Incurable ED

Discussion in 'Men's Health Forum' started by Atillah67, Dec 7, 2018.

  1. Old

    Old Member

    Try using MUSE again. It comes (pun not intended) in different strengths as well, so see if you can get the strongest (another pun not intended).

    I'll say this about alprostadil, with viagra if I get ahead of my wife I got to not think about sex but there is a risk of loosing the erection. With the injection, I can turn sex off and stay the hardest I've ever experienced. Zero pressure sex. So obviously I like this med. I've had ED my whole life. But only at 57 was I diagnosed with venous leak. Its a mild one but its been a thorn in the side.

    Venous leaks can be repaired but usually return within a couple years. TRT can fix a third of them. If one doesn't respond to alprostadil, then one can get an implant.

    Read one case of a guy that could only get erection while standing. So leaks can be positional. Its all weird and docs admit that little is actually known. But there are options. YOU have options. Pursue this med, talk with a good urologist, and also do the shrink thing.

    Since trazadone worked at times, I suspect a touchy neurological thing as well.
    T-Bagger and Atillah67 like this.
  2. Atillah67

    Atillah67 Member

    TRT helped a ton at first. Then it went back to baseline, after maybe 6 months. I thought trt was the miracle drug at first. I was young and stupid (30) not 34 now haha. In your opinion, if MUSE did not work well either time, you suspect part of this could be a physical problem and not entirely psychological/hormonal? I don't get fully erect masturbating on my own either. It's floppy then too, although I'm taking no medications for it.

    I used the suppository and not caverject, because I was trying to avoid pinning my dick. I will obviously do whatever it takes to overcome this and have a functional sex life for my girlfriend or future wife etc. I did not always have this issue this bad. I prided myself in being able to go through women, and variety was important for me in my 20s and up until this started happening. Also, by 33, I started to want a partner, which is pretty normal. When I had ED earlier on, it was pretty much coincided with some depressive episode. Not anymore. This is the only thing that causes massive depression-- and you can tell by my responses I start dwelling and obsessing. Not helpful, clearly.

    But I figured I would at least respond better to the muse. Made no difference. Whatever is in the trazadone gives me very strong erections 6-8 hours after taking. Much better than anything else. Unfortunately, this is hopeless as it knocks you out. I will start trying to force myself into AM sex w my girlfriend, because the erection is there then whether I like it or not. Implant I know is a possibility for the future and gf knows about it too. But I'm a college student who will be graduating in May and probably a grad student next year. I don't have thousands of dollars lying around for that, yet.

    I sincerely thank you for this. No one has given me answers that are comparable to this in my life, including all the professional medical help I've sought (4 years of seeing urologists on student Medicaid)

  3. Atillah67

    Atillah67 Member

    Also- did you inject or use the suppository? From what I've read, the injection gives better results to more people. What you're describing is what I experienced on Melonotan 2 for awhile. Spontaneous boner and I can basically have sex whether my brain wants to or not. Amazing effect for awhile. I was temporarily feeling like a sex god and I really enjoyed being able to give partners some of the best sex of their lives. Suddenly, I had women fall in love with me, something I had lacked for years. But the power of MT2 wanes unfortunately if used multiple times a week. It makes me very nauseated, but I counter that by taking an anti-hystimine. It's possible that same medication dulls the effects of the erection. I will give caverject a try. Its expensive, but solid sex once a week with the girlfriend could save the relationship. She's aware and has been supportive, but we are all human.
  4. Old

    Old Member

    Doctors are an enigma. They can be helpful but if you have a more difficult situation, most don't follow through and help. I could write a book about blatantly inaccurate statements from doctors. Here is a choice one just for fun from a Neurologist I saw last week: "medications do not alter cognitive function". LOL ... so antidepressants don't do any thing? Anaesthesia doesn't make a person unconscious? Alcohol can't cause impairment (thus DUI and DWI are invalid legal charges)?

    I cannot say whether MUSE is less effective than Caverject since MUSE was 15 years ago and injections have only been 12 months now. But in principle, dosage is what matters, not method/application. Ironically, the active med (alprostadil) has a short half-life ~5 minutes but dose is targeted for an erection of 45 to 60 minutes.

    Another thing that can help is a cock ring or strap. [ Yea the forum can get a good laugh now. ] The concept is that of a tourniquet but not to stop blood flow and turn purple but rather to restrict outflow - veins have lower pressure that arteries.

    My experience with:
    1. viagra[/Levitra/cialis] - 25% works very well, 50% works well enough, 25% produces no erection at all. With the latter, if 50mg doesn't work, then doubling it won't either. No explanation. Cialis never works for me, just the nasty side-effects that the others sometimes give: headache and sinus congestion.
    2. MT 2 - increased libido and help with ED, but minor. PT-141(?) works better but perhaps because I've not used it as much. IMO, don't think it good to take more that 0.5 of MT2 per day ... too many sides.
    3. Alprostadil - Best thing I've used. But sometimes there are failures in which I simply do another injection. When discussing these 'failures' with a Urologist, he diagnosed veinous leak without actually testing. As to the failures: a couple times had no erection and a minute later hands were tingling (med didn't stay long enough to cause erection). Sometimes erection are weak. These two instances are always when injecting on left side. Sometimes there is a bent erection (45 degrees to the left) when doing a right side injection. It isn't fibrous or painful and always the same spot. A second injection corrects this. A couple times when erection went away a hour later, the same bend appeared. These bends never happened with PDE5 inhibitors and the doctors have no explaination. The frequency of failures has reduced since doc put me on TC 200mg/wk.
    In the end, what I am doing is working. And the wife and I are happier with it (though injecting kind of freaked her). Sounds like you have a promising relationship.

    As for Trazodone, it actually binds to so many kinds of receptors, its hard to know what is helping. But through alpha-1 adrenergic receptors, it is know to cause erection. Perhaps a lower dose to reduce the sedation?
    Because of this, it seems that a neurological weakness is involved. Basically signals are sent to the arteries supplying the penis to cause erection via NO signaling. PDE5 inhibitors increase NO signaling. Whereas the veinous drainage of the penis is largely passive. Alprostadil works with the latter.
    Obviously emotional states are highly influential with erections. Your positive androgen experiences are likely due to neurosteroidal effects in the brain (a fascinating but long topic) and not necessarily emotions.

    Keep working with finding docs that will help (there are a few out there, it is just a matter of finding them which takes time and $).
    You posted that physically you have a solid weight with low fat. Was this from blasting or were you always able to build muscle fairly easily?
    Last edited: Dec 13, 2018
    Atillah67 likes this.
  5. clear0cn

    clear0cn Member

    What is your baseline T levels, e2. Did you had any blood work while on trt? I was in same boat as you a year and a half eariler, viagra didn't work, depr ssed, no libido. I was on the low end of normal so I couldn't get trt prescribed, so now I self medicate. Whrn I'm dialed in I don't need viagra. When my e2 is unbalanced viagra works
  6. Atillah67

    Atillah67 Member

    Glad that worked for you, man. TRT helps me, but it doesn't guarantee me consistent, decent erections. I thought TRT was going to be the answer to my prayers, but only half so. It doesn't really fix my ED issue that went back well before I touched anything. The only anabolics I have used in the past year were proviron, primobolan, Anavar and dbol. I do not touch deca or tren with a 20 foot pole, ever. never.
  7. Atillah67

    Atillah67 Member

    I definitely cycled anabolics such as proviron, primobolan (my favorite but hard to find), Anavar (once) and dbol. The proviron and the primo I believe helped improve libido. Dbol was neutral and anavar just made me angry (disused once that came up). So I am not natural. However, people have been asking me since HS when I took up weights if I was on steroids. I have the genetics for it. I was the only white guy that was a sprinter on my HS track team and my soccer coach straight up asked me if someone had given me anabolics.

    I didn't touch t or other anabolics until 30. But after using anabolics lightly for two years off an on (most mentally functional, best sex years of my life) people began asking me if I was a competitive bodybuilder. An ex-IBFF pro who now lives in South America encouraged me to try to go pro as did the former Olympic weightlifting coach for the US/Japan. He did all these measurements and tests and he was like "yeah, you're just right for bbing". That wasn't my goal in life, and it was either school or an attempt at that. I couldn't afford both, and likely was way too old to catch up to anything worth showing off. Also, I don't have amazing, Phil Heath genetics.

    About the trazadone: again, your explanation is better than any MD's. I've had this feeling that trazadone actually caused a physical ED, whereas before it was purely psychological. My first real hard cases of ED, where I was wanting sex but couldn't keep it up for an attractive woman, started sometime after trazadone. That was 5-6 years ago. I have been on it ever since. I love how trazadone gives me strong erections In the morning, but what you're describing about the brain getting confused on when to get aroused sounds very familiar. It's like the receptors are dulled to actually sexual stimulation. I went off trazadone for two days, had no nocturnal erections that I could recall, and got freaked out and went back on. I have another sleep aid I can use. It's probably worth trying out, I just wanted some way for my body to continue to have an erection period.

    I had a lot of depression issues through my 20's, but when I actually was in the headspace for sex pre-trazadone, I never had ED. Maybe a bit here or there but my penis was reliable when I actually got in the mood.

  8. Old

    Old Member

    What is your BP med and when did you start it?
    Are you still on Lamictal?
    Any other meds or just Trazodone?

    Before hormone therapies, morning wood increasingly rare. With androgens can get hard erections but if I go to use it I loose it. Very rare in the day and then its a 'minute' erection. Can get 75% there without problem but mush is mush - like the elderly joke, "like stuffing a marshmellow into a piggy bank". Mostly there isn't there. In my case I have autonomic nervous system issues, so perhaps being awake shuts down some necessary signalling. But what good is having sex in one's sleep, lol.
  9. Atillah67

    Atillah67 Member

    BP medication is amplodipine. Doesn't cause ED issues from what I've read. I am no longer on lamictal, in fact I switched off to a low dose of lithium because I was concerned perhaps lamictal was the cause. No changes from lamictal to lithium.

    And you're absolutely right about 75% there isn't there. Try to shove your semi into a woman hoping it will harden is an awful feeling and its a pointless endeavor.

    The fact that I didn't have this extreme of an issue until before trazadone makes me suspect its played a part as you said. I'll switch over to my other sleeping med which doc gave instead of trazadone, although no erections at all for a week can feel very alarming.
  10. Old

    Old Member

    Actually amlodipine can cause ED as do most BP meds. And so can hypertension. But the later relates to clogged arteries (if I understand correctly). When did you start amlodipine? Perhaps it contributes but is not likely the sole factor.

    What is you BP before and now?

    Lithium also causes ED. Perhaps you need to explore if there is a cascade of one med causing need for another. Although you already know depression and BP are long standing, separate issues.

    As far as the hypertension. It wouldn't hurt to get a carotid artery ultrasound. It lets you know the general plaque status of large vessels. If they are plugging, then small arteries are too. But if the are not, there is still are small artery diseases but unlikely.

    Again, it seems that some neurological tweeking might be all that is needed. It will involve reevaluating these meds.
    Atillah67 likes this.
  11. Atillah67

    Atillah67 Member

    So the severe ED dates back to about 5 years ago. I started taking amlodipine 6 months ago, when the ED was especially horrible in hopes of that helping. My BP naturally just runs a bit high, my dad and uncles have been on BP medication since their early 40's and none are overweight or steroid users. I believe the primobolan in its one side effect that I could tell did raise my BP up some. I'm 5'10 and I was 250 lbs at the peak lean, the docs suggested even if I was natty, carrying that amount of weight around would cause a raised BP. BP now checks in around 130/80. I do consume a few cups of strong coffee throughout the day.

    My diet is very healthy. I attempted to cure the ED naturally, so I went with a diet rich in vegetables and fruits, and chicken and fish. Barely any beef. No fastfood. Sugar at a minimum. Only grains are oatmeal and rice. Occasionally sweet potatoes. I jog laps around the park nearly every morning in addition to the weight training.

    Your theory of the psychiatric drugs being the culprit could very well be true. Lamictal balanced me in my mid 20's and I could actually remember what a sex drive was. But it was never very strong consistently, it only came in spurts. When I re-started weight training at 26 (no supps) I developed a consistent desire for sex and ability to perform was fine. I was on lamictal all that time. I was on lamictal until last year. Switched to low doseage of lithium with no change. Sexual ability has been 75% of the time wretched since 32. As strange as it sounds, I can actually survive fine off of lamictal or lithium, but I've only been able to do it with TRT. I did it in Colombia for awhile, but you know, if you get told your whole life "you must be on these drugs for life", any bump in the road makes you jump back on them.

    My psychiatrist knows startlingly little about the sexual side effects of these drugs, and he's actually older and well-educated. The Urologist, GP seem to know nothing and the endocrinologist, a young woman, while admiring of my physique every time I come in, chides me for using t and has only agreed to continue treating me if I stop them forever. GOD BLESS THE AMERICAN HEALTHCARE SYSTEM!
  12. Old

    Old Member

    Well lean at 250 lbs is wow. You respond well. Its hard to know with androgens and balancing estrogen for sexual function. I think DHT is a major factor in drive. Take a look at the effects of its major metabolite 3α-Androstanediol - Wikipedia . That is why finasteride is so risky. T make one more goal oriented and focused. But have read that the 'feel good' effects are largely DHT.

    What dose are you cruising TRT at now? Or did you restore natural production? Do you have any blood tests to show? At one time you were asking about prolactin.
    Atillah67 likes this.
  13. Atillah67

    Atillah67 Member

    I went off all t for 3 months. I went off cold turkey and I was fine aside from loss of gains to about 230 unlean. Sex drive picked up for first month off, I would get spontaneous erections by just hugging my girlfriend, but that all went away by month two. I have just re-started a cruise TRT for the month of December at 200 mg, which I divide and take half on a Monday and half on a Thursday.

    I had a blood test taken at peak of cycle and I had blood drawn at the end of my off-period. I will see an endocrinologist in January about it. I don't think my body remotely jumped back to normal t levels, but I felt generally fine. No depression, no real exhaustion, just less energy in gym and I notice myself being more empathetic towards others and strangely could tell certain things them that I couldn't blasting on t.

    If using t and anabolics like proviron or primo were the culprit in my ED I would go off entirely. I do not touch deca or tren. However, the ED really pre-dates all of that and t and those particular anabolics actually gave me sex I had never experienced before, at least in spurts. Temporarily, bodybuilding and cycling gave me my sex life back, but gave it back in a way I had always wanted but never had.

    I need to look more into DHT and finasteride.
  14. Atillah67

    Atillah67 Member

    My point is I enjoy the gym, I enjoy bodybuilding, I enjoy all the aspects of it and it has helped me beat off most of my worst depression and taught my plenty of life lessons. But I look like I'm taking more steroids than I am. But I am taking cycling off and on some, which has made doctors just write-me off as a dumb meathead who did this to himself.
    Old likes this.
  15. Can psychological issues cause a lack of “morning wood” or “partial wood” or would that mean there’s a physical issue?

    Is that medication that dr’s use to test whether a patients ED is because of blood flow issues?
  16. Old

    Old Member

    I would like to see some of the doctors respond to this.

    However, neurological problems (physical or psychological) will effect this. To say that having morning-wood but having ED proves it is psychological is incorrect. Perhaps if there is absolutely nothing wrong in the brain vascular, metabolic, or neurological ... then maybe that could be said.

    Proper sexual function requires proper arterial blood supply and drainage (vascular health) and balanced Autonomic Nervous System functioning. When you are asleep, the Parasympathetic NS is most active (you are relaxed). When you wake up, the Sympathetic NS is more involved.

    If you have stress/anxiety/depression, then the ANS shift more sympathetic. With weak parasympathetic action, ED is more likely. That is what happens with "performance anxiety".

    Medications mess with ANS functioning. Even AAS as has been observed. Remember that the Hypothalamus regulates many hormones including androgen production. It also is the master control of the ANS. [ See Neurosteroid - Wikipedia and List of neurosteroids - Wikipedia ]

    Summary: Drugs, emotions, hormone balances, and vascular health affect erectile function. Morning wood generally indicates that overall penis vascular health is OK. It doesn't really prove anything else.

    No, it is an ED medication. It is a combo of alprostadil, papaverine, and phentolamine. Whereas Caverject/MUSE is simply alprostadil. They will used alprostadil to verify if a vascular leak is so bad that a person requires an implant.

    Not sure why they bother with trimix unless it is cost. Caverject is often over $100 per injection although it is a decades old med that is generic - just no competition. Outfits selling trimix sell a vial that is good for several uses for ~$80.

    Both papaverine and phentolamine can cause scar tissue in the penis. While technically possible with alprostadil, it generally doesn't happen.
    Both the mix and generic alprostadil purchased outside the USA will store like a peptide. With the generic, before mixing, storage in a refrigerator is up to 2 years. Once mixed, 1-2 months. Usage of generic alprostadil costs $2 to $10 per injection.

    Some people prefer alprostadil over PDE5 inhibitors. It usually does not give bad headaches or sinus problems. The injection is usually less painful than intermuscular. The psychology ... well you might start with anxiety until you get used to it, lol.

    Generally, alprostadil is used because of weak penile arterial supply or because of penile vascular leak. PDE5 inhibitors increase arterial supply (inflow). Alprostadil works to reduce leakage (outflow) issues.
    The Terminator likes this.
  17. I appreciate the detailed response, been having occasional ed/low libido issues, every once in awhile there’ll be a few days then go back to normal but the lase couple months I’ve noticed mostly partial morning wood or non, like 10-50% at most. Figured any ed issues were mental but the lack of morning wood made me wonder if there’s some physical issue. viagra/cialis will work if I take it, if not anxious it works well, but if I were to get anxious it still works just not rigid like it is when I’m calm.

    Anyway thought it was mental, as it’s an occasional issue, but the weak morning wood has been constant, even in my dreams I think about whether I can get wood in my sleep like last time I had a sexual dream I started feeling to see lol. I wondered if it was hormones fluctuating or more likely if it was due to sleep apnea, just diagnosed with mild apnea but could be worse cause I did the less sensitive home study.

    Ah ok I read one of the tests they give was an intracavernous injection to determine whether the blood flow or venous leak as you said. Seems a frightening to inject your own dick. My problem isn’t that bad so I should stop thinking about it so much. I only have ugl viagra/cialis so some caps are weaker, but even when I do take one before sleep I’ll still wake up with a weak one.
  18. Dr JIM

    Dr JIM Member

    I’ve never seen sooooo many males preoccupied with their libido and ED than on this forum.

    And once again ED drugs and AAS, only complicate matters since the cause of
    ED in youngsters is RARELY organic (physiologic/anatomic) but are the result
    of unresolved emotional conflict and/or a distorted body image.

    And the MAJORITY know EXACTLY what I’m talking about yet remain in denial, bouncing from doc to doc and forum to forum discussing ED, when they should be seeking long term mental health counseling, bc “ED” is almost always just the tip of the iceberg.

    The Terminator likes this.
  19. I’m pretty certain that the occasional ed /libido I experience was psychological, but last night I read a couple websites that said if you consistently wake up sans erection to see your dr cause they’re might be a physical issue, which kinda scared me a bit lol. But I’m guessing since it usually works despite not waking up with one that my original guess of a mental cause is most likely which is easy to fix if I make the changes necessary.
  20. Oh and I agree re roids, I only do rx’d trt at this time and hcg to stay fertile. Even tho my T was at 130 right before trt and thought I felt bad I wish I’d waited as I know there were some meds that were contributing to the low #s, suboxone, and I didn’t excersice regularly. Thought since I dropped 80lbs thru diet after quitting drug abuse and the # went down from ~250s to ~130s that it didn’t matter. Anyway I’m hoping now that I do workout and lost an additional 20+ lbs and about to drop the meds that I could possibly recover my natural T.