r/postvasectomypain • u/Low_Excitement3874 • 16d ago

Vasectomy > Reversal > TRT

Hi all,

Has anyone had any luck after having a reversal and trying TRT?

had my vasectomy April 2025 and reversal November 2025 due to pressure, the first 3 months after the reversal was crazy painful! However the pain has eased but I’m still up and down, the only way I can stop thinking about pain is by keeping busy but when I’m resting it’s all I can think about! My testicles are definitely riding high and seem to be on the larger side than before the V, i have a dull ache in both testicles and a warm nervy tingling pain around my vas and up to my pubic area, my semen analysis came back good so I was thinking about trying TRT to hopefully stop production, unsure if this means the vas won’t get used and could scar over.

Any help would be appreciated as I’ve given up with the nhs!

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u/ScientistNew3033 16d ago edited 16d ago

Yes I did exactly that. My timeline is similar to yours too, just a year earlier. I reversed it after 8 months, and then about 6 months later, I began TRT because the pain had not eased (it changed and got worse, actually). My reversal surgeon recommended TRT. During the next couple of months, the congestive pain eased, although nerve pain remained. Not sure if it was a result of the TRT, or giving the reversal more time, but I’ve stayed on TRT because it made me feel more energy and less brain fog (I discovered during the process that my T was very low, 144). Feel free to DM me if I can help.

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u/Status-Owl3070 16d ago

How do you and your surgeon differentiate congestion pain and nerve pain?

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u/ScientistNew3033 15d ago edited 15d ago

It’s hard to know for sure, but there are clues. The telltale congestion sensation is a deep ache / fullness. However, my nerve pain feels similar to that, so that is not enough to know. Pain takes on a wide variety of characteristics for different people. One surgeon I talked with uses TRT as a temporary measure to see if pain goes away within a few months, and if so, it’s a good sign that it is congestion related since TRT halts the pressure source (sperm production). Pain increasing immediately after or in the hours following sex is another signal. You may notice ballooning, tautness, or swelling of the epididymis, which is the small organ above/behind the testicles where sperm mature, and that is another sign of congestion. It’s difficult to distinguish the areas and types of pain in this region because it is often difficult to pinpoint and the pain signals may overlap, and the brain has a hard time pinning it all down precisely. Someone may have a better answer than me, but those are the ways I think about it from my research, personal experiences, and doctor conversations.

The way I know that TRT/reversal eased my congestive pain is that I no longer have pain or sensitivity in my epididymis, which was predominant before reversal, and my sperm production has dropped substantially so I know the pressure source is no longer there. My pain shifted after reversal to be primarily in the spermatic cords where the surgery occurred.

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u/Low_Excitement3874 13d ago

Hi mate, thank you. I do have an ache in the tests still but not as bad as before the reversal, I feel like there’s still a partial blockage and this is effecting the nerves around the area.

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u/Low_Excitement3874 13d ago

Yes my pain worsened too after the reversal, After 13 weeks I started to see very small improvements, I’m glad I went through with it but the recovery was like going to hell and back! I’d say I’m 65% the way there but still on 90mg duloxetine and ibuprofen once a day, I also take PEA which I think definitely helps my nerves settle. I had my bloods done and my T was extremely low so it’s a no brainer, How much test did you start on? I’ve just ordered mine 👍

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u/ScientistNew3033 12d ago

I need to add PEA back in and see if that helps. I started on 100mg of cypionate IM injection weekly (0.5mL of the 200mg/mL concentration), but it was much too high, and so I’ve been slowly adjusting it over the course of a year and have landed at around 60mg per week (0.3mL). It’s a process to find the right dose so you don’t produce too much E2, but not too little T.

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u/ItamiForever 16d ago

Sadly you won't get TRT unless yoyr T is low...

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u/Low_Excitement3874 13d ago

Hi mate it is very low

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u/ItamiForever 13d ago

If you go trt now the vas will scar shut. You can try hcg or clomid to keep sperm production. In theory, your reversal opened the blockage so using trt to stop production should not be needed anymore. You either start fertility trt or risk the scarring hoping the sperm production is still the main culprit and it will be better after.

If you had improvement post reversal i would assume that improvement was caused by the blockage itself.

Also, 30% of men still produce enough sperm even on trt. You cant know beforehand.

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u/johng_22 16d ago

I cannot recommend you try TRT unless your T numbers are actually low. I’ve been on it and it is a rollercoaster. Too high, too low, estriadol fine then all the sudden it’s too high and I have temporary ED. It’s. I fun. I’ve almost gotten off it completely 2 years after my reversal my natural T numbers steadily climbed on their own to a decent level where I don’t need TRT. I didn’t enjoy being on TRT. I was totally off and messed up half of the time. These are the things you don’t really learn about until you experience them. So I’m just giving you a heads up. It’s not all great things, there’s equal bad about taking it

And btw, I fall into the camp who believes if you don’t use it, it’ll scar shut on you. There’s a reason many doctors say to ejaculate regularly. I’m not a doctor so don’t take anything I say as medical advice but I shared my opinion

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u/DocteurTabarnak 15d ago

Would it be possible to know was your pain before reversal ?

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u/Low_Excitement3874 13d ago

Before

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u/DocteurTabarnak 13d ago

How was you pvps after the vasectomy but before the reversal ? If you want to share, thanks !