Chronic testicular pain and low T

[dsmall Senior Member Find all posts View Profile Close dsmall]

As I have posted previously, I have been struggling since a vasectomy with chronic testicle pain. It originally waxed and waned, but now it is pretty much constant. As part of my work up, a testosterone level test was done and the numbers came back around 350. I am very fit and there is no medical reason why I should have such low T-levels. The reference ranges are crazy from 200 -1000; and average for my age is well over 600. Conventional medicine says do nothing, and the alternative docs pushing bioidenticals and HRT are saying, run $600 worth of labs and go on hormone therapy. I am worried that I basically am becoming a eunuch with the combination of pain and low T, but I don't want to throw my hormones in such a state that I have to become dependent upon HRT for the rest of my life. Any further surgery in that area is likely to impair T-levels and the success rates are not great.

Anyone with experience in some of the Low T hormone replacement therapies with some feedback?

[RockstarParkingDude Senior Member Find all posts View Profile Close RockstarParkingDude]

what time of day was the test done? that can affect levels quite a bit.

there are several things you can do to boost your natural T levels. there are several threads about the importance of zinc and magnesium, as well as your overall diet. you can do compound exercises, take herbs like tribbulus or tongkat ali, or get laid more often. all will boost natural T levels.

as for testicular pain after a surgery, talk to your doctor! you might have something wrong down there and dont want to take chances!

good luck

[dsmall Senior Member Find all posts View Profile Close dsmall]

what time of day was the test done? that can affect levels quite a bit.

My initial test was done in the afternoon. I just took a morning test that included the full range of sex and growth hormones today. My doctor made the same point and wants to evaluate all the relevant findings; not just an isolated read on one day. I am hoping that the levels are closer to normal

there are several things you can do to boost your natural T levels. there are several threads about the importance of zinc and magnesium, as well as your overall diet. you can do compound exercises, take herbs like tribbulus or tongkat ali, or get laid more often. all will boost natural T levels.

That's what troubled me frankly. I pretty much do all the things recommended to boost T levels and have a pretty good diet and a very good exercise program which involves resistance, cardio, and stretching. I get laid about 3 times per week--when I am not in pain, but the testicular problem has affected my sex life more recently. My problem with the levels is that the 600 plus average for my age is based upon an average-healthy and unhealthy people; diabetics, obese folks, alcoholics, etc who would be expected to have very low T levels to balance out the higher ones. And the low reference range is based upon an average of those populations. From the limited pub med searching I have conducted, the reference ranges all over the place. I am hypothesizing, that absent any real medical problem to explain why my T-levels are below average, that testicular function has been affected. Hopefully, the full test will give me a better insight.

as for testicular pain after a surgery, talk to your doctor! you might have something wrong down there and dont want to take chances!

good luck

Thanks. I have talked to my doctor. This problem has been going on for about two years post vasectomy and I have been back for ultrasounds, nerve blocks, ED medications; NSAIDS, and antibiotics. He recommended an epidydimectomy, a procedure with a relatively low success rate according to the literature. The preferred procedure is a testicular denervation, which is a radical dissection of the testicular nerves with an effort to maintain vascular function. The animal studies suggest that this procedure causes t-levels to drop, albeit not as dramatically as an orchiectomy, which was the original procedure done for this problem. Accordingly, it is difficult for me to contemplate having a procedure which appears to decrease T-levels when I already appear to have below average T-levels. And there is no guarantee that the pain will go away. The literature reports success rates of 70-90%. it would suck to have the procedure and be the guy it doesn't help.

I was really bumming until I heard an NPR show this morning about soldiers who had their faces blown off in Iraq. I am trying to keep my perspective but this affects cycling and sex, which are basically my favorite activities in the world.

[dieselman Member Find all posts View Profile Close dieselman]

Post vasectomy pain syndrome .....welcome to the club.

My case is exactly what you have and I have received PM's from guys on other forums with the same problem. One good thing is that at least your doctor listens. I just came from a urology specialist and no surprise.....he offered me physcotherapy There was a small study done where vas reversal had a 80% effectness in stopping the pain but it was a very small study (16 people I think) I am on androgel now which I am going to stop. It's did take the pain away (very odd) but it's a pain in the ass and I rather take the pain because it's not really helping with my sex drive at all. There is a post vasectomy pain group on yahoo forums but reading that, not to many guys solve the issue......maybe physcotherapy ....


DM

[Pegasus AdministratorPE Gym EditorPEGym Hero ☺ Admin of the Month Mar 2015 Find all posts View Profile Close Pegasus]

Guys with below average test can have above average libido,muscle mass etc and no problems from it. What actual problems is the low test causeing as distinct from the pain.

[dsmall Senior Member Find all posts View Profile Close dsmall]

Post vasectomy pain syndrome .....welcome to the club.

My case is exactly what you have and I have received PM's from guys on other forums with the same problem. One good thing is that at least your doctor listens. I just came from a urology specialist and no surprise.....he offered me physcotherapy There was a small study done where vas reversal had a 80% effectness in stopping the pain but it was a very small study (16 people I think) I am on androgel now which I am going to stop. It's did take the pain away (very odd) but it's a pain in the ass and I rather take the pain because it's not really helping with my sex drive at all. There is a post vasectomy pain group on yahoo forums but reading that, not to many guys solve the issue......maybe physcotherapy ....


DM

The procedure with the highest published success rate is a testicular denervation. There are two doctors in the US who have published in peer reviewed journals that claim a success rate closer to 70-90%. There is a doctor in FL affiliated with Shands (UF) doing the procedure robotically, and he has even posted a Youtube of the procedure. There is a doctor in Chicago (Larry Levine) affiliated with Rush Medical Center who is doing the procedure microscopically. I have a consult scheduled in the next 6 weeks. I will PM you what I learned. Docs have recommended reversals and epididymectomy but they also admit that the success rates are not even 50%. I have had some nerve blocks that have given some temporary relief.

Yes, this problem really sucks. It is not uncommon for post vasectomy patients. I had a history of this problem even before the procedure so I was probably not a good candidate in the first place. Right now, everything and nothing aggravates the problem. I have been taking NSAIDs for over a year which is causing problems with nose bleeds and stomach issues. When it really flares up, it causes ED, which in turn means that I ejaculate less because of difficulty maintaining an erection due to pain (and lack of interest), fluid builds, which becomes inflamed; and it is a vicious cycle.

I would like to hear from patients who actually had the denervation to see how they fared. It is still a relatively new procedure so there are only a few thousand who have actually had the procedure in the US. Again, peer reviewed studies are great, but I would like to hear from some patients who can confirm good outcomes. Doctors in Brazil, China, and the UK have reported similar success rates. The animal studies demonstrate some lowered T from denervating the testicles so I would also like to make sure that there is good hormone therapy so I do not become a fucking eunuch.

But, in a nutshell, I had a vasectomy to take some of the pressure off my wife who has been taking birth control pills since she was a teen. We are in our 40s so we don't want more kids; and condoms and other barrier methods seemed like high school. In essence, I wanted to improve our sex life. Instead, I have chronic pain and sex is the last thing from my mind when the boys are sore.

Every pain syndrome has physical and psychological pieces to it. If you have a long history of histrionics, missing work, or feigned illnesses for secondary gain, then maybe there is something to the psychological theory. But, in my case, the history is pretty clear; and I am doubting that we are all nuts. my history includes an intermittent history of epididymitis relieved with NSAIDs and antibiotics; a vasectomy; and now chronic pain. This issue is a well documented problem in the literature with percentages ranging from 20-40% post vasectomy. There are also autoimmune inflammatory responses that occur when you are suddenly dumping seminal fluid in your blood stream because the fluid is now being absorbed in the lining of your testicles rather than continuing out the vas. There is scar tissue and fluid buildup post vasectomy. When my area is really inflamed, the whole area becomes visibly red and inflamed. For a large percentage of men, a vasectomy is a momentary blip with no problems. However, there is a significant minority of us who develop chronic pain; and we are not all crazy.

[dsmall Senior Member Find all posts View Profile Close dsmall]

Guys with below average test can have above average libido,muscle mass etc and no problems from it. What actual problems is the low test causeing as distinct from the pain.

The Low T is associated with impaired functioning of the testicles. The testicles make sperm and testosterone. In addition to pain, the problem, at least in my case, has impaired my body's ability to make testosterone. Most of the surgical procedures designed to correct the problem, can impair the body's ability to make testosterone naturally.

They are two distinct problems with distinct symptoms but originate from the same source, which is testicular malfunction. In my case, I have chronic pain, lowered libido, intermittent ED, decreased energy, harder time maintaining my muscle mass. My plan is to see a good surgeon to address the chronic pain; and when that is addressed, see a good endocrinologist to address the hormone deficiency. Post vasectomy pain is believed to be related to a number of factors, including the body's inability to handle the increased pressure in the clamped vessels, scar tissue formation, cyst formation, an autoimmune response.

[Pegasus AdministratorPE Gym EditorPEGym Hero ☺ Admin of the Month Mar 2015 Find all posts View Profile Close Pegasus]

The Low T is associated with impaired functioning of the testicles. The testicles make sperm and testosterone. In addition to pain, the problem, at least in my case, has impaired my body's ability to make testosterone. Most of the surgical procedures designed to correct the problem, can impair the body's ability to make testosterone naturally.

They are two distinct problems with distinct symptoms but originate from the same source, which is testicular malfunction. In my case, I have chronic pain, lowered libido, intermittent ED, decreased energy, harder time maintaining my muscle mass. My plan is to see a good surgeon to address the chronic pain; and when that is addressed, see a good endocrinologist to address the hormone deficiency. Post vasectomy pain is believed to be related to a number of factors, including the body's inability to handle the increased pressure in the clamped vessels, scar tissue formation, cyst formation, an autoimmune response.

it is hard to say ,but it is possible that the pain is causing the symptoms , if you cure the pain it may cure the symptoms.