-Age? 32

-Which 19-nor substance gave you PDD (Deca, Tren, NPP etc.)? Cycle length? Dosage?
Interestingly enough mine was Anavar. It was for 1.5 yrs on and off. Last cycle was 20 mg for 12 weeks. However the source of the var was not pharma grade and honestly could have contained anything.

-Date your PDD started - summer of 2019

-Has it been at least 6 months since you last administered the said 19-nor and have your Testosterone, Free Test and Estrogen levels returned to normal either naturally or through TRT? (If the answer to either of these is no then we should be cautious to assume that you actually have PDD. Your focus should be optimising your Test levels)
Yes

-Are you now on TRT or have your Test/ Free Test/ Estro levels returned to normal naturally?
They've returned to norm naturally. Did PCT with clomid and nolva but not HCG.

-Give a rating for the following out of 10 compared with before PDD. 10/10 means the same as before (feel free to give further comments):
-Sex drive - 2/10
-Erection quality - 2/10
-Orgasm Quality - 3/10. Sometimes PE occurs.
-Ability to experience negative emotion - haven't really paid attention to this
-Ability to experience positive emotion - 1/10
-Ability to experience feelings of confidence (feeling good about being you) - 1/10
-Feelings of pleasure seeking - 1/10
-Feelings of hunger (thinking about what you will eat and salivating) - 4/10
-Ability to handle stress/ not be affected by stress - 3/10
-Memory and cognitive ability - 2/10
-Sleep quality - 2/10. I sleep very poorly. Even when i get 8 hrs i wake up feeling not rested.
-Energy levels - 2/10
-Depression - Always slightly depressed. But for no reason except the PDD.
-Anxiety - skyrocketed since the var usage.

-Have you seen any change (improvement or worsening) of symptoms since PDD started? Do you know what brought about these changes?
Gradually worsened over the years

-During or after your cycle, did you experience any digestive issues? (Bloating, diarrhea, constipation etc)
No

-Any other symptoms of PDD or changes you think were caused by PDD?

-Any other comments?
All my hormones are in the usual ranges. I had an ultrasound of my testes done and a doppler study of my penis. My testes have shrunk for sure, and are 10.5 and 8.5 cc whereas avg volume sits about at 14-15cc for healthy people. However this does not seem to be causing any hormones to be off. Doppler showed healthy blood flow in penis.
Despite these ED problems are rampant. My sex drive is way lower than before but it's still there to an extent, so i do occasionally get hard but erections are at 40-60%. And then i lose it quickly. It's not psychological, happens even when I'm really into the moment. Tadalafil has been working to keep performance up. But i seem to have lost something.
Not sure if this is related but i tried MDMA thrice since the cycle and it did absolutely fuck all for me despite my friends who were also on it getting high.

I had a question - i noticed a list of doctors in another user's post. I do want to reach out to one of them but it's hard to know exactly who they are. Can someone post the list again with a link to where they practice and their full names and specialty please? It would really help the community.

    Hi After_Gap_5184, welcome to the forum. Sorry to hear about your issues. The good news is, I'm pretty confident that some of your symptoms can be improved.

    Hmm that's strange that Anavar caused your issues. There was another guy on a different forum who also believed he had PDD not caused by 19-nor steroids but by Primobolan. We talked about it and concluded that the Primobolan was probably faked with Tren because Primo is often faked with Tren and because he experienced classic Tren side effects while on cycle, eg. jealousy and paranoia in his relationships with women. Did you experience any unexpected side effects while on cycle? Do you still have the Anavar? Also, did you change the brand of Anavar at any point through the 1.5 years and at what point did your problems start?

    Do you have any blood test you can share? Since you may not have taken a 19-nor this would definitely be the first thing to assess.

    Assuming your sex hormone and thyroid blood tests are all in order; looking at your symptoms, I'd definitely recommend a doctor who do a comprehensive assessment of your organic acid profiles (this tests a range of vital metabolic processes including mitochondrial function) and a Dutch test (adrenal test). In my opinion this is the best way to address the energy, stress, sleep, depression, cognitive issues you are having. Dr Daniel Kalish is the best I have found for this stuff.

      Test. Result. Range.
      Total test 5ng/ml. 3.4-11.2
      Free test. 19.9 pg/ml. 1-28.3
      LH. 6.6 mIU/ml. 1.1-7
      FSH. 3.6 mIU/ml. 1.7-12
      Prolactin. 4.8 ng/ml. 4.04-15.2
      E2. 21.4 pg/ml. 7.63-42.6
      TSH. 2.1 (micro)IU/ml 0.27-4.2
      T3. 1 ng/ml. 0.8-2
      T4. 8(micro)g/dl. 5.1-14.1

        Yeah i was only on var. For the first year or so I only noticed a decrease in libido. I changed brands for my last cycle and it came in this sketchy bottle and the pills looked odd and honestly could have been anything. I did come out of the cycle with the dry cut look var gives though so i didn't have reason to doubt it initially. I don't have the bottle anymore since i moved countries etc. Also I can't recall any other side effects.

        Thanks for the support and callout of Dr. Kalish. Could you let me know how i can get in contact with him? Could you refer me to him?..

        After_Gap_5184 It's been a long time since I've had to think about sex hormones so I'm a little rusty but your testosterone and thyroid hormones do not look good to me.

        Have you spent much time looking into sex hormone and thyroid hormone issues?

        Which country are you based in btw?

          I showed these to a urologist and he wasn't concerned about my thyroid. I think the test is a bit low for a 32 yo but when i posted it in the testosterone reddit they didn't think i need TRT. To be clear i still have sex drive. My problem is just the ED.
          I did not get my SHBG tested but i should.

            After_Gap_5184 Yeah some doctors will say you're fine if you're within range. Other doctors (who know what they're talking about) will tell you otherwise.

            Yes, I think getting everything retested is a good idea. Most likely your SHBG will be very low because your total test is very low but your free test isn't too bad. High SHGB can be caused by hyperthyroidism so I'm assuming the opposite is happening in your case. I think you should also get cortisol and DHEA-S tested as a minimum.

            One of the best places on the internet for getting a second opinion on your hormone levels is the T-replacement category on the T-Nation forum (much better than reddit). I would see what they think after you get tested.

            From what I'm hearing, you are unlikely to have PDD which is a very good thing.

            I bet you also have HPA axis dysregulation (I suspect this because of your stress, sleep and energy problems) which will be having a knock on effect on thyroid and sex hormones. You can either go down the hormone replacement route which will probably just mask your problem, or you can spend a lot of time, money and effort and heal yourself holistically which would be the better approach.

            Anyway, the first step for you is to do some more comprehensive testing imo.

                james993 thanks James, I appreciate you taking the time to help me out. You're right the doctor i visited didn't seem to know much about these things. I'll get the rest of the tests done. And joining the T-replacement forum sounds like a great idea. Yeah i really would want to get to the actual root of the problem rather than rely on hormone replacement. I will reach out to doctor Kalish as well.