Considering switching from injections to Jatenzo

[phalloguy100]

Hi everyone. I am looking for your collective wisdom here on E2, low libido, and possibly switching to Jatenzo. My urologist appointment is coming up in a few days so I want to figure out what to ask the doctor!

I have secondary hypogonadism. I am currently on Testosterone Enanthate (allergic to something in cypionate), doing 0.3mL/60mg subq 3x per week. I am also on hcg 500 iu 4x per week, and anastrazole up to 1mg every 3 days (though I usually only do half or 0.5mg). Although libido is hit or miss from week to week, and maintaining erections is still difficult (I take cialis daily and sometimes trimix shots), overall, I think it's working well.

Lab numbers are mostly good, except estrogen that sometimes goes 15-20 (kind of low) while free E stays high. TT 750s, hematocrit 48-49. SHBG is low normal. Prolactin, TSH and T4 all normal. Free T si slightly high. I have monogenic diabetes (with high insulin sensitivity), and I now use an insulin pump which is keeping me at an amazing a1c of 5.3 while preventing low blood sugars.

To start with, the anastrazole dose seems too high, right? Even at 0.5mg? The urologist started me on it when my E2 shot up to 80, so maybe that's why he prescribed something so high but I told him from the start I would probably take only half of that and he said it was fine. SHBG is low normal. I'm pretty sure the low E2 is what's affecting libido since the diabetes is well controlled.

Besides lowering E2, the other thing that's getting to me is the shots. It's just way too many. At least I am no longer doing insulin shots several times a day, but all these T shots are getting old. So, I am thinking, should I try less frequent shots at a higher dose each? Or should I try switching to Jatenzo? I don't think I mind taking pills twice a day, plus I read that even though T has huge daily peaks and valleys, libido actually improves and DHT goes up with oral TU. The majority of posts here about switching to Jatenzo sound like they were a good move with only one user switching back to shots.

I have tried Androgel and Natesto in the past and they were awful. Absorption was very inconsistent, while the gel irritates my skin every time. Natesto just didn't work - peak TT was 450s - and it would often end up in the back of my throat tasting bitter.

I'd appreciate your thoughts!

 

[madman]

Hi everyone. I am looking for your collective wisdom here on E2, low libido, and possibly switching to Jatenzo. My urologist appointment is coming up in a few days so I want to figure out what to ask the doctor!

I have secondary hypogonadism. I am currently on Testosterone Enanthate (allergic to something in cypionate), doing 0.3mL/60mg subq 3x per week. I am also on hcg 500 iu 4x per week, and anastrazole up to 1mg every 3 days (though I usually only do half or 0.5mg). Although libido is hit or miss from week to week, and maintaining erections is still difficult (I take cialis daily and sometimes trimix shots), overall, I think it's working well.

Lab numbers are mostly good, except estrogen that sometimes goes 15-20 (kind of low) while free E stays high. TT 750s, hematocrit 48-49. SHBG is low normal. Prolactin, TSH and T4 all normal. Free T si slightly high. I have monogenic diabetes (with high insulin sensitivity), and I now use an insulin pump which is keeping me at an amazing a1c of 5.3 while preventing low blood sugars.

To start with, the anastrazole dose seems too high, right? Even at 0.5mg? The urologist started me on it when my E2 shot up to 80, so maybe that's why he prescribed something so high but I told him from the start I would probably take only half of that and he said it was fine. SHBG is low normal. I'm pretty sure the low E2 is what's affecting libido since the diabetes is well controlled.

Besides lowering E2, the other thing that's getting to me is the shots. It's just way too many. At least I am no longer doing insulin shots several times a day, but all these T shots are getting old. So, I am thinking, should I try less frequent shots at a higher dose each? Or should I try switching to Jatenzo? I don't think I mind taking pills twice a day, plus I read that even though T has huge daily peaks and valleys, libido actually improves and DHT goes up with oral TU. The majority of posts here about switching to Jatenzo sound like they were a good move with only one user switching back to shots.

I have tried Androgel and Natesto in the past and they were awful. Absorption was very inconsistent, while the gel irritates my skin every time. Natesto just didn't work - peak TT was 450s - and it would often end up in the back of my throat tasting bitter.

I'd appreciate your thoughts!

Clear as day you are most likely overmedicated here if you are injecting 180 mg T/week split (60 mg 3X weekly) + hCG which has you hitting a high-end trough TT 750s and the s**t kicker here is with low-normal SHBG your trough FT would be high.

Your peak TT, FT and estradiol would be higher.

This is a given.

Even then the AI which is driving down one of Ts critical metabolites. estradiol is not doing you any good here.

The reason your doctor threw in the AI is to control the elevated estradiol due to a high trough/steady-state FT.

If anything the smarter move here would be lowering your weekly dose and bringing down your trough FT so you can drop the AI.

Even then if you never had your FT tested using an accurate testing method/assay then you have no clue where it truly sits as it may very well be higher than you think.

What testing method was used for testing FT and post the reference range.

As I have been stressing on the forum over the years the only way to know where your FT truly sits is testing it using the most accurate assay the gold standard Equilibrium Dialysis especially in cases of altered SHBG.

Big red flag here is you are being treated through Defy and they are still clueless when it comes to testing the most critical fraction free testosterone as they still use/rely on the known to be inaccurate direct immunoassay (RIA/CLIA) which is a shame!

What is your SHBG?

Back in 2024 your protocol was 120 mg T/week split (40 mg 3X weekly) + hCG and an AI thrown in to boot.

Yet as of now your dose of T was jacked up from 120--->180 mg/week which is a huge leap as in 60 mg T/week and wiould have a huge impact on driving up your TT and more importantly FT and estradiol further.

Any time the dose of T needs to be increased it would be 20-25 mg/week as this would be the most sensible move.

Looks like you have been struggling with low libido and ED for years.

Need to rethink that high trough FT you are running and drop the AI.

Thread 'TRT questions - Low SHBG and Anastrazole use'

Feb 10, 2024

Hi guys, I have couple of questions about my TRT protocol.

1) In my last labs, SHBG came back low (1 unit below normal range). What effect does that have on things like libido, EQ, etc.? Is it necessary to raise it?

2) Unrelated to #1... from time to time my estradiol has been high. Doctor said to take 0.125 anastrazole (arimidex) 3x per week but ONLY when I saw symptoms of high E2. What symptoms specifically should I be looking out for?

Of note, after this lab test, I was switched from topical cream to T cyp injections 3x week (40mg), and increased hcg from 2x to 3x a week (500iu)...

• phalloguy100
• anastrazole e2 estradiol low shbg
• Replies: 2
• Forum: Testosterone Basics & Questions

Hi guys, I have couple of questions about my TRT protocol.

1) In my last labs, SHBG came back low (1 unit below normal range). What effect does that have on things like libido, EQ, etc.? Is it necessary to raise it?

2) Unrelated to #1... from time to time my estradiol has been high. Doctor said to take 0.125 anastrazole (arimidex) 3x per week but ONLY when I saw symptoms of high E2. What symptoms specifically should I be looking out for?

Of note, after this lab test, I was switched from topical cream to T cyp injections 3x week (40mg), and increased hcg from 2x to 3x a week (500iu). Topical just wasn't working consistently anymore... and neither was Androgel which I was on before that.

 

[madman]

Hi everyone. I am looking for your collective wisdom here on E2, low libido, and possibly switching to Jatenzo. My urologist appointment is coming up in a few days so I want to figure out what to ask the doctor!

I have secondary hypogonadism. I am currently on Testosterone Enanthate (allergic to something in cypionate), doing 0.3mL/60mg subq 3x per week. I am also on hcg 500 iu 4x per week, and anastrazole up to 1mg every 3 days (though I usually only do half or 0.5mg). Although libido is hit or miss from week to week, and maintaining erections is still difficult (I take cialis daily and sometimes trimix shots), overall, I think it's working well.

Lab numbers are mostly good, except estrogen that sometimes goes 15-20 (kind of low) while free E stays high. TT 750s, hematocrit 48-49. SHBG is low normal. Prolactin, TSH and T4 all normal. Free T si slightly high. I have monogenic diabetes (with high insulin sensitivity), and I now use an insulin pump which is keeping me at an amazing a1c of 5.3 while preventing low blood sugars.

To start with, the anastrazole dose seems too high, right? Even at 0.5mg? The urologist started me on it when my E2 shot up to 80, so maybe that's why he prescribed something so high but I told him from the start I would probably take only half of that and he said it was fine. SHBG is low normal. I'm pretty sure the low E2 is what's affecting libido since the diabetes is well controlled.

Besides lowering E2, the other thing that's getting to me is the shots. It's just way too many. At least I am no longer doing insulin shots several times a day, but all these T shots are getting old. So, I am thinking, should I try less frequent shots at a higher dose each? Or should I try switching to Jatenzo? I don't think I mind taking pills twice a day, plus I read that even though T has huge daily peaks and valleys, libido actually improves and DHT goes up with oral TU. The majority of posts here about switching to Jatenzo sound like they were a good move with only one user switching back to shots.

I have tried Androgel and Natesto in the past and they were awful. Absorption was very inconsistent, while the gel irritates my skin every time. Natesto just didn't work - peak TT was 450s - and it would often end up in the back of my throat tasting bitter.

I'd appreciate your thoughts!

A hematocrit 48-49% means nothing when looking at the big picture here without knowing where your ferritin/iron sit.

Have you ever donated over the years and where does your ferritin/iron sit?

 

[phalloguy100]

A hematocrit 48-49% means nothing when looking at the big picture here without knowing where your ferritin/iron sit.

Have you ever donated over the years and where does your ferritin/iron sit?

Thanks for all the info @madman ! Yes I had a feeling I was being over medicated, *especially* with the AI. The T increase was supposedly for libido and EQ. Just to clarify though, the increase wasn't done by Defy, it was after I switched to a local urologist. Defy also had me on AI but a lower dose, 0.25mg 3x per week I think (can't remember but it was lower).

My iron has been normal just on the lower end for a while, but last time it was tested was last year. I'm guessing this should be tested more often?

Thanks again!

 

[phalloguy100]

Oh, and now I think about it, the urologist isn't even ordering ultra sensitive estradiol.

Free T has been upper end of normal, slightly high one time.

 

[madman]

Thanks for all the info @madman ! Yes I had a feeling I was being over medicated, *especially* with the AI. The T increase was supposedly for libido and EQ. Just to clarify though, the increase wasn't done by Defy, it was after I switched to a local urologist. Defy also had me on AI but a lower dose, 0.25mg 3x per week I think (can't remember but it was lower).

My iron has been normal just on the lower end for a while, but last time it was tested was last year. I'm guessing this should be tested more often?

Thanks again!

I see.

Big mistake falling into the myth that a high FT let alone at trough is needed for improving libido and ED.

Having healthy hormones is only one piece of the puzzle here.

As I have stated numerous times on the forum over the years ED is multifactorial and vascular issues are the most common cause.

Yes you need to keep an eye on your ferritin/iron.

Thread 'Largest dataset of mFT levels to date: male reference ranges spanning a wide age range, using a gold standard Equilibrium Dialysis LC-MS/MS method'

Mar 14, 2026

Sit and dwell on that!

Think of all those overmedicated men on T-therapy gassed up on FT well beyond their natty genetic set-point and unfortunately many off them off the hop!

You can blame all those run of the mill T clinics, kiddie forums loaded with all those numbskulls, throw those blast n cruisers in there too and put the icing on the cake the cesspool of so called gurus polluting gootube!

Gotta love all those kiddie forums loaded with the brainwashed sheep still pushing that more T is better mentality dishing out piss poor advice!

So much misinformation littered on the net its...

• madman
• hypogonadism; ft; refernce ranges; assays
• Replies: 8
• Forum: Testosterone and Men's Health Articles

• 

ED is multifactorial and vascular issues are the most common cause.

T plays a small role!

* only about 5% or less of erectile dysfunction is caused by hormone imbalances like a testosterone deficiency, surprisingly but its true because it has a smaller role with erections

* most erectile dysfunction is caused by vascular issues so vascular is the most common cause because many men have high blood pressure, cholesterol issues, heart disease and blood flow problems or even obesity which impedes blood flow, diabetes lots of different things




Stop getting caught up on T, DHT, estradiol let alone the myth that one needs high FT/DHT!

As I have stressed numerous times on the forum over the years ED and libido are complex and multifactorial.

* Getting quality sleep, minimizing stress (physical/mental), following a healthy diet, exercising/staying active, improving overall vascular health will have a far bigger impact than jacking up your trough FT!


This is a given!

Thread 'Assessing the Decline in Libido: Hormonal Complexity, Vascular Health, and Psychosocial Stress'

Apr 9, 2026

Assessing the Decline in Libido: Hormonal Complexity, Vascular Health, and Psychosocial Stress - The Boca Raton Tribune

A Drop in Sexual Drive Among Both Men and Women in Middle Age Is Rarely Solely Due to Plummeting Hormone Levels; Clinicians Point to Erectile Dysfunction, Sleep Disruption, and the Overwhelming Influence of Relationship Quality and Mental Load. A notable decrease in sexual desire, or libido, is...

www.bocaratontribune.com

ED is multifactorial and vascular issues are the most common cause.

T plays a small role!

* only about 5% or less of erectile dysfunction is caused by hormone imbalances like a testosterone deficiency, surprisingly but its true because it has a smaller role with erections

* most erectile dysfunction is caused by vascular issues so vascular is the most common cause because many men have high blood pressure, cholesterol...

• madman
• vascular health; ed; libido; testosterone
• Replies: 0
• Forum: When TRT Is Not Enough (ED, Libido, & More)

• 

 

[madman]

Oh, and now I think about it, the urologist isn't even ordering ultra sensitive estradiol.

Free T has been upper end of normal, slightly high one time.

What testing method was used for FT and where does your SHBG sit?

You stated that your SHBG is low-normal.

 

[Systemlord]

You know my stance on Jatenzo. This is the only therapy where I do have consistent erections, and teenage level libido. My ferritin levels have to be low (<30) to be able to tolerate and respond to well therapy, otherwise it’s a weak response.

 

[phalloguy100]

You know my stance on Jatenzo. This is the only therapy where I do have consistent erections, and teenage level libido. My ferritin levels have to be low (<30) to be able to tolerate and respond to well therapy, otherwise it’s a weak response.

@Systemlord do you really have to eat high fat meals for Jatenzo go be absorbed well? What do you have for breakfast for instance?

 

[madman]

@Systemlord do you really have to eat high fat meals for Jatenzo go be absorbed well? What do you have for breakfast for instance?

No.

None of the newer oral TU formulations (Jatenzo, Tlando or Kyzatrex) need to be taken with high fat meals.

What is critical here is taking it with food that has some fats ideally 15-30 grams.

Post in thread 'Where can I find Kyzatrex? Low cost options'

Jan 3, 2026

Nice congrats on retirement!

I'd say undoubtedly the hardest thing for me is taking it with food, my doctor who prescribed it said I'm not doing myself any good at all if i don't take it with food. So my best guess is it has to have food for absorption somehow. To me that's rough because I hate eating big meals or even anything when I first wake up and I try to be up by 5:30-6am every day I work and 7am on days i'm off. I usually take my 2nd dose around noon or shortly after, I also see some folks complain about burps and after taste but i haven't had much of that unless I...

• madman

Post in thread 'Importance of meals on oral testosterone undecanoate'

May 15, 2026

Just checking for feedback for those that are on any of the oral TU. How important is what you eat with the medication for you? Have you had your labs checked while eating and dosed with healthy fat? I searched for this on here and it's not commonly discussed. My doctor and I have reverted back to oral TU and he says it's absolutely imperative I take it with food.

Feedback is welcome

As I already stated it needs to be taken with a small meal or snack that has some fat.

Again make it a priority to take each dose with a small meal that has some fat as this can easily...

• madman

• 

 

[phalloguy100]

Thanks. 30g fat is a high fat meal for me Well, maybe it's doable with PB&J... or bananas an PB!

And no, I don't know what testing method was used. I'll try to pull up my actual labs.

 

[Systemlord]

@Systemlord do you really have to eat high fat meals for Jatenzo go be absorbed well? What do you have for breakfast for instance?

No, the other day I had to take Jatenzo without food and I felt the effects pretty immediately. For breakfast steak, eggs, butter, etc.. If I’m home and I don’t plan on eating and I have to take Jatenzo together with olive oil shots.

 

[firefighterinNC]

I've gone from Test Cyp to Kyzatrex and now Jatenzo. I'm on the starting dose of Jatenzo which is 237mg twice daily. I am feeling pretty good and I don't feel ramped up all the time like I did on Test Cypionate. Sometimes less is more in my opinion. I have chased the honeymoon phase since i started and its been a hard lesson. HCG really screws with my e2 causing it to sky rocket, even on 250iu twice weekly. If it was me I would drop the HCG and AI and see if you can't get to a good spot on just testosterone for a while. Drop your dose down on the test E a little bit and see if your situation improves, I know mine did when I lowered the dose.