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It's routinely stated that nocturnal erections are important for penile health, providing necessary blood flow and thus oxygenation [R]. In hindsight my attenuated nocturnal erections could have been the canary in the coal mine, warning of the overt hypogonadism to come in a few years. Conventional TRT did restore nocturnal erections, but not with consistency. I've only regained consistency in the past year or two with unconventional protocols.