Sex & Testosterone: A Drug and Supplement Guide

by TC Luoma

Boost Libido, Improve Erection Health

Boost your sexual health, with or without a doctor's prescription. Here's how.

The majority of castrated men lose their ability to achieve an erection. So clearly, testosterone has something to do with erections. But the relationship is tricky, especially considering hypogonadism (low T) isn’t common in men with ED (only about 5%).

That said, elevating testosterone to “normal” or super-normal levels generally improves the quality of erections in most men, turning so-so hard erections into steely monuments to passion. Moreover, a higher T level generally increases sex drive and arousal, which in itself leads to stronger erections.

I covered ways to increase NO levels in the blood here, which can lead to on-demand improvements in erection quality. Improving testosterone levels, however, isn’t as fast acting. A single testosterone injection given this afternoon won’t have much effect on your erection tonight, but regular, repeated injections will. Sexual benefits usually kick in fully at about week 3 and plateau between weeks 19 and 21. (All those details here.)

Supplemental Boosters

Chances are, you don’t need full-blown testosterone replacement as prescribed by a physician; you might just need a small “natural” boost, one that’s easily accomplished by any of the following supplements:

Magnesium/Zinc

Up to 85% of all Americans are magnesium deficient. This is potentially a huge problem because the mineral is intimately involved in over 300 biochemical reactions in the body, including some that influence testosterone production.

Classic symptoms of a magnesium deficiency include fatigue and muscle cramps, but your magnesium gas tank would really have to be low for you to experience them. However, you could be only mildly deficient in magnesium and still experience low testosterone levels.

Deficiencies of zinc aren’t as common, but they pose an equally daunting threat because the mineral plays a big role in hormonal status (and cell division, wound healing, energy levels, and carbohydrate management, among other things).

While not having enough of either mineral is bad news, being deficient in both zinc and magnesium is exponentially worse. Not only can it negatively affect your health in general, but it can also direct a biochemical kick to your gonads.
Without adequate amounts of these crucial minerals, testosterone levels drop, and testicular function falters.

Zinc and magnesium leech out of the body through perspiration, so the more athletes exercise, the harder they exercise, the more zinc and magnesium they lose. That potentially drops testosterone levels even further, making progress even more difficult.

It’s an easy fix, though. Just take Elitepro (Buy at Amazon), an inexpensive, well-absorbed supplement that fortifies zinc and magnesium levels and simultaneously elevates testosterone levels while restoring testicular function.

ElitePro Minerals

Longjack (Eurycoma Longifolia)

Malaysian men have been using this herb for hundreds of years to enhance both the quantity and the quality of their sexual engagements. Up until recently, we thought that eurycoma’s sexual effects were solely related to two particular quassinoids: metabolically altered triterpines.

These two quassinoids – eurycomanone and 13-alpha- (21) dihydro eurycomanone – elevate levels of luteinizing hormone (LH) and follicle-stimulating hormone (FSH), which in turn direct the testes to crank out more testosterone.

It doesn’t stop there, though. Longjack increases testosterone levels further through two additional biochemical mechanisms. It both blocks the conversion of testosterone to estradiol (thus ensuring higher levels of T) and selectively controls the conversion of DHEA to testosterone.

All of that explains why we thought this Malaysian herb led to better erections. Little did we know that another separate mechanism was involved, one that’s far more reliable than just what might occur with elevated levels of sex hormone.

One of the chemical messages that facilitate erections is NO. Another is a family of chemicals known as rho kinases (ROCK). When you inhibit ROCK, you get bigger and stronger erections, and eurycoma specifically inhibits ROCK-2, an action that might explain the herb’s use as an “aphrodisiac.”

Of course, the strong erections attained through Longjack might also result from a synergism between elevated testosterone, ROCK-2 inhibition, and perhaps some other undiscovered mechanisms. Anyhow, this stuff rocks.

You can find it in Biotest’s Omega-Man (Buy at Amazon).

Buy Omega-Man at Amazon

Coleus Forskolii

The active ingredient of this plant is called forskolin, and it does a variety of things for the body that you normally can’t get without dieting and exercising. It does this primarily by stimulating production of an enzyme named adenylate cyclase, which increases levels of a cellular messenger called cyclic AMP, or cAMP for short. In turn, elevated levels of cAMP increase testosterone levels.

You can find forskolin in Carbolin-19 (Buy at Amazon).

Buy-on-AmazonC19

Vitamin D3

The evidence behind this one isn’t as strong as some of the others, but one study found that obese men who used it increased their testosterone levels significantly.

Regardless, it’s a great supplement to take in general because of its huge role in strengthening your immune system. Dosages are all over the board, but 2,000 to 5,000 international units a day should do the trick.

Ideally, use microencapsulated vitamin D3, as found in the D Fix supplement.

D-FIX-AD

Other “Aphrodisiac” Supplements

Various other supplements are said to improve erectile function by means other than increasing testosterone levels. Among these are maca powder, Panax ginseng, fenugreek, and L-Deprenyl, a drug ordinarily used to treat Parkinson’s disease. Chances are, though, that if they actually work, they do so by kicking up testosterone production a notch. They all need further research.

What If You Need a Bigger Boost of Testosterone?

If none of these supplements or drugs gives you the bang you want or allow you to bang the way you want, you may want to go for the real stuff, i.e., straight testosterone.

Testosterone Injections

Testosterone injections are the crème de la crème of testosterone replacement therapy (TRT) or, sometimes more accurately, testosterone enhancement therapy. (Many men get testosterone prescriptions not necessarily because they’re low on testosterone but because they just want more oomph in their lives.)

While it’s true that testosterone gels (see below) create a more natural ebb and flow of testosterone, injections – provided they’re administered properly – give you the most muscle-building, libido-boosting, rock-your-world bang for the buck.

You essentially have two injectable choices in America, testosterone enanthate and testosterone cypionate. The half-lives of these esters differ slightly, but it’s not that big a deal, especially if your dosing is adequate and you’ve chosen a suitable injection method and schedule.

For most men, 100 mg. a week of either ester is enough for effective TRT or, for our purposes, ensuring a highly functional erection.

Even if you’re injecting weekly (always on the same day), you still might suffer a bit of a low-testosterone lull as you get further away from injection day. To remedy this, many men split their dosage in half and inject twice a week instead of once a week. Doing so keeps your blood levels of testosterone fairly stable.

Additionally, consider subcutaneous (sub-q) injections rather than intramuscular injections. Recent research shows that sub-q is much more effective, so much so that 80 mg. of testosterone injected under the skin is equal to 100 mg. injected intramuscularly. There’s also less conversion of testosterone to estrogen.

To do a sub-q injection, just take a pinch of skin on your glute, thigh, or even belly, and inject a tiny needle into the fold at either a 45-degree or 90-degree angle. Fully depress the plunger, release the skin, and you’re good to go.

Testosterone Gels

Testosterone gels provide a much more natural androgen rhythm, and there’s probably some argument to be made that attempting to mimic the body’s natural rhythms is the way to go. However, many believe it doesn’t have the same bang for the testosterone buck as injectable esters.

Besides, gels have their drawbacks. You should only apply gels to freshly showered skin. You should refrain from swimming or working up a sweat for at least an hour. Furthermore, you can’t, under any circumstances, let a child or female (especially a pregnant one) come into contact with the treated area until it’s absolutely dry.

If you decide to use gels, you must apply them once (or, in some cases, twice) a day. Don’t use your hands to apply the gel, though. Any gel on the hands doesn’t soak into the bloodstream; it’s like applying gel onto the back of an armadillo, which isn’t very permeable. Instead, squeeze the gel onto your forearms and rub them together like a fly rubs its forelegs together. That way, you won’t waste any.

Everything Else

Just about everything else, including creams, pellets, and sublingual drops, aren’t much worth discussing. Granted, creams can be effective, but they’re messy and they don’t penetrate the skin as well as gels. Pellets and drops, however, are either ineffective or impractical and make accurate dosing all but impossible.

The Potential Negative Side Effects of TRT

There are a small number of negative side effects possible from TRT. One is only an issue if you have prostate cancer before starting TRT therapy. Note that there’s absolutely no evidence – even after researchers have compiled thousands of studies and patient histories – that TRT can cause prostate cancer. However, for some reason we don’t totally understand yet, TRT can make prostate cancer worse. That’s why it’s important to have digital rectal exams (DREs) every year while continuing to monitor prostate-specific antigens (PSA).

TRT can also cause polycythemia, which simply means that the testosterone therapy has caused your body to produce too many red blood cells. Instead of freely flowing through your veins, your blood gets thick and spurts along like the stuff that comes out of the Dairy Queen soft serve machine. It can understandably cause heart attacks and strokes when it clogs up your plumbing.

That’s why it’s important to monitor both hemoglobin and hematocrit. If hemoglobin exceeds 18.0, or hematocrit exceeds approximately 50.0, you either need to adjust your dosage of testosterone, donate some blood, or submit yourself for what’s called therapeutic phlebotomy (a simple blood draw in a doctor’s office).

Even the much-dreaded gynecomastia is almost unheard of in males receiving TRT. Gynecomastia, or the growth of male breast tissue, is seen almost exclusively in men taking professional bodybuilder levels of testosterone (1,000 to 3,000 mg. a week) or testosterone analogs. Hair loss is a possibility, but it seems to stabilize in your 30s. If you’ve made it that far without losing your hair, it’s highly doubtful that TRT will worsen things.

All of the rest of the stuff you may have heard about testosterone causing heart attacks or anything else bad is horribly, horribly wrong. If anything, men with low testosterone levels are much more prone to a host of maladies, including heart disease, diabetes, dementia, and pretty much everything else usually associated with old age, death, or decrepitude in males.

Finally, it’s extremely improbable that any of these possible side effects would occur if you were just using testosterone-boosting supplements and not actual testosterone.

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A glimpse at the TRT forum brings me headache - someone is asking what to do with aromatase, or why the additional drug is not working, or why libido has disappeared completely, he’s mood does this or that, etc. And you present it as though a daily test gel is nothing to worry about. Why so?

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The majority of men don’t have any problems with TRT. Most wouldn’t trade it for anything and when men DO have problems, they’re usually doing something wrong, most likely using inappropriate doses.

To add to what TC said:

Many of those experiencing problems with their “TRT” aren’t doing “TRT.” They’re not hypogonadal; they do not have low T. They’re just using smaller steroid doses and calling it TRT. And many of them are using double what a true TRT patient is prescribed to boot. It kinda confuses things.

OR…it’s just the nocebo effect.

The nocebo effect is the opposite of the placebo effect. It describes a situation where a negative outcome occurs due to a belief that the intervention will cause harm. It is a sometimes forgotten phenomenon in the world of medicine safety. The term nocebo comes from the Latin ‘to harm’.

I actually remember that happening with creatine back when it first hit the market. The histrionic media went bonkers of course, calling it a steroid, which only made it more popular. Then young guys started “experiencing” side effects like roid rage, testicular shrinkage, and gyno. Creatine causes none of those things of course. So, you may on to something there.

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What about bulbine natalensis? I took it couple years ago and got significant libido boost and as a side effect my balls got visibly bigger during that time.

If you start using low dose test, will the natural production halt? Does it mean that slowly slowly you will have to increase the dose to compensate for faster decline in natural production (besides the natural decline with age)?
And if you stop, will you go back to your natural level, or not?

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Yes, if you start using test, your hypothalamus and pituitary will act in concert and signal your testicles to produce less testosterone. And no, you won’t have to increase the dosage, assuming you’re on the right dosage to start with (alleviates symptoms of low testosterone). It’s possible, though, as you get older, you may need to take more. And in most cases, yes, your natural production would resume once you got off the testosterone, but this might take time. (However, in guys who abuse test/steroids, kick starting the testicles can be a problematic and lengthy procedure.)

There isn’t much research on it yet, but if it worked for you, great!

OK, here is one for you? I have gone from once a week injections to three times a week Monday, Wednesday and Friday subcutaneously. I can’t tell you how much better I feel with a much more increase sex drive. However, and this is a big however, for some reason semen load is greatly decreased. What’s up with that?

Hmm. Sperm production goes down, of course, but that makes up only a small percentage of semen. “Seminal plasma” production should go up. You sure you’re not just getting some more action, consequently not giving the factory enough time in-between to replenish supplies?

mmm??? you could be right . sex drive is through the roof on the 3x a week subQ approach. would there be any benefit to using Clomid or hCG? At the amounts used for TRT? It really doesn’t feel like it does anything for me.

Well, if producing more spunk is something you want to do, you could certainly try that route.