Recent content by Dr.V.P.C.

Also consider proctalgya fugax and anal fissure

Here in Brazil all Pde5 are over the counter.

Nowadays there is a novel trend to use androgens in women this way (low frequency, oral route). Works very well.

Here in Brazil most of the urologists trend the patients to do surgical procedure$. ( and they know just the basic guidelines of pharmacological enhancements . It´s simply not just androgens and PDE5 but they don´t know it )

Yes. I prefer on demand, to avoid tolerance. 0,125 to max 0,25. Timing 1-2h before the game. Some men will have annoying sides (lethargy, fatigue, runny nose, insomnia) even at low doses.

Of course, we are here to help each other. Direct dopamine receptors agonism : for me the best is pramipexole and ocasional cabergoline . Enhance dopamine levels : Mucuna and L dopa ( direct precursors) , L tyrosine ( precursor) , P5P ( cofactor to enhance conversion of L dopa to dopamine) ...

Max0 .25 Even 0,125 should be enough

Prami is power stuff Lots of details IMO before sleep is a no no, just as others dopaminergics, probably will mess big with sleep. Great erectile enhancement and lower refractary period. Go low or it will make you a zombie.

Here in Brazil compounded sublingual Vardenafil is my favorite pde5i treatment. But i really miss apo, not avaliable here anymore. (loved the effect)

Exemestane works great in daily low dosages (compounded), much easier do adjust than anastrozol ,and have some androgenic proprieties .

I have some girls on even 5mg/day doing great .

Nowadays i have 3 patients over 80 on TRT , all of them doing very well. ( 2 on transdermal and 1 on inj undecanoate )

Beside the things everyone knows ( exercise, nutrition , supplements , no smoking, avoid mouthwash ,etc) IMO the main thing most men neglect is emphasis is exclusive nasal breathing . And most of all , correct any degree of OSA . ( Almost every patient that starts CPAP using after some time feel...

Never forget to try to enhance nitric oxide production.

We don´t have pharma grade test prop here in Brazil , so because of legal reasons i have never tried.