Boner question

frankwhite

New Member
I know, never a black and white topic. Bear with me...

The patient: A healthy 45 year old. Great physical shape, gym 6 days a week, good diet, no alcohol and no drugs. No medications, perfect blood pressure. Mild ED a few years ago got progressively worse to the point that most times even Viagra doesn't produce a high quality, lasting erection. And sometimes nothing at all. This is the case whether on or off TRT, and when TRT lab numbers are "perfect" all around.

Now assume this is not a psychological issue.

Where to turn next? I'm guessing physical tests, but there is zero reason to suspect any nerve or vein/artery damage.

I'm posting this because I just read another thread that discusses how incredibly sensitive E2 levels are, and how too high or too low can cause ED issues. Could it be that even when my E2 level is "great" maybe it's still causing this somehow?

Really starting to feel hopeless.
 
I know, never a black and white topic. Bear with me...

The patient: A healthy 45 year old. Great physical shape, gym 6 days a week, good diet, no alcohol and no drugs. No medications, perfect blood pressure. Mild ED a few years ago got progressively worse to the point that most times even Viagra doesn't produce a high quality, lasting erection. And sometimes nothing at all. This is the case whether on or off TRT, and when TRT lab numbers are "perfect" all around.

Now assume this is not a psychological issue.

Where to turn next? I'm guessing physical tests, but there is zero reason to suspect any nerve or vein/artery damage.

I'm posting this because I just read another thread that discusses how incredibly sensitive E2 levels are, and how too high or too low can cause ED issues. Could it be that even when my E2 level is "great" maybe it's still causing this somehow?

Really starting to feel hopeless.

Too much missing here, on TRT, off TRT, no labs, jsut saying thing's like "perfect blood pressure"...can't help you without a more comprehensive look inside what you've got going one. Saying taht I'm not one that believes E affects your physical erection, your libido or desire to have sex, yes it can. So are you saying you want to have sex, you have interest in sex but just can't get it up? Or are you completely apathetic to sex? Or apathetic because you can't get an erection. This is a multifaceted problem.
 
Even if your E2 was high you could still get an erection, it would be just be diminished in size and sensitivity. I had an insane libido when my E2 was high, I even had ache over my entire body. Perhaps you have mechanical destruction of penile tissue and just don't respond well to 5-alpha reductase medications.

Maybe your doctor is ignorant and is missing something on your labs which would indicate a problem, it happens all the time. Cortisol, thyroid and hormones are difficult for most doctors.
 

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TRT Hormone Predictor Widget

TRT Hormone Predictor

Predict estradiol, DHT, and free testosterone levels based on total testosterone

⚠️ Medical Disclaimer

This tool provides predictions based on statistical models and should NOT replace professional medical advice. Always consult with your healthcare provider before making any changes to your TRT protocol.

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Understanding Your Hormones

Estradiol (E2)

A form of estrogen produced from testosterone. Important for bone health, mood, and libido. Too high can cause side effects; too low can affect well-being.

DHT

Dihydrotestosterone is a potent androgen derived from testosterone. Affects hair growth, prostate health, and masculinization effects.

Free Testosterone

The biologically active form of testosterone not bound to proteins. Directly available for cellular uptake and biological effects.

Scientific Reference

Lakshman KM, Kaplan B, Travison TG, Basaria S, Knapp PE, Singh AB, LaValley MP, Mazer NA, Bhasin S. The effects of injected testosterone dose and age on the conversion of testosterone to estradiol and dihydrotestosterone in young and older men. J Clin Endocrinol Metab. 2010 Aug;95(8):3955-64.

DOI: 10.1210/jc.2010-0102 | PMID: 20534765 | PMCID: PMC2913038

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