It is reassuring to hear that transdermal T gels (Androgel, Testogel and Testim) can significantly improve sexual function.
Specifically, I would like some feedback on the effect of these transdermal testosterone gels on the following aspects of sexual function:
1) Rigidity of erection upon sexual arousal
2) Ability to become aroused (arousability)
3) Volume of ejaculate
4) Refractory period between ejaculations
I have been on Testogel (Androgel) on and off, but have never committed myself to it due to the fact that it tends to elevate my oestradiol to supraphysiologic levels, even through I am not obese in any shape or form. If I resume T replacement, I shall include an aromatase blocker (such as Anastrozole) to keep my oestradiol in check.
When patients complain of transdermal T gels not working or losing effectiveness over time, it may be due to excessive aromatisation of T to oestradiol, which negates the therpeutic effects of the testosterone- get your oestradiol checked before changing to other T therapies, increasing the T gel dose or stopping T gel replacement altogether! You may well have an oestrogen issue, which can be tackled by including an aromatase inhibitor with your testosterone replacement regime.
