May be the end of the line on gear for me. Having LUTS saw the urologist and he said my prostate is enormous.

Lipshultz is a pretty big supporter of TRT, he has lots of patients taking more than 200 mg/week. He even stopped testing my total test, although I have to keep reminding him to test for it.

He is world famous, but wanted to do a radical TURP surgery on me. Another doc instead put me on Finasteride which greatly helped my situation.

You are not the first person that I have heard say this about Lipschultz with regards to dosing. Dr McClain says the same sh*t about "numbers" as he doesn't treat numbers but treats the patient. I think this is a better apporach than my previous TRT doc who always though my testosterone much be within range on the lab ranges even after they lowered the upper end to 816. So I would have to play this dance and lower my dose or skip doses.

With regards to prostate interventions, he s mentioned down the line if needed to do a PAE. Its a radiological procedure that is highly touted at the hospital he's affiliated with. The radiologist cuts off bloodflow to certain prostate areas and it shrinks. He said the guy doesn't miss and he's never heard of anyone who has gotten it done by the group at the hospital having permanent sexual side effects. He said you're also exercising the next day.

I asked why anyone would ever get a TURP and his response was that if you are 80 and haven't had an erection in 10 years, TURP would be your choice bc it is the most effective treatment.

My doctor also said while rare, the post finasteride syndrome is real and it really isn't pretty so he understood my hesitation not to take the pill.

Also does Lipschultz have you using HCG at all? If so whats that protocol?

 
I recently ramped to 400 test + 200 primo and have been having urinary issues. I'm 43. Urgency, pissing all night. Saw my urologist today and he said my prostate is enormous and wants an ultrasound. I could feel this coming on even on 200 test a bit. For anyone who has has a swollen prostate, does this go away if you take a break?
Is only envious of ur huge prostate
 
Same as OP. PSA been stable at 0.45 but now gotta go all the time. Too big.

Rx'ed alfuzosin, fin, and cialis. F/u with scope in 8 weeks.

Be careful with the GH and DHT derivatives guys. I probably just shouldn't be messing with this stuff.

Did you get a digital rectal exam or ultrasound to confirm the size? A good uro can estimate the size with his finger.

From what I have learned/read (not sure if it is correct) is that BPH tends to involve fibrous stromal tissue primarily. This tissue doesn't create much PSA whereas epithelial does. Many of these TRT studies involving the prostate overly focus on lack of effect on PSA due to the cancer aspect and rightly so, but omit the fact that TRT in the long term can perhaps accelerate stromal growth which leads directly to BPH, not cancer. My guess is that if your PSA is that low, it's nearly impossible to have a high degree of enlargement unless your stromal growth is literally out of control.
 
Did you get a digital rectal exam or ultrasound to confirm the size? A good uro can estimate the size with his finger.
DRE. Maybe 30-35 mm. Estimate. So not huge but symptoms are nuts. Thanks for the info and taking the time.

My guess is GH plus Mast really got that stromal going.
 
You are not the first person that I have heard say this about Lipschultz with regards to dosing. Dr McClain says the same sh*t about "numbers" as he doesn't treat numbers but treats the patient. I think this is a better apporach than my previous TRT doc who always though my testosterone much be within range on the lab ranges even after they lowered the upper end to 816. So I would have to play this dance and lower my dose or skip doses.

With regards to prostate interventions, he s mentioned down the line if needed to do a PAE. Its a radiological procedure that is highly touted at the hospital he's affiliated with. The radiologist cuts off bloodflow to certain prostate areas and it shrinks. He said the guy doesn't miss and he's never heard of anyone who has gotten it done by the group at the hospital having permanent sexual side effects. He said you're also exercising the next day.

I asked why anyone would ever get a TURP and his response was that if you are 80 and haven't had an erection in 10 years, TURP would be your choice bc it is the most effective treatment.

My doctor also said while rare, the post finasteride syndrome is real and it really isn't pretty so he understood my hesitation not to take the pill.

Also does Lipschultz have you using HCG at all? If so whats that protocol?

Lipschultz will write your script for whatever you need. Having said that. I bought a bunch of HCG off Sigma, much cheaper although it burns.

I don't follow Lipschultz's HCG protocol. I've been using HCG for more than 30 years, long before Lipschutz ever had a protocol. I go a couple of months until the old boys shrink up noticeably, then I run 1500 iu's 3 times a week for 2 weeks.

Years ago he wanted me to take a month of TRT and pound 3k iu's of HCG e2d which would kill my Leydig cells. He would get pissed when I would try and explain this stuff to him....he got even more pissed when I started making my own test 11 years ago. But we are cool now. He knows I was a steroid GURU from back in the Dan Duchain days. Much of what modern medicine does came from Dan. I actually am pretty unhappy that he did a Cytoscopy on me (thats when they ram a camera down you penis to view your prostate) with no meds whatsoever. Pretty Nazi Dr stuff. He was also premature in his call for a TURP.

But I stay with him because he writes me whatever I need and I have been seeing him for 15 years.

I saw another Euro for a second opinion...and actually have a third if I actually need a procedure, which I may in the future. Only problem with PAE is my insurance does not cover it, as far as I know.

And GH....I did not know that it caused prostate enlargement. I run 3 iu's 4 days a week.
 
DRE. Maybe 30-35 mm. Estimate. So not huge but symptoms are nuts. Thanks for the info and taking the time.

My guess is GH plus Mast really got that stromal going.
I have not messed with Mast since my competition days. I did not know GH caused prostate problems. I run 3 iu's 4 days a week.
 
Lipschultz will write your script for whatever you need. Having said that. I bought a bunch of HCG off Sigma, much cheaper although it burns.

I don't follow Lipschultz's HCG protocol. I've been using HCG for more than 30 years, long before Lipschutz ever had a protocol. I go a couple of months until the old boys shrink up noticeably, then I run 1500 iu's 3 times a week for 2 weeks.

Years ago he wanted me to take a month of TRT and pound 3k iu's of HCG e2d which would kill my Leydig cells. He would get pissed when I would try and explain this stuff to him....he got even more pissed when I started making my own test 11 years ago. But we are cool now. He knows I was a steroid GURU from back in the Dan Duchain days. Much of what modern medicine does came from Dan. I actually am pretty unhappy that he did a Cytoscopy on me (thats when they ram a camera down you penis to view your prostate) with no meds whatsoever. Pretty Nazi Dr stuff. He was also premature in his call for a TURP.

But I stay with him because he writes me whatever I need and I have been seeing him for 15 years.

I saw another Euro for a second opinion...and actually have a third if I actually need a procedure, which I may in the future. Only problem with PAE is my insurance does not cover it, as far as I know.

And GH....I did not know that it caused prostate enlargement. I run 3 iu's 4 days a week.

Appreciate your thoughts on HCG. I have been trying to figure out my protocol and can never get it quite right. I've read his research on running a month of HCG at 3k iu EOD for 4 weeks while off T every 6 months and he has 2 reasons for this. (I think he could probably accomplish the same thing using 1000iu EOD). I'm actually doing this right now and feeling pretty good (better than I usually feel on TRT) before I resume TRT. It's not as insane as it sounds IMO. I also think that one wouldn't even notice being off normal TRT and only on HCG for a month from a negative performance perspective etc.

1. "To maintain effectiveness of testosterone therapy" - I do not know what he means by this other than general well being on T that some men lose (they feel flat and have reduced libido so perhaps this prevents this). This is where I struggle in my protocol. I have flat periods and then I feel great and I cannot exactly nail down what it is with regards to my HCG dosing.
2. "To maintain fertility" - I understand this. I used 250iu of HCG 2x per week for years on T and became completely sterile on it. The dose was too low to work while using exogenous T.

As for PAE. I don't know what it costs but if it is 15-20k and you have the funds, I wouldn't let that be the deciding factor. My wife's uncle just paid out of pocket to get spinal surgery at Hospital for Special surgery and the surgeon fee was 15k. The other components (anaesthesia etc were covered by insurance I think).

Back to HCG, when I resume TRT in a couple of weeks I'm going to try to run his near baseline protocol of 500iu MWF perpetually and see where it lands me, but the protocol you are using has me intrigued. Do you notice anything different other than testicle size between the on and off HCG periods?

I had a cystoscopy and the only medicine that I got was lidocaine jelly stuffed in my urethra. Hurt like hell when the camera passed thru the prostate area but I was fine next day.
 
I thought I would update this. I had a video urodynamics test done and I have a severe obstruction based on the BOOI index. Anything over 40 is severe and mine is 60+. Also my bladder neck does not open properly either from the BPH or some other PBNO cause. I follow up with uro tmrw will report back.
 
I thought I would update this. I had a video urodynamics test done and I have a severe obstruction based on the BOOI index. Anything over 40 is severe and mine is 60+. Also my bladder neck does not open properly either from the BPH or some other PBNO cause. I follow up with uro tmrw will report back.
Oh man. Is this related to gear or something that was going to happen anyway?
 
Same as OP. PSA been stable at 0.45 but now gotta go all the time. Too big.

Rx'ed alfuzosin, fin, and cialis. F/u with scope in 8 weeks.

Be careful with the GH and DHT derivatives guys. I probably just shouldn't be messing with this stuff.
I looked into GH and prostate enlargement. Supposedly there’s no correlation….Now Masteron and primo on the other hand. I know for sure that will enlarge it. Two of my gym mates got enlargement from that gear and one of them ended up having to have a catheter just to pee.
 
Oh man. Is this related to gear or something that was going to happen anyway?

Well I'm in my mid 40s so I think I would have to have my head in the sand to think this was "going to happen anyways" by this age. I've got very little doubt that my gear use has contributed to this. I may also have some sort of additional problem as this began in my late 20s. I don't know. When I started using gear 15-20 years ago everyone was using large amounts of testosterone. The standard beginner cycle was 500mg of testosterone per week. Looking back, I probably would have gone a different route and avoided all of that DHT. I didn't know any better. I didn't touch gear for 10 years and had some prostate flares which were dubbed chronic prostatitis by my uro (but it was most likely the beginnings of my current issues). I started TRT again 5 years ago and have cycled a little during that time. Pretty sure my cycling days are done.
 
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