Is my ED physical, psychological or hormonal?

[TestBoosted]

Much more like your natural test production and better DHT conversion and estrogen management. IMO the best TRT protocol.

Thank you Kemp! Will look into this!

 

[TestBoosted]

I tend to agree with you that with my numbers, I don't think my hormones are the problem. I was going to try one final protocol of 40mg on Monday, Wednesday and Friday. I doubt it will help though, especially since 10mg of cialis is not working. Do you think it is worth a shot?


No harm in trying as you have room to bring up your trough FT if need be but again highly doubtful your issues with ED are due to your FT level.




I am currently also reducing my anafranil to switch completely to Trazadone under the supervision of my psychiatrist.

I am also abstaining completely from porn (3 weeks in) to see if that makes a difference.

I also have an appointment lined up with a pelvic floor therapist to see if there are any issues with my pelvic floor.


Smart move ditching the Anafranil as it poses a higher risk for sexual dysfunction (ED, reduced libido ejaculatory issues) due to its strong serotonin reuptake inhibition.

* Anafranil, a tricyclic antidepressant, frequently causes sexual dysfunction, including ED and ejaculatory problems, because it potently blocks serotonin transporters

Thank you madman. I have upped my testosterone dosage to 40mg x3 per week. Will see if it makes a difference.

Since a week ago, I have reduced the Anafranil to 5mg everyday, so far I feel my depression is under contril.

 

[TestBoosted]

After the response I just got, I would drop your original post into ChatGPT. Seriously.

Thank you wondering.

I did put my original question in both ChatGPT and Gemini with the 'Thinking' model. Both of them gave me similar responses.

Number 1 suggestion was to see a pelvic floor therapist. Got an appointment lined up in 2 weeks.

Number 2 suggestion was to remove the Anafranil. Currently reducing the dosage until I can get rid of it completely.

They also suggestrd that the issue can be a physical venous leak, in which case I can try Trimix and an implant as a final resort

 

[TestBoosted]

Everyone on the forums so caught up T and this needing a high/absurdly high FT/DHT when it comes to libido/erectile function!

It's a MYTH that needs to be put to rest!

Much more involved here than T and its metabolites estradiol and DHT when it comes to erectile dysfunction.

Having healthy hormones is essential but you need to understand that erectile dysfunction let alone libido are complex and multifactorial.


*ED is a condition that affects a multitude of men and is multifactorial in its etiology

*There is a multitude of etiologies for ED, including vasculogenic, neurogenic, psychogenic, endocrinologic, and medication-induced ED

Post in thread 'Testosterone + Men's Sexual Health'

Nov 10, 2024

14:20-16:47 (erections/erectile dysfunction)


You need 5 things to get a good erection:

1. good blood flow
2. good nerves
3. good testosterone levels
4. neurotransmitters/arousal
5. state of mind

• madman

4:20-16:47 (erections/erectile dysfunction)


You need 5 things to get a good erection:

1. good blood flow
2. good nerves
3. good testosterone levels
4. neurotransmitters/arousal
5. state of mind








* “A lot of people think that testosterone controls erectile function, and therefore, ‘I have ED, so I’m going to go to the low-T center and get more testosterone for my ED,’” he says. “That may help if they have low T, but if they have normal T or if their T is even just a little bit low, that’s probably not the primary thing that’s causing their erectile dysfunction, nor is it the primary treatment.”

Thread 'Is Morning Wood a Sign of Good Testosterone?'

Jan 26, 2025

This needs to be hammered home!

Dr. Sun hits the nail on the head here!

* “A lot of people think that testosterone controls erectile function, and therefore, ‘I have ED, so I’m going to go to the low-T center and get more testosterone for my ED,’” he says. “That may help if they have low T, but if they have normal T or if their T is even just a little bit low, that’s probably not the primary thing that’s causing their erectile dysfunction, nor is it the primary treatment.”...

• madman
• hypogonadism; t-therapy; erections; men's health
• Replies: 18
• Forum: Testosterone and Men's Health Articles

• 

Thread 'Neurovascular control of penile erection'

Mar 15, 2025

Neurovasculat control of penile erection

• madman
• ed; neurogenic/vascular; endothelium
• Replies: 15
• Forum: When TRT Is Not Enough (ED, Libido, & More)

• 

Thread 'Neural and Vascular Regulation of ED Development'

Mar 14, 2025

• madman
• ed; pathogenesis; neurogenic; vascular
• Replies: 6
• Forum: When TRT Is Not Enough (ED, Libido, & More)

Thread 'The hormonal regulation of men’s sexual desire, arousal, and penile erection'

Jun 20, 2025

Briefing Document: Hormonal Regulation of Male Sexual Desire, Arousal, and Penile Erection​

Source​

• Rastrelli, G., Antonio, L., Carrier, S., Isidori, A., & Maggi, M. (2025). The hormonal regulation of men’s sexual desire, arousal, and penile erection: recommendations from the fifth international consultation on sexual medicine (ICSM 2024). Sexual Medicine Reviews, 2025, 1–23.

Overview​

This invited review from Sexual Medicine Reviews (2025) provides an extensive, evidence-based overview of the hormonal and neurochemical regulation of male sexual...

• madman
• hormones' erectile function; sexual desire
• Replies: 7
• Forum: When TRT Is Not Enough (ED, Libido, & More)

• 

Thank you so much madman.

Will read and process this information. You truly are a gem of information!

 

[Guided_by_Voices]

A general comment; erection quality is always a combination of things across the spectrum you listed, as well as others such as pheromone-like signaling from your partner. My approach and recommendation is to always be looking to maximize all of them as best you can. It's way too complicated to narrow down to just one thing, and even if you were optimized, things can change over time so it is best to address them all.

 

[TestBoosted]

A general comment; erection quality is always a combination of things across the spectrum you listed, as well as others such as pheromone-like signaling from your partner. My approach and recommendation is to always be looking to maximize all of them as best you can. It's way too complicated to narrow down to just one thing, and even if you were optimized, things can change over time so it is best to address them all.

Thank you for your comment and hope you had a wonderful Christmas.

I agree, I'm trying to tackle it from all angles. By reviewing antidepressant medication, losing weight, optimizing my TRT levels and so on. Hope that I manage to find a solution as for the past 3 years function has been very poor and nothing seems to be working for me. Wish me luck, I will definitely need it.

 

[wondering]

Thank you so much for this valuable information, really appreciate it!

Before I did the NPT (Nocturnal penile tumescense test), I was 99% convinced that I had venous leak. However, the NPT suggested I had 3 erectile episodes lasting 1 hour at 85% rigidity, which then put me in doubt whether my ED is truly psychological or caused by the antidepressants.

I have some questions regarding this:

i) Can depression or the anti depressants lead to NO response to Cialis, Viagra and Levitra?
ii) Can depression or the anti depressants lead to NO response to Caverject? Tried Caverject 5 times, with the same response each time (60% erection, penis head still soft)

iii) Can depression or the anti depressants cause the veins in the penis to NOT constrict when aroused, thus leading to loss of erection? In other words, can depression or the antidepressants mimic a venous leak?


Regarding dynamic cavernosography, I am interested in trying it. Do you know of any hospital or clinics in the UK, Italy, Spain or somewhere else in Europe that do this test? Unfortunately, only the Penile Doppler is done in my country.

Also regarding dynamic cavernosography, will it still give a correct result irrespective of the depression or anti depressants? In other words, is there a way for me to know that my erectile dysfunction is 100% being caused by a physical issue and NOT a psychological or medication issue?

Thank you so much!

Yes. At your age, the depression and anti-depressants are the most likely cause vs rarer things. People on forums like to dig in and go right to rare things and unique treatments. As the late Dr. Crisler would say - "when you hear hoofbeats, think horses not zebras."

 

[TestBoosted]

Yes. At your age, the depression and anti-depressants are the most likely cause vs rarer things. People on forums like to dig in and go right to rare things and unique treatments. As the late Dr. Crisler would say - "when you hear hoofbeats, think horses not zebras."

Hi guys,

Hope all is well and that everyone is doing fine.

I have 2 updates regarding my situation.

I went to a pelvic floor physiotherapist and she examined my pelvic floor both externally and internally. When she was doing the external examination and putting pressure on my pelvis, I felt a lot of pain. She told me this was not normal.

She then proceeded to examine me internally and said that I had a very tight pelvic floor and that she could feel a very stiff (like a guitar chord) muscle near my penis.

Out of 10, she rated my tightness a 9.

She gave me stretching and diaphram breathing exercises at home and will be visiting her weekly or bi weekly for internal messages and exercises.

In addition, I purchased the FirmTech TechRing and it is showing me that I do have around 3 erections, lasting around 20 minutes each at around 80% rigidity at night.

We'll see how it goes with the pelvic floor exercises.

 

[iago009]

Hi guys,

Hope all is well and that everyone is doing fine.

I have 2 updates regarding my situation.

I went to a pelvic floor physiotherapist and she examined my pelvic floor both externally and internally. When she was doing the external examination and putting pressure on my pelvis, I felt a lot of pain. She told me this was not normal.

She then proceeded to examine me internally and said that I had a very tight pelvic floor and that she could feel a very stiff (like a guitar chord) muscle near my penis.

Out of 10, she rated my tightness a 9.

She gave me stretching and diaphram breathing exercises at home and will be visiting her weekly or bi weekly for internal messages and exercises.

In addition, I purchased the FirmTech TechRing and it is showing me that I do have around 3 erections, lasting around 20 minutes each at around 80% rigidity at night.

We'll see how it goes with the pelvic floor exercises.

Hello mate, how do you feel now?

 

[TestBoosted]

Hello mate, how do you feel now?

Hello iago009

Unfortunately still no change regarding my erections, even after 3 months of physiotherapy.

FirmTech TechRing shows I do have strong erections (Level 10) at night, so that is encouraging.

My TSH (hovers around 3.0 micIU/ml or more) and my insulin resistance are borderline and not optimized, even though I eat healthy and am at a healthy weight. My latest HBA1C was 5.7%, and this was after 4 months of low carb dieting, walking 5 times a day and losing 7kg. I am now at 18% body fat. Furthermore, my HDL is always around 0.7 to 0.85 nmol/L and never goes beyond the 1 nmol/L threshold.

I have read that all of these conditions (collectively called metabolic syndrome) usually first impact the small arteries and veins of the penis before affecting the heart and rest of the body, as they are some of the tiniest in the body.

I have accepted that my insulin resistance, thyroid and cholesterol factors are likely genetic (My father discovered he was Type 2 diabetic at 30, I am now almost 34). For this reason, around a week ago I started 1000mg metformin, 25 mcg Levothyroxine and around 2000mg Omega 3 daily. Let's see if this makes a difference.

 

[iago009]

Hello iago009

Unfortunately still no change regarding my erections, even after 3 months of physiotherapy.

FirmTech TechRing shows I do have strong erections (Level 10) at night, so that is encouraging.

My TSH (hovers around 3.0 micIU/ml or more) and my insulin resistance are borderline and not optimized, even though I eat healthy and am at a healthy weight. My latest HBA1C was 5.7%, and this was after 4 months of low carb dieting, walking 5 times a day and losing 7kg. I am now at 18% body fat. Furthermore, my HDL is always around 0.7 to 0.85 nmol/L and never goes beyond the 1 nmol/L threshold.

I have read that all of these conditions (collectively called metabolic syndrome) usually first impact the small arteries and veins of the penis before affecting the heart and rest of the body, as they are some of the tiniest in the body.

I have accepted that my insulin resistance, thyroid and cholesterol factors are likely genetic (My father discovered he was Type 2 diabetic at 30, I am now almost 34). For this reason, around a week ago I started 1000mg metformin, 25 mcg Levothyroxine and around 2000mg Omega 3 daily. Let's see if this makes a difference.

Hello, thanks a lot for letting me know. Can you share a chart of Firmtech just to see how It looks like? This is, my doctor is also telling me my ED is psycological since Firmtech shows several erections that last around 30 minutes almost 10/10. However I have a lot of problems to keep an erection longer than 5 seconds. I do not have any issue such us diabetes or such thing. Maybe Firmtech do not monotorize correct?

 

[Gman86]

Hello iago009

Unfortunately still no change regarding my erections, even after 3 months of physiotherapy.

FirmTech TechRing shows I do have strong erections (Level 10) at night, so that is encouraging.

My TSH (hovers around 3.0 micIU/ml or more) and my insulin resistance are borderline and not optimized, even though I eat healthy and am at a healthy weight. My latest HBA1C was 5.7%, and this was after 4 months of low carb dieting, walking 5 times a day and losing 7kg. I am now at 18% body fat. Furthermore, my HDL is always around 0.7 to 0.85 nmol/L and never goes beyond the 1 nmol/L threshold.

I have read that all of these conditions (collectively called metabolic syndrome) usually first impact the small arteries and veins of the penis before affecting the heart and rest of the body, as they are some of the tiniest in the body.

I have accepted that my insulin resistance, thyroid and cholesterol factors are likely genetic (My father discovered he was Type 2 diabetic at 30, I am now almost 34). For this reason, around a week ago I started 1000mg metformin, 25 mcg Levothyroxine and around 2000mg Omega 3 daily. Let's see if this makes a difference.

What’s ur diet look like? I know I beat a dead horse on here about diet, but 99% of the time whenever someone says they eat healthy, they’re not

Genetics obv play a role in our health, but epigenetics can play an even bigger role. Epigenetics are what parts of ur genetics that get turned on and off based on lifestyle factors. So don’t think u have to have poor metabolic health simply because of a familial history of people with poor metabolic health. My grandfather had diabetes for years, but I’ll personally never have diabetes. Simply because I know exactly what I need to do to avoid it. My labs always come back stellar, in regards to metabolic health, and risk factors in bloodwork associated with diabetes specifically. I’ll be 40 this year, for reference

And a TSH of 3 is definitely indicative of hypothyroidism. Another issue usually very easy to correct

So ya let me know what a regular day to day diet looks like for u, and I can help u get rid of the foods that are causing ur issues, and give u food options to replace those foods with that will help correct ur health issues

I can also give u some tips to improve cardiovascular health, improve blood flow, and thus improve erections

 

[TestBoosted]

What’s ur diet look like? I know I beat a dead horse on here about diet, but 99% of the time whenever someone says they eat healthy, they’re not

Genetics obv play a role in our health, but epigenetics can play an even bigger role. Epigenetics are what parts of ur genetics that get turned on and off based on lifestyle factors. So don’t think u have to have poor metabolic health simply because of a familial history of people with poor metabolic health. My grandfather had diabetes for years, but I’ll personally never have diabetes. Simply because I know exactly what I need to do to avoid it. My labs always come back stellar, in regards to metabolic health, and risk factors in bloodwork associated with diabetes specifically. I’ll be 40 this year, for reference

And a TSH of 3 is definitely indicative of hypothyroidism. Another issue usually very easy to correct

So ya let me know what a regular day to day diet looks like for u, and I can help u get rid of the foods that are causing ur issues, and give u food options to replace those foods with that will help correct ur health issues

I can also give u some tips to improve cardiovascular health, improve blood flow, and thus improve erections

Thank you so much Gman86 for your kindness and offer to help, really appreciate it.

Alright, so when it comes to drinks, I don't drink alcohol, juices or sugary drinks. The only exception is maybe one small glass of diet cola with my lunch. Apart from that, I only drink water.


The below is an example of what I eat in a typical day after guidance from dietician. This diet plan led to improvement from 3.89 to 2.27 HOMA-IR, 15.7 to 9.7 fasting insulin but HBA1C went from 5.5% to 5.7%.


Morning

35g Branflakes
Half cup skimmed milk
10 bluberries


Mid-Morning

5 tablespoons Greek yogurt 0% fat (Around 4g carbohydrates per 100g)
15 almonds
3 slices lean turkey
1 small apple


Lunch

250g chicken or pork or beef
4 to 5 tablespoons of brown rice
Mixed vegetables

OR

100g brown pasta
100 g chicken
Once or twice a week


Snack

5 tablespoons Greek yogurt 0% fat (Around 4g carbohydrates per 100g)
15 almonds
3 slices lean turkey


Dinner

Omelette with 2 eggs, tuna
100g chicken

OR

Caponata
Tuna


This is what my typical day of eating looks like right now.

In the weekend, I usually indulge in a pizza, burger or pasta as a cheat meal (once, sometimes twice). Again, no drinking alcohol or soft drinks. During the week I am strict with my diet.

What do you think about this please? Do you think there are some serious offenders?

 

[TestBoosted]

Hello, thanks a lot for letting me know. Can you share a chart of Firmtech just to see how It looks like? This is, my doctor is also telling me my ED is psycological since Firmtech shows several erections that last around 30 minutes almost 10/10. However I have a lot of problems to keep an erection longer than 5 seconds. I do not have any issue such us diabetes or such thing. Maybe Firmtech do not monotorize correct?

Sure iago009. Let me get on my mobile phone and upload some screenshots of my FirmTech TechRing readings.

 

[TestBoosted]

Sure iago009. Let me get on my mobile phone and upload some screenshots of my FirmTech TechRing readings.

Hi iago009.

Here are my readings.

The first 4 are when I wore my FirmTech TechRing properly, that is, putting my testicles through the loop to keep the device firm in place. Unfortunately, this wakes me up after 3 hours with pain in my testicles and I have to remove the device and stop the recording.

The last 2 are when I wore it around the shaft only to get a longer reading, however I don't know how accurate these 2 readings are. The one with 3 peaks looks reliable, but I doubt the other one with one peak and then going down to a plateau of 5 for a long time is reliable.

 

[iago009]

Hi iago009.

Here are my readings.

The first 4 are when I wore my FirmTech TechRing properly, that is, putting my testicles through the loop to keep the device firm in place. Unfortunately, this wakes me up after 3 hours with pain in my testicles and I have to remove the device and stop the recording.

The last 2 are when I wore it around the shaft only to get a longer reading, however I don't know how accurate these 2 readings are. The one with 3 peaks looks reliable, but I doubt the other one with one peak and then going down to a plateau of 5 for a long time is reliable.

Thanks for sharing mate. Your charts look good to be honest. FYI, I put the ring around the shaft as well, the other way is just to keep erection (that was my understanding). Another question, when you made the doppler, did they mentioned you have VL or blood flow was just correct? We need to keep working together to find an improvement, some guys I talked too told me that Kegels have helped them a lot.

 

[Gman86]

Thank you so much Gman86 for your kindness and offer to help, really appreciate it.

Alright, so when it comes to drinks, I don't drink alcohol, juices or sugary drinks. The only exception is maybe one small glass of diet cola with my lunch. Apart from that, I only drink water.


The below is an example of what I eat in a typical day after guidance from dietician. This diet plan led to improvement from 3.89 to 2.27 HOMA-IR, 15.7 to 9.7 fasting insulin but HBA1C went from 5.5% to 5.7%.


Morning

35g Branflakes
Half cup skimmed milk
10 bluberries


Mid-Morning

5 tablespoons Greek yogurt 0% fat (Around 4g carbohydrates per 100g)
15 almonds
3 slices lean turkey
1 small apple


Lunch

250g chicken or pork or beef
4 to 5 tablespoons of brown rice
Mixed vegetables

OR

100g brown pasta
100 g chicken
Once or twice a week


Snack

5 tablespoons Greek yogurt 0% fat (Around 4g carbohydrates per 100g)
15 almonds
3 slices lean turkey


Dinner

Omelette with 2 eggs, tuna
100g chicken

OR

Caponata
Tuna


This is what my typical day of eating looks like right now.

In the weekend, I usually indulge in a pizza, burger or pasta as a cheat meal (once, sometimes twice). Again, no drinking alcohol or soft drinks. During the week I am strict with my diet.

What do you think about this please? Do you think there are some serious offenders?

First off, thanks for being open to being helped. Lots of people wouldn’t even be open to other’s opinions on what they’re doing. So good for u for being open to getting criticism and learning

So when it comes to insulin resistance, u have to remember what is the root cause of it. And the root cause of insulin resistance isn’t carbohydrates, like most people assume. The root cause is damage to ur cells. Cells in muscles, cells in organs, just cells in general throughout ur body that uptake glucose. Being metabolically healthy, and having healthy mitochondria in all of ur cells is the way to avoid being insulin resistant. And the root cause of metabolic disease is simply things that are damaging ur body. Whether that be foods that cause damage, or stress, or environmental things that damage the body, poor sleep, etc. Anything that is causing harm to the body/ causing it to not function properly is going to lead to poor metabolic health, and thus lead to the person being more likely to be insulin resistant

So now that u understand more about the root cause of insulin resistance, lets go over the things in ur diet that are causing inflammation in ur body, and just damaging ur cells and mitochondria throughout ur body in general.

Branflakes are processed, usually have ingredients that cause damage. But even if it’s a very simple ingredient list branflake cereal, it’s wheat, that has gluten. Gluten causes inflammation and damage. So definitely wouldn’t consume those on a regular basis

As far as dairy goes, most commercial dairy is going to cause inflammation/ damage. It’s a mix of it being from non grassfed cows, aka cows fed a crap diet/ not their natural diet, and the milk being homogenized and pasteurized. So I definitely would not consume dairy, on a regular basis, unless it’s raw and from grassfed cows. Both ur skim milk and Greek yogurt aren’t raw, or from grassfed cows, so definitely cut both of them out. Again, at least as something u consume on a daily/ regular basis

Vegetables are full of endogenous pesticides, toxins/ defense chemicals, and antinutrients. Definitely don’t want to consume vegetables on a regular basis. They’re just causing damage. Yes, they’re obv much better than a Big Mac, but still causing damage nonetheless. And have nothing in them that u can’t get from other sources of food, that don’t contain things that cause inflammation and damage along with them. So unless u really enjoy eating veggies, cut them out. They cause much more harm than people realize. And even if they’re organic, it doesn’t make much of a difference. 99% of pesticides in veggies come from within the plant itself (endogenous pesticides) and the studies show that endogenous pesticides lead to cancer more than exogenous sprayed on pesticides do. So it’s mostly the endogenous pesticides that u have to worry about.


Almonds I would cut out as well. They contain anti-nutrients like phytic acid, tannins and oxalates, not to mention the fact that they contain cyanide. Definitely wouldn’t consume any nuts or seeds on a regular basis

Brown pasta, and pasta in general has gluten. Definitely something I would stay away from. Again, gluten is inflammatory and damages the intestinal wall, leading to poor nutrient absorption over time, as well as leading to leaky gut. So definitely cut out any grains that contain gluten out of ur diet. Again, at least on a daily/ regular basis

And obv the things u mentioned that u consume on the weekend aren’t great for u. But u already know that. Hence why u called them ur cheat meals.

And a diet soda everyday isn’t great, and causes damage/ inflammation, but not a ton of ur only consuming one a day

So the things I mentioned above are absolutely things I would cut out, if I were u, and are definitely contributing to ur metabolic health not being where u want it, and ur fasting insulin and hgbA1c not being where u want it. I know they seem like “healthy foods” but the truth is they’re not. They’re all causing inflammation and damage in ur body, and it’s going to be hard to have optimal metabolic health while consuming them

As far as foods to consume to optimize metabolic health, just remember that the best food on the planet to consume regularly is fatty ruminant animal meat. So always try to prioritize eating as much of that as possible. But overall, if u just stick as close to the carnivore diet as possible, u’ll be on the right track. Just remember, the closer u are to eating carnivore, the more optimal ur overall health will be. The further u are from eating carnivore, the less optimal ur overall health will be. It’s literally that simple

This will go against ur nutritionist’s advice, I’m sure, but it’s just the facts. Doesn’t matter what someone with a nutrition degree says or doesn’t say. The facts about optimal health and nutrition are what they are. They’re not going to change any time soon. Evolution takes a long time to occur. And what’s optimal for the bodies that we currently have at this time in history, is basically the carnivore diet. What’s even more optimal is the lion diet. Just fatty ruminant animal meat and water. But sticking as close to the carnivore diet is definitely enough to have optimal health. And if u want to add carbs to it, just try to stick to raw organic honey, fruit (organic if possible), organic white rice, potatoes without the skin, and raw/ grassfed dairy

So overall yes, it’s very easy to see why ur metabolic health isn’t ideal, and why u could have poor endothelial health/ blood flow, especially to areas such as ur penis, which contain small blood vessels. Areas that have small/ narrow blood vessels tend to be the areas that suffer the most, whenever there’s issues with endothelial lining and poor blood flow

Good news is, if u remove all the things I mentioned, and introduce the things I recommended, everything will get better. Ur metabolic health, ur insulin resistance risk, ur fasting insulin level, and ur hgbA1c level. And ur erections should improve as well. As well as overall cardiac function. And honestly it will just improve ur entire body, in general. Zero downsides, only upsides. Can’t lose

 

[TestBoosted]

Thanks for sharing mate. Your charts look good to be honest. FYI, I put the ring around the shaft as well, the other way is just to keep erection (that was my understanding). Another question, when you made the doppler, did they mentioned you have VL or blood flow was just correct? We need to keep working together to find an improvement, some guys I talked too told me that Kegels have helped them a lot.

Hi iago009,

So I did 2 dopplers. On both dopplers, I had very high PSV (around 150cm/s if not mistaken).

Edv on first doppler were 11cm/s and 13cm/s.

Edv on second doppler were 7cm/s and 18cm/s.

I only got around 60% erect with caverject 20mcg. The radiologist concluded "In view of sub-optimal tumescence, the prescence of a venous leak can't be excluded".

When I showed my results to my urologist, he was sceptical and told me most probably I was experiencing anxiety dueing the test, hence the results. He did not believe I have venous leak due to my young age and overall health.

He kindly decided to refer me to an overseas hospital to do NPT using Rigiscan as this test is not done in my home country.

I did the test and the overseas doctor who gave me the result told me I had 3 erectile episodes at 85% rigidity lasting 1 hour (I think in total). He concluded that my issue is not physical but psychological.

I have been trying to work on my mental health as I do suffer a bit from depression and anxiety, but it is usually well controlled and I can function normally in life (apart from my erectile dysfunction).

In the meantime, I am trying to optimize my health as I discovered I suffer from insulin resistance and have always had low HDL, TSH around 3 or higher and high triglycerides.

Till now, I haven’t seen the improvement I want and am still not functional without a very tight cock ring.

This is tonight's NPT using firmtech by the way.

 

[TestBoosted]

First off, thanks for being open to being helped. Lots of people wouldn’t even be open to other’s opinions on what they’re doing. So good for u for being open to getting criticism and learning

So when it comes to insulin resistance, u have to remember what is the root cause of it. And the root cause of insulin resistance isn’t carbohydrates, like most people assume. The root cause is damage to ur cells. Cells in muscles, cells in organs, just cells in general throughout ur body that uptake glucose. Being metabolically healthy, and having healthy mitochondria in all of ur cells is the way to avoid being insulin resistant. And the root cause of metabolic disease is simply things that are damaging ur body. Whether that be foods that cause damage, or stress, or environmental things that damage the body, poor sleep, etc. Anything that is causing harm to the body/ causing it to not function properly is going to lead to poor metabolic health, and thus lead to the person being more likely to be insulin resistant

So now that u understand more about the root cause of insulin resistance, lets go over the things in ur diet that are causing inflammation in ur body, and just damaging ur cells and mitochondria throughout ur body in general.

Branflakes are processed, usually have ingredients that cause damage. But even if it’s a very simple ingredient list branflake cereal, it’s wheat, that has gluten. Gluten causes inflammation and damage. So definitely wouldn’t consume those on a regular basis

As far as dairy goes, most commercial dairy is going to cause inflammation/ damage. It’s a mix of it being from non grassfed cows, aka cows fed a crap diet/ not their natural diet, and the milk being homogenized and pasteurized. So I definitely would not consume dairy, on a regular basis, unless it’s raw and from grassfed cows. Both ur skim milk and Greek yogurt aren’t raw, or from grassfed cows, so definitely cut both of them out. Again, at least as something u consume on a daily/ regular basis

Vegetables are full of endogenous pesticides, toxins/ defense chemicals, and antinutrients. Definitely don’t want to consume vegetables on a regular basis. They’re just causing damage. Yes, they’re obv much better than a Big Mac, but still causing damage nonetheless. And have nothing in them that u can’t get from other sources of food, that don’t contain things that cause inflammation and damage along with them. So unless u really enjoy eating veggies, cut them out. They cause much more harm than people realize. And even if they’re organic, it doesn’t make much of a difference. 99% of pesticides in veggies come from within the plant itself (endogenous pesticides) and the studies show that endogenous pesticides lead to cancer more than exogenous sprayed on pesticides do. So it’s mostly the endogenous pesticides that u have to worry about.


Almonds I would cut out as well. They contain anti-nutrients like phytic acid, tannins and oxalates, not to mention the fact that they contain cyanide. Definitely wouldn’t consume any nuts or seeds on a regular basis

Brown pasta, and pasta in general has gluten. Definitely something I would stay away from. Again, gluten is inflammatory and damages the intestinal wall, leading to poor nutrient absorption over time, as well as leading to leaky gut. So definitely cut out any grains that contain gluten out of ur diet. Again, at least on a daily/ regular basis

And obv the things u mentioned that u consume on the weekend aren’t great for u. But u already know that. Hence why u called them ur cheat meals.

And a diet soda everyday isn’t great, and causes damage/ inflammation, but not a ton of ur only consuming one a day

So the things I mentioned above are absolutely things I would cut out, if I were u, and are definitely contributing to ur metabolic health not being where u want it, and ur fasting insulin and hgbA1c not being where u want it. I know they seem like “healthy foods” but the truth is they’re not. They’re all causing inflammation and damage in ur body, and it’s going to be hard to have optimal metabolic health while consuming them

As far as foods to consume to optimize metabolic health, just remember that the best food on the planet to consume regularly is fatty ruminant animal meat. So always try to prioritize eating as much of that as possible. But overall, if u just stick as close to the carnivore diet as possible, u’ll be on the right track. Just remember, the closer u are to eating carnivore, the more optimal ur overall health will be. The further u are from eating carnivore, the less optimal ur overall health will be. It’s literally that simple

This will go against ur nutritionist’s advice, I’m sure, but it’s just the facts. Doesn’t matter what someone with a nutrition degree says or doesn’t say. The facts about optimal health and nutrition are what they are. They’re not going to change any time soon. Evolution takes a long time to occur. And what’s optimal for the bodies that we currently have at this time in history, is basically the carnivore diet. What’s even more optimal is the lion diet. Just fatty ruminant animal meat and water. But sticking as close to the carnivore diet is definitely enough to have optimal health. And if u want to add carbs to it, just try to stick to raw organic honey, fruit (organic if possible), organic white rice, potatoes without the skin, and raw/ grassfed dairy

So overall yes, it’s very easy to see why ur metabolic health isn’t ideal, and why u could have poor endothelial health/ blood flow, especially to areas such as ur penis, which contain small blood vessels. Areas that have small/ narrow blood vessels tend to be the areas that suffer the most, whenever there’s issues with endothelial lining and poor blood flow

Good news is, if u remove all the things I mentioned, and introduce the things I recommended, everything will get better. Ur metabolic health, ur insulin resistance risk, ur fasting insulin level, and ur hgbA1c level. And ur erections should improve as well. As well as overall cardiac function. And honestly it will just improve ur entire body, in general. Zero downsides, only upsides. Can’t lose

Wowwww, thank you so much for this goldmine of information gman86! I am really grateful for your interest in my case and for always providing sound and detailed assistance For that, I am very grateful.

Thank you for the eye opening information, certain things like brown pasta I knew were not ideal (hence why I usually take them once a week) but other things like the milk and 0% fat greek yoghurt, I did not know.

I will look more into the carnivore diet and will try to learn as much as possible on it.

What would you recommend as a healthy breakfast instead of the branflakes? What do you usually have?

 

[iago009]

Wowwww, thank you so much for this goldmine of information gman86! I am really grateful for your interest in my case and for always providing sound and detailed assistance For that, I am very grateful.

Thank you for the eye opening information, certain things like brown pasta I knew were not ideal (hence why I usually take them once a week) but other things like the milk and 0% fat greek yoghurt, I did not know.

I will look more into the carnivore diet and will try to learn as much as possible on it.

What would you recommend as a healthy breakfast instead of the branflakes? What do you usually have?

Hi iago009,

So I did 2 dopplers. On both dopplers, I had very high PSV (around 150cm/s if not mistaken).

Edv on first doppler were 11cm/s and 13cm/s.

Edv on second doppler were 7cm/s and 18cm/s.

I only got around 60% erect with caverject 20mcg. The radiologist concluded "In view of sub-optimal tumescence, the prescence of a venous leak can't be excluded".

When I showed my results to my urologist, he was sceptical and told me most probably I was experiencing anxiety dueing the test, hence the results. He did not believe I have venous leak due to my young age and overall health.

He kindly decided to refer me to an overseas hospital to do NPT using Rigiscan as this test is not done in my home country.

I did the test and the overseas doctor who gave me the result told me I had 3 erectile episodes at 85% rigidity lasting 1 hour (I think in total). He concluded that my issue is not physical but psychological.

I have been trying to work on my mental health as I do suffer a bit from depression and anxiety, but it is usually well controlled and I can function normally in life (apart from my erectile dysfunction).

In the meantime, I am trying to optimize my health as I discovered I suffer from insulin resistance and have always had low HDL, TSH around 3 or higher and high triglycerides.

Till now, I haven’t seen the improvement I want and am still not functional without a very tight cock ring.

This is tonight's NPT using firmtech by the way.

Hello!

Thanks for sharing. Honestly, PSV should be around 5 cm/s or less. It is true that normally they must inject Trimix as caverject does not rule out anxiety. I also keep having nocturne erections and I dont undeestand how I can keep 45 min erected at night and 5 seconds awake. I honestly do not know what else we can do. My urologist do not trust doppler...