Time to update you on how things are going with my ongoing TRT (testosterone) program. With one hiccup that wasn’t related to the TRT, everything has been wonderful.

If you’d like to get up to speed, you should read the first four parts of this series if you haven’t already. Most of this won’t make sense if you haven’t read the prior installments.

Part 1

Part 2

Part 3

Part 4

This part 5 will probably be my final installment in this series, unless anything unusual happens. It really has been smooth sailing.

As of this writing it is almost exactly one year since I started TRT last October and about seven months since my last update on this blog. Why so long? Because everything is going great! I’m feeling good, and all the benefits of TRT are still rolling along, as consistently as ever.

The only problem I encountered was something that had nothing to do with TRT. Earlier in the year my shoulders started to hurt, and I discovered I had calcium deposits in both. During this time I had to stop lifting weights, which means I’ve probably lost some of the gains I was experiencing.

No problem. Muscle mass wasn’t the reason I went on TRT in the first place. Plus, between the TRT and my very endomorphic body type, I’ll gain them all back once I start lifting weights again, which I did in mid-September now that the deposits are gone, so I’m not concerned. I wrote about this shoulder problem in more detail over at the CJ Blog, specifically here and here.

My free testosterone levels are now the highest they’ve been throughout the TRT process. My last blood test, which I still take every 60-90 days, reported the following:

Free Testosterone (Direct): 18.3

Estradiol (Estrogen): 21

PSA: 0.9

Those are some fantastic numbers. The testosterone figure might be a little confusing so I’ll explain.

Usually when guys talk about “testosterone,” they are referring to total testosterone. This is the total amount of testosterone in your system, often measured by a three-digit number. Guys with 200 or 300 are low-T guys. Guys with 700 or 900 are high-T, and guys with 1200 or higher are super high-T (and possibly unhealthy). My total testosterone levels have gone between 750 and 950 throughout this process.

The problem is, this figure everyone brags about is not very meaningful. A sizable percentage of that testosterone is bound up by proteins, making it impossible for the body to use. The real number you want to brag about is free testosterone, which is a much smaller number. This is the amount of testosterone your body can actually use and benefit from. If your total T is 750 but your free T is 80, that kinda sucks, and bragging about your 750 testosterone is meaningless.

This is further complicated by more medical industry bullshit, in that free T is measured in two completely different ways, using two completely different sets of numbers, even though both types use the same units of measure, which is pg/ml. (As usual, it’s almost as if the medical and fitness industries purposely try to make this shit more complicated than it needs to be.)

You can measure free testosterone or direct free testosterone. They’re different. (Yes, stupid I know.) Free T falls between a range of 46 – 224. Direct free falls between a range 6.8 – 21.5. Yet both tests are measured pg/ml, making reading your blood tests really damn confusing unless you know what’s going on.

Direct free testosterone is a more accurate way to take the test since free testosterone (non-direct) is test result based on various assumptions and formulas. Earlier I was measuring free T. From now on I’ll be measuring direct free T (as well as total T, since that’s no extra cost).

As you can see above, my current direct free T is 18.3, and that’s within a range of 6.8 – 21.5. In other words, it’s awesome; around the level of a healthy 18 year-old teenage boy. Not bad for a guy who’s 43. <flexes muscles, adjusts tie, smiles>

You can also see that my PSA, which anti-TRT people always freak out about, is a ridiculously healthy 0.9, and my estrogen is at 21, which is exactly where you want to be for maximum masculine health and sexual performance. Too much estrogen and you won’t do well in bed, but too little estrogen and you won’t be able to get an erection at all. Low 20s is exactly where you want to be (if you’re a man).

On top of all this, my lipid panel, c-relative protein, and homocystine are all at 100% optimal levels, which means my arteries and cardiovascular health are equivalent to an active man in his early 20s who eats a near-perfect diet. TRT is a big reason for this, though my new ultra-low carb diet I started in August is also a strong contributor.

Even when I had less body fat in my early 20s, I still ate garbage on a regular basis, so it’s not a stretch to say that now, at age 43, I’m literally the healthiest I’ve ever been in my entire life.

Lastly, my average monthly income has shot way up since starting TRT last October. Much of this is due to my book being published and an unrelated business project I finished earlier this year, but a lot of this is also directly attributable to my further enhanced focus and drive due to the TRT (not that I needed much help in that area to begin with, but with TRT it did improve!). I’m not going to tell you exactly how much my income has improved, but it’s a lot. It has far more than paid for the cost of the entire TRT program, making my TRT yet another profit center for my financial life.

In other words, TRT. IS. FUCKING. AWESOME.

I am now an official believer and fan, and highly recommend it to any man who could use it. It’s one of the best decisions I’ve made (and that’s saying something).

How Much Does This All Cost?

I get a lot of questions regarding ongoing costs of TRT, so I’ll give you a breakdown of the monthly costs you can anticipate if you intend on going this route.

Much of my personalized TRT program involves stuff that’s entirely optional. So I’ll give you the breakdown of mandatory costs and a second one of the optional costs that I utilize, but that you may not want or need.

Average Monthly TRT Costs – Bare Minimum Budget

(To the nitpickers, the time frames on how long these things last is an estimate. Also, these are numbers for the United States; if you’re international your numbers may be very different.)

– 1 vial of 5ml of testosterone cypionate: $60, but lasts about 5 weeks, so monthly cost is about $48

– 10 syringes at 20 cents each: $2

– 10 doses (half-pills) of Anastrozole (to keep estrogen from rising; most men will need this): $35

– Minimal blood tests every 90 days: About $180 per test once your health insurance stops paying for it, so divide that by three: $60 per month

– Doctor visits or consults: About $100 every 90 days once things are rolling and all the initial stuff is done, so divide by three: $33

Monthly Total: $178

That means that you’ll spend at least $178 for the bare-bones program, perhaps less if you don’t use a doctor which I do not recommend. (Please use a doctor, guys. At least when you get started. Don’t be stupid.)

Additional monthly items that I have for my own TRT program that you may or may not want or need:

– 1 vial of HCG (helps retain your natural T, improves sexual sensation, and reduces testicular shrinkage, not that I care about that last one because I have big balls, literally): $60, but lasts about 5 weeks, so monthly cost is about $48

– 1 vial of Vitamin B compound (provides near-100% absorption of vitamin B via injections instead of taking pills which are only 30% absorption): $149, though often “on sale” for $99, lasts about 5 weeks, so average monthly cost is: $99

– Further blood tests to check things like thyroid, cardiovascular health, DHEA, vitamin D, and other areas important to long-term health: about $40

– DIM+ (natural supplement to help maintain ideal estrogen levels): $15

– Vasectomy test kits to regularly check sperm count, if using TRT as male birth control, which I am: $40 for two kits, one needed every 60-90 days, so about $9 per month. (I also use a microscope but that’s a one-time cost.)

Extra Items Monthly Total: about $211

Blackdragon’s Grand Total Average Monthly TRT Costs: $389

So I personally spend $389 a month on this stuff, though you may end up spending less. Again, my average monthly income has gone up by thousands of dollars a month since starting TRT, so I don’t really care about an extra $389. Also, at some point, when I’m very comfortable that I have 100% of everything figured out, I will (nicely) drop my doctor and self-manage the program, saving me about $33 a month from that total.

Unless something usual happens, which I doubt since it’s been smooth sailing for a year, this will be my final entry in this TRT series. I hope this information has been helpful. While every man’s body is different and reacts differently to things like this, TRT has certainly worked out great for me in every respect. My health, energy levels, work focus, muscle growth, sleep, sexual prowess, and monthly income have all dramatically improved since I started the program. On top of all that, my sperm count is still verified zero so I can’t get anyone pregnant; another HUGE benefit of doing this and one of the main reasons I started TRT in the first place.

While your mileage may vary, I now officially recommend TRT, or at least talking to a doctor about it, for any guy who has lower-than-average T levels. It’s certainly worked out for me.

44 Comments on “My Journey with Testosterone Replacement Therapy (TRT) – Part 5

  1. Im very familiar with test therapy since i have had severe test deficiencies since about 21 years old. Im now 38.

    Anyway,

    3 months ago i started going to a hormone “specialist”. Costing me 350 a month. Ive had erectile dysfunction ever since.. i’m dangerously irritated. Any suggestions on good doctors in boston that specialize? I dont think this guy knows what hes doing. Thanks -S

  2. Any suggestions on good doctors in boston that specialize?

    Nope. But yes, switch doctors ASAP if you don’t like yours. Having a good doc you trust is extremely important.

    3 months ago i started going to a hormone “specialist”. Costing me 350 a month. Ive had erectile dysfunction ever since

    I had a similar problem. Your estrogen has gone up. Get a blood test ASAP and look at your estrogen levels. If they’re over 30, you (likely) need to start taking an estrogen blocker like Anastrozole/Arimdex like I do.

    Very common problem.

  3. Ditto on this post. I started TRT at age 50 4 months ago and am starting to see very good results from it. I also workout and eat clean, but there is no doubt in my mind that TRT is a life changing positive impact. Every woman that I date says I have a 30 year old body and that makes them very happy. Thanks BD!

  4. Hey,

    I’m a younger reader (23) and was curious what would your opinion, obviously not medical, just a suggestion would be to hop on TRT for male birth control purposes. I obviously lift seriously, so a little more T would always be helpful when it comes to working out but I would like the ease of mind of not having to worry about pregnancy scares. Would appreciate the advice.

    Thanks in advance.

  5. How do you manage to stick to the routine when your travelling? Particularly if you’re going abroad, sure some airport’s would get a bit suspicious of needles and vials on your luggage.

  6. I’m a younger reader (23) and was curious what would your opinion, obviously not medical, just a suggestion would be to hop on TRT for male birth control purposes.

    If you have decent T levels already and are young, then I wouldn’t do it. If it ain’t broke, don’t fix it. Too many possible variables there.

    But, you can get a T blood test for under $100. Go for it, and if you find your T levels are low for your age (under 400 or so?), then sure, go for it.

    How do you manage to stick to the routine when your travelling? Particularly if you’re going abroad, sure some airport’s would get a bit suspicious of needles and vials on your luggage.

    Not a problem. Old people and fat people travel with insulin needles all the time for diabetes which (my understanding is) the TSA security Nazis are required to let you have on the plane, since it’s part of a prescription.

    The TRT protocol when you travel is the exactly the same protocol as with your vitamins. Just figure out how many days you’ll be gone, and pack accordingly (vials, needles, and alcohol swabs). That’s one of the many reasons I use insulin needles instead of testosterone needles (since security screeners are accustomed to seeing insulin needles all day long) and leave my prescription labels on my vials, just in case there’s a problem.

    I’ve traveled by plane all over the place with tons of needles in my bag and have never had a problem once. And that’s on top of the fact I always opt-out of the naked scanners and have them pad me down instead.

  7. Thanks for this followup.

    Your TRT installments (1 and 2) were hugely helpful when I was gathering information on starting earlier this year, and going from low to high T is a game changer.

    You’re still pinning 100mg twice a week? If you’ve scaled back the dose, have you noticed any differences in how you feel?

  8. The estrogen blocker caused the ED. I was taking Tamaxofen. Your doc mention Tamaxofin? And what made you go with arimidex? Thanks again

  9. You’re still pinning 100mg twice a week?

    Using 1ML syringes I load to the 6 (out of 10) and inject that twice a week. I can’t give you the mg equivalent. I’ve been pretty consistent with that. Initially I was loading to the 5, we upped it to 6 earlier this year. 6 seems to be the sweet spot for my body.

    The estrogen blocker caused the ED.

    Then your problem is way beyond my ability to help. Yeah, to talk to another doctor.

    Your doc mention Tamaxofin?

    Never.

    And what made you go with arimidex?

    That’s what my doctor recommended.

    But I don’t take specifically take armidex; I take anastrozole, which I believe is more or less the same thing only under a different brand. Apparently there are less side effects with anastrozole (I’ve had none) than with armidex, but as usual opinions on this will differ wildly.

  10. Hi BD,

    A very simple step that any man of any age can take is to get their Vitamin D levels checked.

    I have no idea what these figures mean but as an example, a “desirable” level is a count of 100. (I’m guessing that not all countries and doctors use the same scales, don’t know.)

    A few years back, mine was 17. Others I knew had a figure as low as 7.

    I find that I can keep my levels up by taking 2,000 iu a day.

    All the advice to keep out of the strong sun is good advice but it has lead to low vitamin D counts in lots of people.

    Vitamin D3 is actually a hormone and does it’s job in men and women equally well.

    I’m not saying folks shouldn’t go further with TRT but the Vitamin D thing is a good place to start and can have very beneficial effects.

  11. Vitamin D is interesting – I recently had it checked out and although I thought I was pretty healthy, mine is only 14 (aged 35). I believe under 30 is considered deficient. I don’t know what a “desirable” level is though.

     

    As for testosterone, I also had that checked last month and I am 1253(!). No idea how much of that is free testosterone but I feel pretty normal for me (obv!). Doesn’t “feel” like I have a high level..

  12. YES, vitamin D is hugely important. Several years ago I found I was very deficient, started taking it, and my work focus noticeably increased. It was almost like a mini-TRT. Great point!

  13. Hi BD,

    I forgot to mention that Vitamin D is cheap and has no known side effects even when taken in large doses. There are 50,000 iu injections available to be taken once a month.

    You say that you take 4,000 iu a day. Can I ask, do you take this in one go or in smaller doses several times a day? Have you had any info as to whether spreading it out over the day is any different / more effective than in one dose?

  14. You say that you take 4,000 iu a day.

    That was a while ago. I have since jacked it up to 9,000 iu per day, since blood tests report I’m still not at optimal vitamin D levels.

    Can I ask, do you take this in one go or in smaller doses several times a day?

    One dose per day, then and now. Always taken with food with high fat content, and always my first meal of the day, which is usually at around noon.

    Have you had any info as to whether spreading it out over the day is any different / more effective than in one dose?

    I don’t, though I haven’t delved that deep into the data. I try not to over-analyze this stuff, and keep things as simple as possible for time management purposes.

    In other words, even if the studies showed that taking vitamin D several times a day instead of once per day improved results by 10% or whatever, I still would likely take it only once per day.

  15. BD, thank you so much for these posts.

    Between the information that you, Mike from D&P, and Nate over at Iron & Tweed put out, any man would have more than enough info as to how to go about a TRT protocol.

    Quick question though:  Say you’re a man who falls into the “normal” ranges on most of the important categories, but want to get into the high-normal ranges, much like you did, to reap the benefits.

    Are most doctors, in your experience, going to scoff at this idea if you’re relatively healthy?  Basically, does there have to be something “wrong” in order to get on a TRT protocol?  Or does it really vary from doctor to doctor?

  16. Say you’re a man who falls into the “normal” ranges on most of the important categories, but want to get into the high-normal ranges, much like you did, to reap the benefits.

    Are most doctors, in your experience, going to scoff at this idea if you’re relatively healthy?

    Some will, some will not. I depends on the doctor.

    Most normal (non-TRT) doctors, when they look at a guy who’s 50 with total T levels around 220, says, “Yep, that’s normal for your age, you’re fine.” When in fact, that’s not fine. That’s terrible.  Just like most doctors will tell men in their 50s, “Yep, your penis will never be as hard during sex as it was when you were 20. That’s normal for men your age.” It’s BULLSHIT.

    As is always the case, “normal” has the bar set very low.

    Basically, does there have to be something “wrong” in order to get on a TRT protocol?

    Generally, for most doctors, yes, but “wrong” could be “my cock isn’t as hard as it was when I was 20.” In other words, you have to have some symptoms of some problem, but they don’t have to be severe.

    When my doctor asked me these questions, even though my T levels were “good” (as in above “normal,” which is bad) for a man my age, he still needed to hear something was wrong. So I told him my cock performance, while okay, wasn’t quite as awesome as it was when I was 23 (which was true) and that I had trouble losing weight when I didn’t when I was 25 (also true). That was enough.

  17. Thank you for your website. I am 44, I deadlift and squat and that keeps my testosterone up and I know this without testing. I can feel it the next day.

    As to calcium deposits, start taking Organic Apple Cider Vinegar in tea or juice once a day. It will take the calcium out and redeposit it in your bones. Folk medicine suggests raw honey should also be taken. I have been taking ACV with regular honey every day for the past 1.5 years and lost an inch off my waist. Also, cod liver oil will protect your joints. Good luck.

  18. You say you take Adex 24 hours after injection.

    What if you are not home at that time do you take it before or after?

    I notice if I take Adex before 24 hours after I feel negative effects.

    24-36 hours seems to be sweet spot.

  19. I saw you always talking about blood tests, free T direct, but I saw a doctor telling that the saliva test is the best and most accurate way to know the real T levels. Did you know anything about this? What do you think?

  20. You say you take Adex 24 hours after injection.

    What if you are not home at that time do you take it before or after?

    I always take it 24 hours after. If I know I won’t be home I’ll have it with me, or perhaps take it 1 hour before or 1 hour later. It doesn’t really matter.

    I notice if I take Adex before 24 hours after I feel negative effects.

    I have felt zero negative effects from what I’m doing. But everyone’s body is different.

    I saw you always talking about blood tests, free T direct, but I saw a doctor telling that the saliva test is the best and most accurate way to know the real T levels. Did you know anything about this? What do you think?

    I’ve never heard of this nor done any research on it. It sounds very odd to me that saliva would render a more accurate test than blood. But I’m not a doctor.

    Does TRT therapy have an effect on the refractory period.

    No idea. I’m not on TRT for muscle gain. That’s a good question to ask over at Danger and Play’s blog.

  21. Sorry.

     

    I don’t understand your answer. I’m not sure what muscle gain has to do with it.

     

    I will return to Google and rephrase my question there.

  22. Fantastic series, BD.

    One note: if you are still not achieving the bodyfat level you’re looking for, ask your doc if he will add metformin to your stack. (He will.)  But definitely titrate up very gradually, or there can be some GI issues.

    Study where those on met lost an average of 13 pounds while those on placebo gained an average of a pound:
    https://www.ncbi.nlm.nih.gov/pubmed/23147210

  23. Since metformin has also been put forth as a longevity drug (it mimics the mild life-extending effects of calorie restriction), ‘reader’ might be right. Personally I’ll wait a few more years for more conclusive data about the side effects etc before I start taking it. But I’m gonna try Resveratrol soon, that thing has a shitload of benefits including testosterone increase.

  24. Personally I’ll wait a few more years for more conclusive data about the side effects etc before I start taking it. 

    I think conservatism is always the smart move when it comes to putting drugs in your body.  Metformin is a very old compound, though. (It was discovered in 1922.)

    Currently, Dom D’Agostino is studying it as part of a possible cancer therapy. Metformin’s ability to control blood sugar is what reduces fat storage, but it also helps it retard cancer growth. (Since many cancers are fueled by glucose.)

    http://ketonutrition.blogspot.com/2012/09/metformin-and-cancer.html

    (btw, D’Agostino has appeared on Tim Ferriss’ podcast three times, and they’re great episodes.)

  25. My N=1: Metformin killed my libido at 1gm per day. This despite my T and free T levels being above the normal range. Not saying it will happen to anyone else, but something to look out for.

  26. Been a while since I heard you give updates on TRT- how are things feeling Caleb? Still happy, strong, etc? How about sperm count, everything still the same?

    I’m looking into doing it myself.

  27. How about sperm count, everything still the same?

    Years later, everything is the same except sperm count, which has completely returned. Very irritating. But other than that, everything is the same and its still awesome. I’ll be on TRT (or its future equivalent) for the rest of my life, proudly so.

  28. Glad to hear it. Would you be willing to share your recommendation for TRT doctor/clinic in the Portland/Vancouver area? I’m local.

  29. So to be clear, it’s not actually functioning as a contraceptive anymore?

    Correct. It worked that way for about 1.5 years, then suddenly my sperm count came back, with no change in TRT protocol. Weird. I’m assuming my body “adjusted.”

  30. Hi BD,

    Outstanding series. Your regimen is absolutely spot on, and your doctor is excellent. It can be extremely difficult to find one that knowledgable.

    As I mentioned previously, I ran a TRT clinic with 4 doctors working for me. You may want to consider adding in at some point:
    Oxandrolone for immune system function, fat loss (preferentially around the abdominal region, it being the only compound which will actually do this), recuperation, hardness and other effects. 20mg per day 6 weeks on, 4 off. In combination with your other meds no effect on HTPA axis
    Thyroxine thyroid T4 for energy, fat loss, circulation, multiple others – too many to detail here. 12 to 15mcg per day
    2IU HGH 2 days on 1 day off
    Proviron for DHT / libido and increase in free T. 25mg per day.

    Regarding your sperm count, have you been tracking your FSH levels? It is absolutely possible to get someone pregnant given what you are using.

  31. Oxandrolone for immune system function, fat loss (preferentially around the abdominal region, it being the only compound which will actually do this), recuperation, hardness and other effects. 20mg per day 6 weeks on, 4 off. In combination with your other meds no effect on HTPA axis

    Interesting! I’ll look into it.

    Thyroxine thyroid T4 for energy, fat loss, circulation, multiple others – too many to detail here. 12 to 15mcg per day

    I already take a natural thyroid supplement daily (Nature Thyroid) and it’s been working great.

    2IU HGH 2 days on 1 day off

    I’m trying to avoid any kind of HGH for as long as humanly possible.

    Proviron for DHT / libido and increase in free T. 25mg per day.

    Fuck no. I don’t need any more increase in libido. Jesus. I’m one of the highest sex drive men I know, of any age, and if my libido got any higher I’ll start having sex with my desk.

    Regarding your sperm count, have you been tracking your FSH levels? It is absolutely possible to get someone pregnant given what you are using.

    Yes, but my sperm count already returned quite a while ago. More detail here:

    http://www.blackdragonblog.com/2017/02/02/qa-various-updates-trt-sampson-etc/

  32. Well I’ve gotten lucky enough to find a doctor that will actually do this with me (I’ve been thrown out of three offices so far because my T levels are not below 200)

    Unfortunately he knows nothing about it. He tests total testosterone in his patients and that’s it.

    He’s never heard of using HCG and the hospital doesn’t stock it, so I have not yet determined if it will be possible to get this or not. I need to check other hospitals. I get the feeling they won’t give me the home injection option, and going into the hospital four times a month is out of the question. I need to consider doing without I guess but I really don’t like the sound of this.

    My estrogen levels came in at 13

    I’m wondering since your doctor told you you dont’ want to be below the 18 you are at, what are the concerns?

    Could you please consider posting a complete list of the tests your doctor is giving you? This guy will help me, but I have to tell him everything to do.

  33. Well I’ve gotten lucky enough to find a doctor that will actually do this with me (I’ve been thrown out of three offices so far because my T levels are not below 200)

    Unfortunately he knows nothing about it. He tests total testosterone in his patients and that’s it.

    Get a new doctor.

    My estrogen levels came in at 13

    Too low.

    I’m wondering since your doctor told you you dont’ want to be below the 18 you are at, what are the concerns?

    Weight gain, water retention, mood swings, reduced sexual function, etc.

    Could you please consider posting a complete list of the tests your doctor is giving you? This guy will help me, but I have to tell him everything to do.

    Maybe someday, but seriously, get a new doctor. This is your body we’re talking about; dicking around with a doctor who doesn’t know what he’s doing is playing with fire.

  34. Elijah, a couple of good forums on the subject of TRT are ExcelMale and PeakTestosterone.

    Steer clear of the bodybuilding forums.

  35. The issue is this is just how it is in this country. They measure total testosterone, and if it’s under 200, they put you on TRT. Oh and the PSA level they do check that. That’s it, even estradiol is not standard. That I found a doctor who is actually willing to prescribe it to me in spite of having a total T of 600 is as good as it’s going to get.

    Obviously there’s info on which tests are important (thanks for the forum recommendations) in the first place online, I just wanted to compare  notes since it sounds like you’ve got a particularly good doctor.

  36. One thing that never seems to be mentioned, regarding another benefit of T therapy, is that slightly boosted Estrogen levels can really, really make you look better.

    The reason for this is increased subcutaneous water retention, which acts to efficiently smooth out small wrinkles etc.

    Studies prove that women are at their most attractive around the time of ovulation for the same reason.

    For this reason, as well as the others BD mentioned, driving your E levels down too low is a mistake…it will leave you very drawn looking.

    However, regarding the HCG and a degree Estrogen management, TRT is like a tripod – mishandle or worse remove any one of these elements and the tripod can fall over. Get them right and the synergy can be excellent.

    HCG can be as simple as 250-500IU 2-3x per week and BD has already discussed estrogen.

    Unfortunately few doctors understand these aspects.

  37. Hi BD,

     

    I think your sperm count returned because you’re using hCG. It’s supposed to stimulate the gonads to do their work, meanwhile  TRT on its own does the opposite. So adding hCG in eventually worked like that.

     

    cheers

  38. I’m in my mid-forties. I’m physically fit and energetic. I just started looking into TRT and my only goal is to achieve longer and harder erections. Have any improvements in this area been significant for you? Do they justify TRT?
    Thank you.

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