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: 14
• 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!