I recently saw my urologist because pills were no longer working. He sent a script to a local compounding pharmacy for Prostaglandin E1 20mcg/ml. I have tried all kinds of doses over the past 3 months without much luck. Erections have been mediocre at best. Last night I injected 1ml and still barely had enough erection for sex. I have read about other mixes that include more than just prostaglandin such as trimix and quadmix. Should I move on to those mixes since this alone is not working? Very discouraged at this point. Thanks for any advice.
Prostaglanin E1 20mcg/ml not working
- Thread starter Lowmanr
- Start date
CoastWatcher
Moderator
Follow this link, scroll down, and you'll find a number of excellent threads dealing with Trimix. You have given us very little information to open a conversation. How old are you? How long have you had ED? Has your testosterone been checked? Your blood sugar? The more data you provide the better the comments will be.
https://www.excelmale.com/forumdisp...Energy-and-Mood-Boosters-ED-drugs-Trimix-etc)
https://www.excelmale.com/forumdisp...Energy-and-Mood-Boosters-ED-drugs-Trimix-etc)
Thank you coastwatcher. I am 40 years old and have been dealing with ED since about age 25. I am 5'10 and weigh 220lbs. I am on Clomid for testosterone and my most recent test about 1 month ago my level was 850. My blood sugar is perfect. I take Lisinopril for high blood pressure. I have had optic neuritis twice in my life but mri scans are negative for ms. It still make me wonder if there is nerve damage in my body cause in the past couple of years my hearing has declined to the point I need hearing aids. My wife and I have been married 20 years and we have 3 kids. My ED is causing a major strain on our love life. I am hoping to find some help here. Let me know what else I can answer. Thank you for your help.
CoastWatcher
Moderator
I apologize as I'm working off my phone. Clomid can send estradiol up like a skyrocket - has sensitive estradiol been measured?
CoastWatcher
Moderator
If that's the case, the doctor directing your Clomid protocol is not providing you the care you need. Monitoring estradiol is an element of protocol management, be it testosterone replacement or Clomid stimulation, that can't be stressed sufficiently. Pull it yourself, www.discountedlabs.com. Be sure it's the sensitive, LC, MS/MS test. Estradiol, high or low, can impact sexual function and libido profoundly.
CoastWatcher
Moderator
Perhaps you can tell us why you are on Clomid. You are hypogonadal? At what age was that diagnosed? Clomid and not exogenous testosterone? You discussed certain other health challenges you have - can you expand on them? How are you being monitored, and can you share any lab tests you have, with reference ranges? The discussion should expand and offer you some ideas as to which way to proceed.
The Clomid was prescribed by my urologist in order to increase my testosterone levels. They were about 180 prior to taking Clomid and now they are 850. The desire for sex is there, just not the functionality. I don't have any other conditions other than high blood pressure. 15 years ago I had 2 cases of optic neuritis and the doctors all felt confident I had MS. However, the mri results were negative. In the last couple of years my hearing had deteriorated to the point I now wear hearing aids. Other than that I am in good health. All of my physical results have come back in range and normal.
CoastWatcher
Moderator
To be told you are "in range" is to simply say...not very much. Too many doctors do a quick glance and don't study the nuances that the results imply. Why were you hypogonadal and why Clomid? Has estradiol ever been mentioned during the course of your therapy?
Estradiol has never been mentioned. I have had low t for several years. I tried using gels and shots but they were not working well for me. So my urologist said we should try Clomid to get my body to make testosterone. If this didn't work then he was going to try a pellet implant of some kind. The Clomid has raised the low t from 150 to 850 so that's good I guess, but I still suffer from ed and the injection he gave me isnt working.
CoastWatcher
Moderator
It could be worse, your total testosterone rose, but to do so in the absence of estradiol monitoring, via the sensitive (LC, MS,MS) test is poor medical management. Why did your testosterone protocol fail? What is your SHBG and how was testosterone prescribed? SHBG levels frequently undermine TRT protocols, but they can almost always be worked around.
CoastWatcher
Moderator
Frankly, your care has been substandard. I would go so far to say that testosterone replacement didn't fail you, your doctor failed you by not testing properly during your efforts with exogenous testosterone. Sex Hormone Binding Globulin levels determine how often and how much testosterone should be injected. The research is clear - smaller, more frequent injections will typically lead to success (50-60mg every 3.5 days is a typical starting protocol). Adjustments, based on SHBG (the higher that value the fewer injections per week are needed - typically), help sort things out. We've members who inject on an EOD basis, and a very few of us inject every morning. The more frequently one injects, the less testosterone is needed to achieve solid levels and the risk of estradiol peaking is minimized as well.
But that's past history in your case. You have had success in boosting levels with Clomid. But by not running estradiol tests, your doctor has fallen into a trap, and taken you with him, undermining your efforts. Clomid sends estradiol, estrogen-2, upward. Too much estradiol weakens erections, washes libido out, and can cause water retention and weight gain. Estradiol is a very important hormone for men - but not in excess.
I would test free testosterone, estradiol/sensitive, DHT, and prolactin. These may help you solve the puzzle you've been presented. Were they they run before you started your initial therapy? Was a full thyroid panel obtained?
madman
Super Moderator
CoastWatcher
Moderator
You aren't the first man who realizes he has been ill-served by his doctor. I lost many months on an absurd protocol, being treated by a man who held an endowed chair in the endocrinology division of one of the medical schools in the city in which I live. Simply put, most doctors are taught very little in the way of male, hormone managment. We have to become our own advocates. The first step is finding one of those doctors who knows how this works - in my case I was fortunate to be introduced to a practice where a doctor, a young woman, understood this field. But it can be a challenge to find such a doctor. We can, if you are interested, offer you the names of several. Treatment provided by someone who doesn't know what they are doing simply compounds your misery.
I urge you to read as much as you can here on the Forum - particularly the sticky posts in each folder. Only by knowing the basics of this field will you be able to engage with a doctor and get the best care you deserve. Be an active member here, ask questions.
CoastWatcher
Moderator
Thanks, Madman. As we know, ED is typically the last challenge for men dealing with hormone-related issues. Even though the member has a confirmed, pre-Clomid testosterone level of 180, other causes should certainly be investigated.
CoastWatcher
Moderator
Did the urologist you're consulting rule out functional/structural issues - a doppler scan of the penis to rule out venous leakage, for example?
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