At my wits end - progressively cannot achieve an erection

[GeauxBears]

Started DHEA and feel a bit more libido actually but no improvements (yet) to erections.

Ranitidine - I take this for the reflux caused by Cialis. It lists erectile dysfunction as a side effect but I’ve never heard anyone complain of that with this standard OTC med. I take 150mg in AM, 150mg in PM. Maybe this is inhibiting?

Edit: from Wikipedia:
Libido loss and erectile failure can occur during treatment with histamine H[SUB]2[/SUB] receptor antagonists such as cimetidine, ranitidine, and risperidone.[SUP][22][/SUP] The injection of histamine into the corpus cavernosum in men with psychogenic impotence produces full or partial erections in 74% of them.[SUP][23][/SUP] It has been suggested that H2 antagonists may cause sexual difficulties by reducing the functional binding of testosterone to its endogenous receptors.[SUP][22][/SUP]

 

[DDD]

Have you ever been tested for a venous leak? If your hormone levels are normal and you're having erection problems, you could have a penile occlusive venous leakage.

 

[Vince Carter]

Histamine is one of those things you need, you get typically the same possible sides from Anti-histamines and like all of this some guys get the sides and some don't. It's simple enough to remove the drug and see what resolves, or does not.

 

[Nixter]

Pardon me for asking but are those T blood levels typical for someone on a relatively high trt dose such as yourself? 210mg a week seems like a lot for only having upper normal T levels.

FWIW, i had erection issues on 200mg. I dropped down to 100mg and things improved. E2 was always kept in check.

 

[Leesto]

Dhea is the cheapest and easiest attempt

Yes it's over the counter so you can pick it up anywhere. It did the trick for me after spending lots of time and money on tests, protocol changes, and so forth. I had almost given up on erections till I popped 25 mg. of DHEA.

 

[Smokey]

Guys - realize this is a long read. Hoping for some help. I am 33 years old and have been on a stable TRT protocol for 3 or so years now. Recently, I’m progressively unable to achieve a solid erection. In my most recent consult in March, my doctor (who is great and well respected here) added Doxazosin as I complained that I was unable to complete intercourse due to losing my erection... this has given me morning erections for the first time in years which is great. But I have been increasingly unable to mentally cause myself an erection during the day, nor can my wife cause me to get one prior to intercourse.

My libido is good - I even think sometimes during manual stimulation that I might orgasm - without getting an erection! This has gotten progressively worse over the past several months.

Protocol
30mg T ED
0.07mg anastrozole EOD
500ius HCG twice a week
0.125mg Cabergoline twice a week
5mg Cialis ED (sometimes I cheat and go to 10mg just to see if anything will help)
3mg Doxazosin ED
90mg Armour Thyroid ED

My latest numbers:
Total T: 830 (264-916)
Free T: 20.9 (8.7-25.1)
E2-Sens: 25.3 (8.0-35)

SHBG: 15.5 L (16.5-55.9)
DHEA: 130.2 L (138.5-475.2)

TSH: 2.00 (0.450-4.500)
FT4: 1.14 (0.82-1.77)
FT3: 6.5 H (2.0-4.4)

Cholesterol numbers are good - am active on the Peloton and have minimal body fat. TRT has had a fantastic affect on my physique as well as mood stability. I do have a high stress job, suffer from a bit of generalized anxiety/high idle HR but no depression. I am generally very happy and grateful for life.

What am I missing here? 10 years ago, I would use Viagra every now and then to take the edge off performance anxiety and it gave me an erection that lasted several hours (incl. a massive headache and nasal congestion!). Now I take those drugs at similar dosages and have literally no response (that I can tell).

I do not feel “alive” down there.

Thanks for reading and for any suggestions. Plan on getting an out of cycle appointment with the doc soon to discuss.

Drop the HCG before anything else. This was the case for me and a close friend of mine. I cycle it but don't stay on it as a ongoing protocol due to erection problems.

 

[ryan98366]

Started DHEA and feel a bit more libido actually but no improvements (yet) to erections.

Ranitidine - I take this for the reflux caused by Cialis. It lists erectile dysfunction as a side effect but I’ve never heard anyone complain of that with this standard OTC med. I take 150mg in AM, 150mg in PM. Maybe this is inhibiting?
[SUP][22][/SUP]

Hey bro...you need to follow my buddy Jay Campbell. You are taking too much shit. Start over. Just do straight testosterone. Dump the HCG and the AI. HCG and AI did nothing but fuck me up. Start over. HCG made me irritable and anxiety ridden. AI made me moody. It was the HCG/AI Rollercoaster from hell.

Try straight testosterone. Get with an expert doctor like Dr. Saya at Defy or Dr. Keith Nichols. Then add in ONE thing. Like DHEA.

You are probably just jacked up on too much stuff. Maybe your dose is a tad high. Maybe it's a tad low. But my guess is the HCG and AI are leading you round and round and round like it did to me.

Are you doing cardio? Are you drinking? Alcohol and TRT have been libido and boner killers for me. My best days on TRT have been sober. Alcohol, HCG and AI together are BAD for me. Do you drink at all? Just a thought.
Talk to Dr. Saya at Defy.

 

[GeauxBears]

Wanted to circle back here with an update. I think my issue was slightly too much T dosage. I was on 210mg/wk (injected 30mg/day). The past few weeks I’ve pulled back to 26mg/day and WOW the difference in so many ways. ED has gone away, I’m now responding to PDE5 inhibitors and other symptoms I was experiencing that I don’t think I realized when originally posting (high resting HR, heat intolerance, etc.) have dissipated.

90 day labs due now, so I’ll talk to the doc about this when we get the results back. Not sure why this has started to affect me now as I’ve been stable on this protocol for quite some time... the only thing I can think is that I am way more active now than I have been in the past (courtesy of Peloton), so I’m wondering if I don’t need as much as I did in the past.

It will be very interesting to see where the T levels are after this adjustment. Will post lab results when I get them.

 

[Cataceous]

@Vince Carter I dug up some old labs from a little over a year ago. I don’t think I’ve had protocol changes since then, but I can’t be sure.

Total T: 913 (348-1197)
Free T: 27.3 H (8.0-25.1)

E2-Sens: 27.0 (8-35)
Free E2, Serum: 0.81 (0.2-1.5)
Free E2, Percent: 2.9% (1.7-5.4)

SHBG: 14.5 L (16.5-55.9)

Chalk up another win for the free E2 calculator. It says 0.82 pg/mL, versus 0.81 measured.