Is my ED physical, psychological or hormonal?

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.
 
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
 

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TRT Hormone Predictor Widget

TRT Hormone Predictor

Predict estradiol, DHT, and free testosterone levels based on total testosterone

⚠️ Medical Disclaimer

This tool provides predictions based on statistical models and should NOT replace professional medical advice. Always consult with your healthcare provider before making any changes to your TRT protocol.

ℹ️ Input Parameters

Normal range: 300-1000 ng/dL

Predicted Hormone Levels

Enter your total testosterone value to see predictions

Results will appear here after calculation

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

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