ED day and night but ok in the morning

[AMrockstar]

I am a 42 year old male who has suffered with erectile dysfunction my whole life. I have been to two urologists, one endocrinologist, holistic practitioners, and a sex specialist psychologist for 1.5 years. These days the only time things work properly are in the morning which leads me to believe that I am "high strung" chemically. And the only time I can have success is when I am fully relaxed.
In my younger days I used to not have problems when I masturbated but now I do. I take 20 mg of Cialis before my girlfriend comes over but it doesn't help. However the next morning I can perform two or three times. It is really night and day.

I am
42 years old
6'2 tall 215lbs
In very good shape, workout 6 days a week

Here are my latest labs from Labcorp.
I have been on TRT for 9 weeks. One month in my estradiol was at 54.4. I was taking .5mg of AI the month before this last test. I am on .5 mg /week now to try and bring my estradiol back up a little.
Before TRT my
testosterone was 441
Estradiol. 21.5
FSH. 3.5
SEX HORM GOB. 31.5
Free test 9.57
49.8%
----
After 2 months of TRT
I think I'm doing 160 of test and 60? Of HCG/week
(I had a sandwich 30 min before test)
Glucose,serum 116 mg/dl. HIGH ref 65-99
BUN. 18 mg/dl Ref 6-24
Creative, serum. 0.90 Ref 0.76-1.27
eGFR if nonAfricn AM 105 mL/min/1.73 ref >59
BUN/creatinine ratio 20. Ref 9-20
Sodium, serum 141 mmol/L REF 134-144
Potassium,serum 4.3 mmol/L ref 3.5-5.2
Chloride, serum 100 mmol/L REF 97-108
Carbon dioxide, total. 23 mmol/L REF 18-29
CALCIUM serum 9.4 mg/dl ref 8.7-10.2
Protein total serum 7.1 g/dl ref 6.0-8.5
Albumin,serum 4.7 g/dl ref 3.5-5.5
Globulin, total 2.4 g/dl ref 1.5-4.5
A/G ratio 2.0 ref 1.1-2.5
Bilirubin, total 0.7 mg/dl ref 0.0-1.2
Alkaline Phosphatase,S 70 IU/L REF 39-117
AST (sgot) 38 IU/L ref 0-40
ALT (SGPT) 33 IU/L 0-44
Lipids
Cholesterol, total 258 HIGH mg/dl ref 100-199
Triglycerides 78 mg/dl ref 0-149
HDL cholesterol 84 mg/dl ref >39
VLDL Cholesterol cal 16 mg/dl ref 5-40
LDL cholesterol calc 158 HIGH mg/dl ref 0-99
Hematology
Hemoglobin 16.1 g/dl ref 12.6-17.7
Hematocrit 47.4 % ref 37.5-51.0
TSH 1.170 uIU/mL ref 0.450-4.500
Triiodothyronine,free,Serum 3.6 pg/ml ref 2.0-4.4
T4,Free (direct). 1.27 ng/dl 0.82-1.77
Testosterone,serum 695 ng/dl ref 348-1197
FSH <0.2 LOW mIU/ML ref 1.5-12.4
Prolactin 9.8 ng/ml ref 4.0-15.2
Estradiol 19.1 pg/ml ref 7.6-42.6
Prostate specific Ag serum 0.4 ng/ml ref 0.0-4.0
Sex horn binding glob, serum 30.5 Nmol/L ref 16.5-55.9

I'm not sure what to do now. I'm thinking about seeing a psychiatrist that specializes in ED to see if anxiety melds would help. I think my issue might be high noradrenaline. I have never had a test for it, I don't even know if there is one. I had my cortisol checked 5 years ago. It was 14.2 mcg/dl . The test was done by Emory hospital. I don't have the reference range.

 

[Mark Hurley]

Well your initial testosterone reading at 441ng/dl is perfectly fine, especially considering you had a decent T->E ratio. Your free testosterone, however, was slightly on the low side, but I don't think your hormone profile contributed to the ED you've been experiencing. I also have slight ED at 25 years old and my testosterone is 927.1ng/dl. You should also check your DHT levels, which has a huge role in libido and nitric oxide production. I would recommend pomegranate concentrate and taurine to boost nitric oxide and circulation. It has helped me somewhat to reduce ED.

 

[Dr JIM]

AND you come to an PED forum to solve a "life long PSYCHOLOGICAL problem", well heads up fella a little fine tuning of that E-2 with an AI won't make any difference, but will give something to do and make you "feel" like something is being done.

Yea good luck fella!

 

[Dr JIM]

You should also check your DHT levels, which has a huge role in libido and nitric oxide production.
.

NO production, ah he's taking Cialis

 

[AMrockstar]

AND you come to an PED forum to solve a "life long PSYCHOLOGICAL problem", well heads up fella a little fine tuning of that E-2 with an AI won't make any difference, but will give something to do and make you "feel" like something is being done.

Yea good luck fella!

I don't think it is psychological. I have the same brain in my head in the morning as I do at night. Same doubts and anxiety. I perform multiple times in the morning but struggle to masturbate during the day or evening.

I came here because I have been to two urologist and one endocrinologist who said I was fine. Two sexual dysfunction therapist for 2 years that could not help. I came here because the medical community cannot help me. And the people on this forum don't seem like they just deal with the cards they are dealt.

 

[Ryno1980]

High cholesterol and poor circulation can play a huge role in sexual function.... I know this because I have naturally poor circulation in my extremities and because of this have also dealt with ed at certain times in my life.... I was unable to get much help from the doc until I went to Iraq 3 times and was diagnosed with ptsd... after that they threw the ed meds at me....
I don't think an anxiety med is your best bet... nor do I think u should rule out a mental Ed situation.... I know you say u have the same head ni the am and pm but there are tons of unseen things going on in our sub concious that we are basically unaware of.
That being said, being one of those guys who doesn't accept things the way they sometimes are...... I would suggest first to try some different ed meds brother.... just because cialis doesn't do the trick doesn't mean viagra or lavetra wont... cialis in my opinion is mild compared to viagra... my body does well on 20mg cialis and it helps keep my bp in check.... try 100 mg viagra and see what that does for you

 

[Ryno1980]

AND you come to an PED forum to solve a "life long PSYCHOLOGICAL problem", well heads up fella a little fine tuning of that E-2 with an AI won't make any difference, but will give something to do and make you "feel" like something is being done.

Yea good luck fella!

And why do u feel the need to talk to people like they are idiots? Does that shit make you feel like more of a man? People come to you with valid concerns and you talk to them like they fucking stupid.....

 

[Genghis K.]

However the next morning I can perform two or three times. It is really night and day.

ED at night, but not in the morning................ you're afraid of the dark!! Leave a nightlight on in the bedroom! Life long problem solved. Make a donation toward anaboliclab.com as payment for my services.

 

[Dr JIM]

You obviously fail to understand why I elect to emphasize the causation of someones problem and that's why those of your ilk don't help folk like the OP. But nothing about my post was a personal attack CLOWN, so get a life, as I'm not the first who has informed the OP his problem was psychological!

Hey but if you wanna hold hands and tell the OP all is well that's your prerogative but
it's not my approach and it NEVER will be!

 

[Ryno1980]

You obviously fail to understand why I elect to emphasize the causation of someones problem and that's why those of your ilk don't help folk like the OP. and nothing about my post was a personal attack CLOWN, so get a life, bc I'm not the first who has informed the OP his problem was psychological!

Hey but if you wanna hold hands and tell the OP all is well that's your prerogative but
it's not my approach and it NEVER will be!

Telling someone what his problem is quite different than talking to them like they are stupid.. this isn't the first time someone has called you on being an asshole and I'm sure it won't be the last but hey .... I'm just a fucking clown so what do I know.... your status and your profession does not give you the right to treat people like they are ignorant

 

[Dr JIM]

That's your interpretation NOT mine and your comments have proven why I should care less about yours . .. . . . . . IGNORE

 

[Ryno1980]

That's your interpretation NOT mine and I could care less about yours . .. . . . . . IGNORE

Lol.... wow ... you really are that guy....

 

[Gramps]

Such professionalism and a wonderful bedside manner. What degrees do you hold, Jim?

 

[LW64]

I take 20 mg of cialis before my girlfriend comes over but it doesn't help. However the next morning I can perform two or three times.

I'll take a shot at it and say you should try one of the other PDE5Is like Viagra or Levitra. Cialis as a 'take it and be ready anytime' pill is great in theory but not always in practice.

Viagra is more potent as a 'take it when you need it' pill. Try to take it at least two hours away from food and avoid alcohol. (Do you know how many men do NOT follow this advice and then are flabbergasted as to why it doesn't work?)

Instead of swallowing it, grind it into smaller pieces with your teeth and put them under your tongue. It goes to work faster this way.

 

[Ryno1980]

Such professionalism and a wonderful bedside manner. What degrees do you hold, Jim?

Whatever degrees he may hold obviously did nothing for his people skills or for his ability to communicate like a normal human being.

 

[Gramps]

I'm not attacking character here as none of us show much. I AM curious if there is a degree involved as that ads credibility. Other "docs" are in name only and self admitted.

 

[Mark Hurley]

I remember a time when I experienced "solid" morning wood that then subsided within three months. That occurred roughly three years ago from July->September. My diet at the time consisted of a lot of lamb, eggs, olive oil and sprouted grain bread. I was consuming upwards of 24 scrambled eggs/day at one point. I felt great and full of energy, and for the first time was confident enough to approach girls at ease. Otherwise during Winter/Spring, I would have no morning wood and ED. I am now started to experience morning wood again for the first time, and its July again. The one variable, I believe, induced this effect back then was "sunbathing." Most days I would expose my entire chest/back to the sun for an hour. I was also exercising (weight lifting and mild running) at the time. After all, exercise is good for circulation, mood, and stress. Diet just helps regulate optimal hormone production. This is the reason I consumed a lot of eggs and lamb in order to obtain the necessary fats for secretion of testosterone. There are many research articles on the "effects of sunlight on testosterone production." I enjoy experimenting, so I wanted to prove whether this is indeed true. What I noticed is that in the months I exposed my chest/back/testicles(crazy,huh) to sunlight, my libido shot up and every night I would have vivid dreams and nocturnal erections. Maybe neurotransmitters played a role here, since sunlight increases dopamine (hence increased libido). I would recommend that you sunbath during the summer months, which will increase your vitamin D, lower stress, and regulate your mood. I guarantee you will have positive results. Good luck

 

[AMrockstar]

I remember a time when I experienced "solid" morning wood that then subsided within three months. That occurred roughly three years ago from July->September. My diet at the time consisted of a lot of lamb, eggs, olive oil and sprouted grain bread. I was consuming upwards of 24 scrambled eggs/day at one point. I felt great and full of energy, and for the first time was confident enough to approach girls at ease. Otherwise during Winter/Spring, I would have no morning wood and ED. I am now started to experience morning wood again for the first time, and its July again. The one variable, I believe, induced this effect back then was "sunbathing." Most days I would expose my entire chest/back to the sun for an hour. I was also exercising (weight lifting and mild running) at the time. After all, exercise is good for circulation, mood, and stress. Diet just helps regulate optimal hormone production. This is the reason I consumed a lot of eggs and lamb in order to obtain the necessary fats for secretion of testosterone. There are many research articles on the "effects of sunlight on testosterone production." I enjoy experimenting, so I wanted to prove whether this is indeed true. What I noticed is that in the months I exposed my chest/back/testicles(crazy,huh) to sunlight, my libido shot up and every night I would have vivid dreams and nocturnal erections. Maybe neurotransmitters played a role here, since sunlight increases dopamine (hence increased libido). I would recommend that you sunbath during the summer months, which will increase your vitamin D, lower stress, and regulate your mood. I guarantee you will have positive results. Good luck

Thanks Mark. I will try it.

 

[AMrockstar]

I'll take a shot at it and say you should try one of the other PDE5Is like Viagra or Levitra. Cialis as a 'take it and be ready anytime' pill is great in theory but not always in practice.

Viagra is more potent as a 'take it when you need it' pill. Try to take it at least two hours away from food and avoid alcohol. (Do you know how many men do NOT follow this advice and then are flabbergasted as to why it doesn't work?)

Instead of swallowing it, grind it into smaller pieces with your teeth and put them under your tongue. It goes to work faster this way.

Thanks! I have tried the other meds. Even combined them But it has been awhile. I will try again.

 

[AMrockstar]

I had some success on Saturday night. Did it 1.5 times! It was my 4th day on Wellbutrin. And I took an HCG shot one hour before. Hopefully it was the Wellbutrin. The only other difference makers that I can think of was that I got some sun earlier that day. Or the nap I had right before she came over.