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Hey ExcelMale,
I was wondering if anyone knows of SKILLED docs in or near New York for Erectile Dysfunction (arteriogenic dysfunction confirmed during penile doppler scan) and libido issues. I don't mind traveling a few hours if needed. Based on past experiences, I have no interest in visiting any random local doctor without doing research. After doing research, I became a patient of Dr.Saya thru telemedicine. He has me on tadalafil and is treating low T to combat ED/low libido. Together, both definitely helped the plumbing and libido to some degree. He’s knowledgeable and I only have good things to say about him. Even so, for something I need to be committed to for probably the REST of my life, a 2nd opinion from another skilled doc can't hurt and can only help. With a 2nd opinion from a local doc, I can:

1. Go over current protocol and get opinions on other ways to treat ED that may only be available locally. I've only recently heard of shockwave therapy. The little I read so far sounds promising. I read about it on Dr. Michael Werner's website (Anyone try him?). I'm also a low SHBG guy, so I’m only willing to inject more frequently if there’s no other better solution.

2. See if doc can help find the cause for arteriogenic dysfunction in a young male, and rule out any serious issues that ED is a sign of like heart disease/atherosclerosis. While I believe Dr. Saya ruled out some causes, the cause remains unknown. Knowing cause can help figure out best solution. The cause may/may not be related to 4 other health issues I have (none of which bother me as much as ED):

-Despite being active and eating normal, my cholesterol is often on the high side since I was a teen. Maybe genetics. For me, eating a low fat plant-based diet lowers these #s greatly, and eating a low-carb ‘paleo’ diet raises the bad/good cholesterol greatly. I realized the thought of having to eat a restrictive diet for rest of my life is almost as depressing as ED. There’s pleasure in eating variety of foods socially. I think plant-based diet helped my ED a bit, but made me feel weaker. Low carb made ED worse, but made me feel stronger. Now I just eat mostly clean without restricting food groups. Exercising and eating clean without restrictions is hard enough for most people, so that’s as far as I prefer to go diet-wise.

-2-3x a week or so, stool is loose. I had a colonoscopy done that came back fine. Just benign polyps. Doc thinks cause depends on what I eat and suggested an elimination diet, starting with eliminating gluten. I believe to confirm celiac. I think diarrhea’s a sign of not absorbing food properly which can cause many health problems. While I tested eliminating some food groups, I wasn’t thorough. It’s on the list of things to do. For now, I’m testing if eating more probiotics and fiber helps. I believe it’s best to add more healthy foods that may target the problem to see if that helps enough, instead of going straight to restricting healthy foods you love. I also just started testing out a serving of psylium husk daily to combat diarrhea AND lower cholesterol!

-Moderate pains all on the left side of my body (leg/core & neck/eye region). Right side of body is perfect. L5-S1 disc herniation and mild levoscoliosis was found which may be the cause of left leg/core pain. Not much was found with neck/eye, except 1 chiropractor mentioned arthritis seen in an x-ray. As part of exercise, I’ve been strengthening/stretching for years. Maybe helps to stop pain from getting worse, but doesn’t help much to get it better.

-Occasional eczema

Thanks for any help.

<blockquote data-quote="Bentiger07" data-source="post: 124911" data-attributes="member: 13543">Hey ExcelMale,I was wondering if anyone knows of SKILLED docs in or near New York for Erectile Dysfunction (arteriogenic dysfunction confirmed during penile doppler scan) and libido issues. I don&#039;t mind traveling a few hours if needed. Based on past experiences, I have no interest in visiting any random local doctor without doing research. After doing research, I became a patient of Dr.Saya thru telemedicine. He has me on tadalafil and is treating low T to combat ED/low libido. Together, both definitely helped the plumbing and libido to some degree. He’s knowledgeable and I only have good things to say about him. Even so, for something I need to be committed to for probably the REST of my life, a 2nd opinion from another skilled doc can&#039;t hurt and can only help. With a 2nd opinion from a local doc, I can:1. Go over current protocol and get opinions on other ways to treat ED that may only be available locally. I&#039;ve only recently heard of shockwave therapy. The little I read so far sounds promising. I read about it on Dr. Michael Werner&#039;s website (Anyone try him?). I&#039;m also a low SHBG guy, so I’m only willing to inject more frequently if there’s no other better solution.2. See if doc can help find the cause for arteriogenic dysfunction in a young male, and rule out any serious issues that ED is a sign of like heart disease/atherosclerosis. While I believe Dr. Saya ruled out some causes, the cause remains unknown. Knowing cause can help figure out best solution. The cause may/may not be related to 4 other health issues I have (none of which bother me as much as ED):-Despite being active and eating normal, my cholesterol is often on the high side since I was a teen. Maybe genetics. For me, eating a low fat plant-based diet lowers these #s greatly, and eating a low-carb ‘paleo’ diet raises the bad/good cholesterol greatly. I realized the thought of having to eat a restrictive diet for rest of my life is almost as depressing as ED. There’s pleasure in eating variety of foods socially. I think plant-based diet helped my ED a bit, but made me feel weaker. Low carb made ED worse, but made me feel stronger.&nbsp; Now I just eat mostly clean without restricting food groups. Exercising and eating clean without restrictions is hard enough for most people, so that’s as far as I prefer to go diet-wise.-2-3x a week or so, stool is loose. I had a colonoscopy done that came back fine. Just benign polyps. Doc thinks cause depends on what I eat and suggested an elimination diet, starting with eliminating gluten. I believe to confirm celiac. I think diarrhea’s a sign of not absorbing food properly which can cause many health problems. While I tested eliminating some food groups, I wasn’t thorough. It’s on the list of things to do. For now, I’m testing if eating more probiotics and fiber helps. I believe it’s best to add more healthy foods that may target the problem to see if that helps enough, instead of going straight to restricting healthy foods you love. I also just started testing out a serving of psylium husk daily to combat diarrhea AND lower cholesterol!-Moderate pains all on the left side of my body (leg/core &amp; neck/eye region). Right side of body is perfect. L5-S1 disc herniation and mild levoscoliosis was found which may be the cause of left leg/core pain. Not much was found with neck/eye, except 1 chiropractor mentioned arthritis seen in an x-ray. As part of exercise, I’ve been strengthening/stretching for years. Maybe helps to stop pain from getting worse, but doesn’t help much to get it better.-Occasional eczemaThanks for any help.</blockquote>

[QUOTE="Bentiger07, post: 124911, member: 13543"] Hey ExcelMale, [B][U]I was wondering if anyone knows of SKILLED docs in or near New York for Erectile Dysfunction (arteriogenic dysfunction confirmed during penile doppler scan) and libido issues.[/U][/B] I don't mind traveling a few hours if needed. Based on past experiences, I have no interest in visiting any random local doctor without doing research. After doing research, I became a patient of Dr.Saya thru telemedicine. He has me on tadalafil and is treating low T to combat ED/low libido. Together, both definitely helped the plumbing and libido to some degree. He’s knowledgeable and I only have good things to say about him. Even so, for something I need to be committed to for probably the REST of my life, a 2nd opinion from another skilled doc can't hurt and can only help. With a 2nd opinion from a local doc, I can: 1. Go over current protocol and get opinions on other ways to treat ED that may only be available locally. I've only recently heard of [B][I]shockwave therapy[/I][/B]. The little I read so far sounds promising. I read about it on Dr. Michael Werner's website (Anyone try him?). I'm also a low SHBG guy, so I’m only willing to inject more frequently if there’s no other better solution. 2. See if doc can help find the cause for arteriogenic dysfunction in a young male, and rule out any serious issues that ED is a sign of like [B][I]heart disease/atherosclerosis[/I].[/B] While I believe Dr. Saya ruled out some causes, the cause remains unknown. Knowing cause can help figure out best solution. The cause may/may not be related to 4 other health issues I have (none of which bother me as much as ED): -Despite being active and eating normal, my [B][I]cholesterol is often on the high side[/I] [/B]since I was a teen. Maybe genetics. For me, eating a low fat plant-based diet lowers these #s greatly, and eating a low-carb ‘paleo’ diet raises the bad/good cholesterol greatly. I realized the thought of having to eat a restrictive diet for rest of my life is almost as depressing as ED. There’s pleasure in eating variety of foods socially. I think plant-based diet helped my ED a bit, but made me feel weaker. Low carb made ED worse, but made me feel stronger. Now I just eat mostly clean without restricting food groups. Exercising and eating clean without restrictions is hard enough for most people, so that’s as far as I prefer to go diet-wise. -[B][I]2-3x a week or so, stool is loose[/I][/B][I].[/I] I had a colonoscopy done that came back fine. Just benign polyps. Doc thinks cause depends on what I eat and suggested an elimination diet, starting with eliminating gluten. I believe to confirm celiac. I think diarrhea’s a sign of not absorbing food properly which can cause many health problems. While I tested eliminating some food groups, I wasn’t thorough. It’s on the list of things to do. For now, I’m testing if eating more probiotics and fiber helps. I believe it’s best to add more healthy foods that may target the problem to see if that helps enough, instead of going straight to restricting healthy foods you love. I also just started testing out a serving of psylium husk daily to combat diarrhea AND lower cholesterol! -[B][I]Moderate pains all on the left side of my body (leg/core & neck/eye region).[/I][/B] Right side of body is perfect. L5-S1 disc herniation and mild levoscoliosis was found which may be the cause of left leg/core pain. Not much was found with neck/eye, except 1 chiropractor mentioned arthritis seen in an x-ray. As part of exercise, I’ve been strengthening/stretching for years. Maybe helps to stop pain from getting worse, but doesn’t help much to get it better. -Occasional eczema Thanks for any help. [/QUOTE]

Verification

TRT Hormone Predictor Widget

Understanding Your Hormones

Estradiol (E2)

A form of estrogen produced from testosterone. Important for bone health, mood, and libido. Too high can cause side effects; too low can affect well-being.

DHT

Dihydrotestosterone is a potent androgen derived from testosterone. Affects hair growth, prostate health, and masculinization effects.

Free Testosterone

The biologically active form of testosterone not bound to proteins. Directly available for cellular uptake and biological effects.

Scientific Reference

Lakshman KM, Kaplan B, Travison TG, Basaria S, Knapp PE, Singh AB, LaValley MP, Mazer NA, Bhasin S. The effects of injected testosterone dose and age on the conversion of testosterone to estradiol and dihydrotestosterone in young and older men. J Clin Endocrinol Metab. 2010 Aug;95(8):3955-64.

DOI: 10.1210/jc.2010-0102 | PMID: 20534765 | PMCID: PMC2913038