance.

I was brought to this website after experiencing pain from my vasectomy 1.5 years ago. On day 3, my pain shot up to a 10 and had to go on antibiotics. My guess is that’s when my sperm granuloma started. It got progressively worse over the following year, up to about 5 on the pain scale some days. I did a nerve block steroid shot at about 6 months and it didn’t seem to do anything.

I was then offered sperm granuloma surgery, which I unfortunately decided to have 3 months ago. I am not sure if I am fully healed yet, but now my pain unfortunately instead of bouncing between 1-5 on the pain scale, is now ranging between a 2-7. They want to do an epididymectomy but I am currently saying no and looking into other options talked about on this forum.

As far as my TRT, I was diagnosed as having low testosterone about 4 years ago when I was going through my divorce.

Low mood, low energy, gaining fat even though I worked out a ton, less spontaneous erections.

Since starting, I have been able to go off my antidepressants, I’d say my depression and anxiety are about 40% better. I still have days where I am sad, but I also have a genetic disposition with a MTHFR gene deformity from both parents that makes it difficult for my body to build neurotransmitters.

Ive lost about 10 lbs around my waist and gained good muscle (when I was able to work out before surgery) Now that I am recovering from surgery and less active these last few months, my body has been able to keep that weight off because my metabolism is faster due to TRT.

Alot more energy, I basically wake up with a BOOM and not feeling tired and lethargic all day, wondering how i am even going to make it through the day. Alot of days i don’t even require coffee anymore.

Here are my 1 year progress photos. As you can see, less belly fat. Most of the health perks of TRT is due to reduction in belly fat. Belly fat in men is the devil when it comes to disease.


There was a major trend in lower ALL CAUSE cancer deaths in recent studies.

In this study, after 3 years on a low dose of testosterone, there was 1.8% cancer death with low testosterone, 0.9% risk of death on a mid testosterone range , and ONLY 0.4% risk on high dose testosterone

So they are beginning to show that TRT actually helps prevent ALL TYPE cancer death as well.

For some reason the website with the study stopped working, but somebody commented the chart in the TRT and Hormone Optimization Facebook group that shows you all the percentages broken down with having low testosterone, medium range testosterone, and high testosterone.

Here’s the chart.

Making me jealous man

1 Like

I would recommend TRT mainly to men with low testosterone for sure. You can even be treated if you are lower on the range. I was below range

323 ng/dL Total Testosterone (8.95 for the UK audience)

52.3 pg/mL Free Testosterone – measured not calculated.

Have felt low T type stuff since the vasectomy (no libido, less energy, less focus, +10 lb. belly fat, moob buds)

I have been on the fence about TRT for several years. If there was a reputable TRT clinic in my area, I would probably give it a whirl myself.

I am currently clinically low T - right at or below the cutoff of ~275. I had one test come back as 91 a year and a half ago :grimacing:

I took another test thinking there must’ve been a mistake about 4-6 weeks later and that time it was ~250 - 275ish.

From there - my GP referred me to another urological center that is an hour away to consider TRT treatment at a place without so many rules regarding doping T, etc. My GP advised against TRT for several reasons if I felt like I could get by without it and I understood what he was getting at. He did elaborate on the risks of TRT - as have several docs I have seen over the past decade. Whatever the case, I never made the appointment with the place an hour away. It’s not a TRT center either.

Who knows. Sometimes you have to take risks to get where you want to be. As I have said in the past - I could easily be the next guy that is on TRT.

Thanks for sharing all of this @Daveydealz

1 Like

No worries. It took me 3 years and a divorce to finally decide to hop on. I honestly wish I had done it sooner. To me the benefits outweigh the risks. I would rather live my life feeling my best than trying to drag my ass through it, regardless how it works out.

I tried a few natural remedies beforehand, making sure my Vitamin D, magnesium, Zinc were good, as well as tried Tribulus and a few others. The only regret is maybe I should of tried a holistic nutritionist first. I tested my levels over about 2 years and didn’t see a change.

With the research I have done, even with natural supplements like Maca, Ashwagandha, D-aspartic acid, your best case scenario is you might “potentially” raise your testosterone by 50%.

So a guy like me who naturally had a 6 on a scale of 8.8-28 (Canadian standards at the time) I would have brought myself to a 9… still dragging my ass near the bottom and missing out on the perks and benefits.

Something to think about, anyway.

I also want to strongly emphasize, the reason you see alot of these bodybuilders dropping dead is because alot of them are injecting like 10x the amount your body produces naturally, as well as mixing in anabolics and using estrogen blockers.

A good TRT doctor will not always go by numbers, but also by how you feel. It has also been found that the lab ranges are garbage and are based off of a sick population. Based off of when a patient comes in and reports that they dont feel well.

My hormone doctor is happy having me at a 28 (current range 8-26) after injection and then I fall down to about 19-20 right before my next injection. I inject more frequently (3x a week) so my hormones don’t fluctuate as much, and alot less potential side effects that way.

Anyway i can talk for hours on the subject haha.

Yep, well said.

So, is it fair to assume that TRT did not help with the pain aspect of your pvps? Had no effect on your sperm granuloma such as the size of it - did it get smaller, bigger, no change, etc? Did the surgeon have any comments regarding it’s size or anything else when you had it removed? Did he or she have any thoughts regarding why TRT didn’t seem to help?

In the past, several of us hypothesized that TRT or papaya seed powder would likely shut down the leak at the source and the body might heal itself in time, but over the years making observations in forums like this one, my thoughts changed. I am more of the opinion that once the damage is done - or gets to far out of hand via painful sperm granuloma - it’s done. That’s not a hard fast rule - just based on my observations.

The surgeon didn’t really make any comments in that regard, I wish I would have had xrays to track its progress over the years.

I also could potentially be a bad example, as I’m also an independent professional wrestler on the side :sweat_smile: Its a possibility that some of it could have been made worse from that, but I don’t think so. May have to officially retire because of this last surgery messing my life up.

All in all, I’d say that once the damage is done, you’re hooped. But that’s just my opinion and I haven’t been on this forum very long