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Poor penile arterial flow or venous leak do indicate a more serious form of ED that could require stronger therapy than PDRS inhibitors such as trimix and various doses of Trimix. I can't quantify prognosis as it is different in each sscenario. I can tell you I have had patients on injections...

Hi, I do occasionally come across a case like yours where the symptoms do not correlate with the numbers. I do not believe cabergoline is indicated in your clinical situation. In cases like yours, I will use a multidisciplinary approach and involve other specialists to address the patients...

Hi, I do occasionally come across a case like yours where the symptoms do not correlate with the numbers. I do not believe cabergoline is indicated in your clinical situation. In cases like yours, I will use a multidisciplinary approach and involve other specialists to address the patients...

Fall 2017 is what I hear.

Fall 2017 is what I hear.

Hi Bud, how old are you roughly if you don't mind my asking? What protocol are you on now ? Were you using the anastrazole under medical guidance?

Hi Bud, how old are you roughly if you don't mind my asking? What protocol are you on now ? Were you using the anastrazole under medical guidance?

Yes there are, but are used primarily in patients having an orchiectomy at a young age for reasons such as testicular cancer, and are used to simulate appearance of a testicle in the scrotum. I would not implant one along side a small testicle just for cosmetic appearance. And you certainly...

Yes there are, but are used primarily in patients having an orchiectomy at a young age for reasons such as testicular cancer, and are used to simulate appearance of a testicle in the scrotum. I would not implant one along side a small testicle just for cosmetic appearance. And you certainly...

i do sometimes see pain during TRT without hcg , sometimes caused by testicular shrinkage and other times for unknow reasons. I rarely if ever see it in patients on both T and HCG.

i do sometimes see pain during TRT without hcg , sometimes caused by testicular shrinkage and other times for unknow reasons. I rarely if ever see it in patients on both T and HCG.

i don't really use free T much in practice anymore and have completely adopted bioavailable T which is a much more accurate measure.

i don't really use free T much in practice anymore and have completely adopted bioavailable T which is a much more accurate measure.

I believe it's valid and Baylor University has also published an article on this. I take this into consideration when I follow PSA tests in patients on TRT.

I believe it's valid and Baylor University has also published an article on this. I take this into consideration when I follow PSA tests in patients on TRT.

Thank you Dr Saya for answering this question. I agree with all of your answers. We are learning all the time about the variances of TRT as it still is an evolving field. Lots of good questions here.

Thank you Dr Saya for answering this question. I agree with all of your answers. We are learning all the time about the variances of TRT as it still is an evolving field. Lots of good questions here.

In my experience many patients have slightly elevated prolactin levels which upon consultation with endocrinologists do not require a work up. When it is much higher , a workup is indicated. The level you have would not give you any symptoms not should you use cabergoline for this level.

In my experience many patients have slightly elevated prolactin levels which upon consultation with endocrinologists do not require a work up. When it is much higher , a workup is indicated. The level you have would not give you any symptoms not should you use cabergoline for this level.

yes, I do use Trimix for ED but only after all oral options have been exhausted. Penile injections do cause scarring which can lead to further deterioration. I would try other oral options and consider a penile vascular exam as well.

yes, I do use Trimix for ED but only after all oral options have been exhausted. Penile injections do cause scarring which can lead to further deterioration. I would try other oral options and consider a penile vascular exam as well.

There is no definitive way to tell your trough level just based on dose and weight. I would not be so concerned with your level as much as your overall wellbeing. If you are doing well on the dose and don't have any adverse effects , I would not concern myself.

There is no definitive way to tell your trough level just based on dose and weight. I would not be so concerned with your level as much as your overall wellbeing. If you are doing well on the dose and don't have any adverse effects , I would not concern myself.

Hi Andre, I do not generally prescribe finasteride for hair loss unless the patient has a strong family history of male pattern baldness and requests it. Finasteride can impact libido, fertility and erectile function with some patients stating they continue to have these side effects even...

Hi Andre, I do not generally prescribe finasteride for hair loss unless the patient has a strong family history of male pattern baldness and requests it. Finasteride can impact libido, fertility and erectile function with some patients stating they continue to have these side effects even...

Thank you Dr Saya! I have been following this forum for quite some time and have seen and learnt quite a bit from your contributions. I am always happy to contribute to a forum with with patients that are so well educated and who ask such pertinent questions.

Thank you Dr Saya! I have been following this forum for quite some time and have seen and learnt quite a bit from your contributions. I am always happy to contribute to a forum with with patients that are so well educated and who ask such pertinent questions.

Paradoxical here meaning that your numbers may improve to normal or high normal yet your symptoms do not improve. There was one abstract from Baylor that used that protocol in past with succcess in maintaining sperm function in patients on TRT. Thanks

Paradoxical here meaning that your numbers may improve to normal or high normal yet your symptoms do not improve. There was one abstract from Baylor that used that protocol in past with succcess in maintaining sperm function in patients on TRT. Thanks