Erectile Dysfunction Explained - Why testosterone is sometimes not enough to correct

[endopa-c]

http://www.merckmanuals.com/professional/genitourinary-disorders/male-sexual-dysfunction/erectile-dysfunction?tag=mail

Key Points

Vascular, neurologic, psychologic, and hormonal disorders and sometimes drug use can compromise achievement of satisfactory erections.

Evaluate all men with ED for hormonal, neurologic, and vascular disorders and depression.

Measure testosterone levels and consider other testing based on clinical findings.

Treat underlying disorders and use an oral PDE5 inhibitor if necessary.

If those measures are ineffective, consider intracavernosal or intraurethral prostaglandin E1 or use of a vacuum device; surgical implantation of a penile prosthesis is the final line of treatment.

 

[CoastWatcher]

Thanks for the link. No more print editions of the Merck every five years!

 

[ERO]

A bigger issue for a fair number of TRT users, IMHO, is that their libido gets worse, not better on TRT. Then you have both ED and lowered libido to try to deal with.

 

[thecarter72]

A bigger issue for a fair number of TRT users, IMHO, is that their libido gets worse, not better on TRT. Then you have both ED and lowered libido to try to deal with.

Interesting, I've noticed the same with myself, though not consistently. Have you seen data or studies to back this up or is it just an observation?

 

[Vince Carter]

Its anecdotal reports...many men moving in to TRT find a whole buffet of ancillary problems...Thyroid, Adrenal, pre/Diabetes, Cholesterol, Prostate, et al.., that all roll up in to one. Add in mismanaged treatment protocols that get lumped in to "TRT made things worse".

 

[madman]

Its anecdotal reports...many men moving in to TRT find a whole buffet of ancillary problems...Thyroid, Adrenal, pre/Diabetes, Cholesterol, Prostate, et al.., that all roll up in to one. Add in mismanaged treatment protocols that get lumped in to "TRT made things worse".

So true, so much more involved but many seem to blame trt!

 

[HarryCat]

Interesting, I've noticed the same with myself, though not consistently. Have you seen data or studies to back this up or is it just an observation?

It has certainly been true in my case. Clear cut drop in libido and increase in ED after starting TRT, despite ideal labs and consulting the top TRT doctors in the US. It's rare, but it happens.

 

[ERO]

Agreed. I am working with one of the top TRT docs in the country with a state-of-the-art protocol.

 

[madman]

Seems that when we are young all our brain chemicals are working optimally.....................the most insignificant things seem to bring joy and aside to having a genetic predisposition for chemical imbalances it makes you wonder that by the time we go through our teenage years and become young adults so many people seem to have some level of neurotransmitter damage/function maybe related to drug/alcohol abuse/toxins/unhealthy addictions/bad relationships/prescription drugs. I honestly think neurotransmitter imbalances play a strong role in libido/ed issues trt or not!https://bebrainfit.com/balance-neurotransmitters/

 

[HarryCat]

Interesting, I've noticed the same with myself, though not consistently. Have you seen data or studies to back this up or is it just an observation?

Here is a thread with a link to a study that talks about this:
https://www.excelmale.com/forum/sho...nes-How-Well-You-Will-Respond-to-Testosterone

From the study referenced in that thread:

"However, in view of our results, the largenumber of subjects who are not sexually responsiveto TRT could actually result from the modulatoryeffect of CAG polymorphism; therefore, a reassessmentof TRT effects on sexual parameters, alsoconsidering AR gene CAG repeat number and performedon a large number of cases, could help usto shed more light on the subject."

 

[Mr_Self_Destruct]

http://www.merckmanuals.com/professional/genitourinary-disorders/male-sexual-dysfunction/erectile-dysfunction?tag=mail
surgical implantation of a penile prosthesis is the final line of treatment.

As a 35yo with ED the thought of this terrifies me.