Help - I think I have an ED problem - Dr says No.

[lunchbeast]

I'm 62 and have had ED for about 30 years. Looking back, I can see roughly when it gradually began and continued to slowly get worse over time. When Viagra and Cialis came out, they were miracle drugs for me - I couldn't have been happier with their performance. However, their effectiveness has declined over the years even as I worked my way up to the max dosage. I've alternated back and forth and tried combinations with minimal success.

I've been on HRT through Defy for a little over a year, and I'm currently using Gene's stack as documented on another thread - arginine, citrulline, horny goat weed, generic cialis, pycnogenol. The only item I'm missing is Doxazosin - I couldn't find it online anywhere w/o a prescription, but subsequent comments on that thread indicate Doxazosin isn't that critical.

When I know a sexual encounter is likely, I supplement that stack with 50mg of generic viagra a couple of hours ahead of time. This is probably the most effective system I've found in recent years, but even at that, the longest I'm able to get an erection to last is ten minutes, and it's frequently less than that - a far cry from the 45 - 60 minutes I could easily maintain an erection the first times I used viagra and cialis.

After researching extensively and finding nothing but a lot of very expensive 'maybe' options propped up by aggressive marketing, I decided to see a urologist. He seemed shocked and alarmed that I was mixing low-dose cialis with a sub-max dose of viagra, and he warned me that my HRT program made me much more susceptible to prostate cancer. He asked if I had any issues getting an erection or with premature ejaculation and I replied No to both. When I indicated my problem was that on my absolute best days I could only sustain an erection for a max of ten minutes, he replied that that was
"normal". After a long awkward pause, and some back-and-forth conversation about what I felt was normal vs what he thought, I decided I wasn't dealing with one of the more enlightened doctors I was hoping to find and wrapped up the appointment.

So, my question is, do I have the problem I think I have, or are my expectations as unrealistic as the urologist made them seem?

 

[Mountain Man]

Yes, you do. Your doctor, who has not kept current with the research, is not treating the patient, he is following the cookie cutter approach of many urologists. You can take a combination of cialis and viagra if you are in good shape and have no heart risks. My clinic encourages it, although the clinic director is Abraham Morgentaler who is the guy behind most of the research of the past 25 years. You need a more enlightened urologist, one who specializes in ED and men’s health. I take 5 of cialis daily and will take as much as 20 cialis and 100 viagra mid afternoon before planned sex. My practitioner knows and aproves.

I have a few questions to go with this. Are you in good shape? Are you working out, eating, sleeping, and doing all of that? Do you have a partner? Are you attracted to them? Do you use porn, which can waste the libidinous energy that could be channeled into in person sex? Do you and your partner have a good relationship and communication? As we age, sex can get more difficult without these boxes checked off. Consistent sex with a long time, loving- and fit - partner, can make this a lot easier and a lot more meaningful as we age. It also helps if you doctor is impressed when you take off your shirt. I truly believe that my doctors listen to me, and I research a lot so I know what to ask as well as am always familiar with any recommendations, because of this. I hardly look impressive in street clothes, but get a lot of double takes shirtless and in a tank top. Doctors often comment and ask what I do to stay in shape. Helps, because if you look like you are doing the work, they are usually open to helping, rather than blow you off as your doctor did.

Bottom line? Find a doctor who will treat you, not statistics. I personally would be disappointed with the “average” five to six minutes of penetration for intercourse. I owe myself, and my wife of 34 years, more than that. Good luck.

 

[Systemlord]

He seemed shocked and alarmed that I was mixing low-dose cialis with a sub-max dose of viagra, and he warned me that my HRT program made me much more susceptible to prostate cancer.

Run, don't walk away from this doctor. The TRT prostate cancer was a myth (belief) created by doctors without any studies showing TRT caused prostate cancer and proven untrue by Dr. Abraham Morgentaler.

It's also very common to mix Cialis and Viagra together.

Your doctor is living comfortably under a rock.

 

[lunchbeast]

Mountain Man, I sincerely appreciate your response and incite. I left out a lot of the info you asked for because I've been dealing with ED for so long that it far precedes my current condition, and all of it would be irrelevant anyway if the doctor was correct and my performance is in fact 'normal'.

I am in good shape and work out hard at least every other day and have for most of my adult life. I'm 6'1" and weigh 225 and, like you, do not typically draw any attention in normal street clothes but frequently get side glances and favorable comments with a snug t-shirt or tank top. Annual physicals and frequent blood work for my TRT plan all indicate excellent health aside from slightly elevated creatinine levels (attributed by my Defy doctor to my creatine supplementation) and a PSA score towards the high end of the acceptable range

I am currently working to get my BP back down - it has crept up to 140/70 over the past year as serious arthritis in my knees has eliminated running and squats and I'm transitioning to rowing for cardio. So far, knock on wood, I'm still able to deadlift heavy without much trouble. However, the BP issue is recent - my ED spans back over 30 years of running and lifting where my BP was consistently 110/70 and pulse was low 40's, so the recent increase, while not ideal, doesn't appear to be a major contributor.

I do have a very attractive partner, but not really long term (yet) - we've been together about six months or so, and she has been extremely understanding. As you indicated with your wife, I owe her much more than the few minutes I can presently offer. I won't completely rule out the mental aspect, but given that I can look back and see a slow steady 30 year decline, I'm 99% sure that's not the problem. I have no problem getting an erection - just a glance or wink from my woman has me pulling my shirt tails out real quick if we're in public - and I stay hard just long enough to think everything is going to work ok before it doesn't. I do last longer with the cialis/viagra/NO supps than without (that's how I sometimes make it to ten minutes), so I can't say they do nothing - they just don't work for me nearly as well as they used to. Porn use is little to zero - I don't have much use for it when I'm in a relationship.

I've researched my situation as much as I know how and I'm leaning towards venous leakage. I've read that TRT can help with that, but 12+ months of supplemental Test has not improved anything yet. As I alluded to in my post, only the pricey, more speculative, and highly marketed options - stem cells, PRP, GainWave - would appear to offer any hope of solution. Surgical repair has also been discussed in the forums, but that option appears to have very little success. However, I don't want to blindly throw money (lots!) at this without a firmer diagnosis - that's what I was hoping to move towards with the urologist.

Thanks again for your advice - I will seek out a more open-minded and enlightened doctor.

 

[madman]

I'm 62 and have had ED for about 30 years. Looking back, I can see roughly when it gradually began and continued to slowly get worse over time. When Viagra and Cialis came out, they were miracle drugs for me - I couldn't have been happier with their performance. However, their effectiveness has declined over the years even as I worked my way up to the max dosage. I've alternated back and forth and tried combinations with minimal success.

I've been on HRT through Defy for a little over a year, and I'm currently using Gene's stack as documented on another thread - arginine, citrulline, horny goat weed, generic cialis, pycnogenol. The only item I'm missing is Doxazosin - I couldn't find it online anywhere w/o a prescription, but subsequent comments on that thread indicate Doxazosin isn't that critical.

When I know a sexual encounter is likely, I supplement that stack with 50mg of generic viagra a couple of hours ahead of time. This is probably the most effective system I've found in recent years, but even at that, the longest I'm able to get an erection to last is ten minutes, and it's frequently less than that - a far cry from the 45 - 60 minutes I could easily maintain an erection the first times I used viagra and cialis.

After researching extensively and finding nothing but a lot of very expensive 'maybe' options propped up by aggressive marketing, I decided to see a urologist. He seemed shocked and alarmed that I was mixing low-dose cialis with a sub-max dose of viagra, and he warned me that my HRT program made me much more susceptible to prostate cancer. He asked if I had any issues getting an erection or with premature ejaculation and I replied No to both. When I indicated my problem was that on my absolute best days I could only sustain an erection for a max of ten minutes, he replied that that was
"normal". After a long awkward pause, and some back-and-forth conversation about what I felt was normal vs what he thought, I decided I wasn't dealing with one of the more enlightened doctors I was hoping to find and wrapped up the appointment.

So, my question is, do I have the problem I think I have, or are my expectations as unrealistic as the urologist made them seem?

Pick a study!

post #5

TRT and prostate cancer

Introduction: It has been well established that male hypogonadism has a significant impact on patient quality of life and that replacement of testosterone can markedly improve symptoms and potentially offer a protective effect. The connection between testosterone replacement therapy (TRT) and...

www.excelmale.com

TRT in the Setting of Prostate Cancer

Abstract Since the 1940s, elevated serum testosterone (T) levels have been infamously suggested as a causal factor in the development of prostate cancer (PCa); this time was also the dawn of both surgically and pharmacologically induced castration. However, men suffering from primary or...

www.excelmale.com

 

[madman]

Alternative Treatment for ED

Abstract Purpose of Review To highlight and review encouraging preliminary studies behind several alternative products and interventions for erectile dysfunction (ED). Recent Findings Alternative treatments for ED are becoming more prevalent with increased consumer interest. “Natural” products...

www.excelmale.com

does PDE5 inhibitors downregulate NO production?

I'm considering to start a daily or most days or the week 5mg Tadalafil to help in reversing Peyronies diseases (PD), I don't have any erection issues, but to my understanding it is really important to have a "solid" erection during sex not to worsen PD. I'm 34 years old now, and I'm wondering...

www.excelmale.com

 

[VacationMan]

Kick that doc to the curb and let Defy help you out instead.

 

[lunchbeast]

Defy is who I've been working with for my HRT, and I've frankly been a little underwhelmed. Looking at switching clinics...

 

[NoVa Biker]

Mountainman, I was in your same situation at about your age. For me, trimix was the answer. Later I also went on TRT. I don't think TRT had much effect on my sexual ability.

 

[VacationMan]

Defy is who I've been working with for my HRT, and I've frankly been a little underwhelmed. Looking at switching clinics...

To be honest, HRT has helped me tremendously...not so much from the standpoint of erections, but from many other quality of life aspects. I no longer suffer from brain fog and can concentrate at work. I now sleep like a baby and wake up fully refreshed every morning, with no form of pain and ready to seize the day...every day.

From the erection standpoint, HRT hasn't been "the" answer. Neither Viagra or Cialis helped either. Viagra just makes me stuffy and gave me blue vision. Cialis might as well be a sugar pill that gives me a bit of lower back pain. The solution? TriMix! My PA at Defy approved me for TriMix and it's been the bomb!

Incidentally, my PCP noticed that I had thyroid issues...but didn't know how to address it effectively. It was Defy Medical that guided me through all that (I have a pretty severe case of Hashimotos). My PCP was clueless, Defy was spot on.

So to think you're underwhelmed by the service by Defy kind of defies my personal experience. Your urologist is an idiot (so was mine). I kicked my urologist to the curb because he didn't understand how to correctly treat male hormone issues much less what exactly to test, and it was the best decision I ever made. Defy is my go-to for all things HRT now.

Standard disclaimers apply: Batteries not included, some assembly required, no warranties expressed or implied...etc.

 

[Mountain Man]

Mountainman, I was in your same situation at about your age. For me, trimix was the answer. Later I also went on TRT. I don't think TRT had much effect on my sexual ability.

Thanks. I am having a great result with this regimen. Thirty to forty minutes has become the norm and I will definitely consider trimix if it comes to that.

 

[lunchbeast]

Alternative Treatment for ED

Abstract Purpose of Review To highlight and review encouraging preliminary studies behind several alternative products and interventions for erectile dysfunction (ED). Recent Findings Alternative treatments for ED are becoming more prevalent with increased consumer interest. “Natural” products...

www.excelmale.com

does PDE5 inhibitors downregulate NO production?

I'm considering to start a daily or most days or the week 5mg Tadalafil to help in reversing Peyronies diseases (PD), I don't have any erection issues, but to my understanding it is really important to have a "solid" erection during sex not to worsen PD. I'm 34 years old now, and I'm wondering...

www.excelmale.com

Thanks Madman - I'd read through all those links and articles on alternative treatments while trying to figure out why my own ED issues have become increasingly resistant to the PDE5's. I'm leaning toward venous leakage and I was expecting the urologist to ask enough questions to help confirm whether that's the direction I need to move for treatment or if there's something else to try that I've overlooked. That said, given everything I've read on excelmale about venous leakage, there does not appear to be any treatment with a high success rate anyway...