Morning Erections Question

[SoCalSurfer]

Hi
I have been on TRT for a while now about 4 months. Still ED issues and no morning wood, no erections without Viagra(which does work). When I first when on TRT for about 2 weeks every morning but now nothing. I have an appointment this week with Endo to go over new labs and wondering what else I should cover during my appointment. He has not tested for E2 and says they normally dont test till there is breast tissue. (Other post on that question).

I am wondering what questions I should bring up.
I will post my labs once I get them.

 

[Gene Devine]

Get Estrogen tested; elevated it can and will cause ED among other nasty side effects.

 

[SoCalSurfer]

That is my number one topic to talk to him about. waiting till you form breast tissue is a bit late in my opinion.

 

[Gene Devine]

That is my number one topic to talk to him about. waiting till you form breast tissue is a bit late in my opinion.

You may not get any breast issues before other sides present themselves like ED.

How's your Libido?

How do you feel overall?

Get cold easily?

Joints sore?

Anything else not quite right?

 

[Nelson Vergel]

It is usually good to bring papers or articles printed so that they know you did your homework. They may dismiss it as garbage but they know you are reading. Many accept those print outs from patients. Those are the open minded doctors who really are ahead of the game and want to learn more even if it is not from clinicians.
They are out there. A patient provided fact sheet can do wonders sometimes not only to educate docs who are too busy to read but also to benefit all of his/her patients.

Here are a few: http://www.excelmale.com/search.php?searchid=6142

 

[SoCalSurfer]

You may not get any breast issues before other sides present themselves like ED.

How's your Libido?

How do you feel overall?

Get cold easily?

Joints sore?

Anything else not quite right?

How's your Libido? not as good as I would like, back when I was doing the 100mg once a week for about two days it was good but now on on twice a week lower dose libido not as high.

How do you feel overall? Fairly good, Focus is better for a day or two after shot but then falls off. so for a day feel a bit off before its time next show. (Sun, Wed)

Get cold easily? No dont get cold usually I am hot.

Joints sore? Very sore at times. joint sore after sitting for a while. Knees, back and neck.

Anything else not quite right? I get headaches that come on real quick and can go away without taking anything or using Excedrin

 

[SoCalSurfer]

Nelson, the link is not working.

 

[Dave Barry]

If you are going to bring articles/research to your doctor, make damn sure it's legit. Personally, I would bring something from a scientific journal or the results of research. Generally, many doctors will immediately dismiss information from some .com or Wikipedia so pick your sources like you are writing an English composition paper for College. Here is a good example of some legitimate research: The following research was reported in The Journal of Clinical Endocrinology & Metabolism. "Testosterone Therapy in Men with Androgen Deficiency Syndromes: An Endocrine Society Clinical Practice Guideline."
http://jcem.endojournals.org/content/91/6/1995.full.pdf+html

 

[Gene Devine]

I agree with Dave here; but the challenge is that Testosterone Replacement Therapies and Anti Aging Medicine is relatively new and there just are not a lot of medical or scientific journals that one can use as fact based evidence...that's the frustrating part.

For example, the use of an an aromatase inhibitor or HCG as a components to TRT protocols will be difficult to find.

Nevertheless, Dave's point should be tried first and foremost than fall back on other informational sources to support your position.

 

[SoCalSurfer]

Thanks for all the info. I hope it goes well on Thursday.

 

[BigJohn]

I know an Endo is a hormone doctor but my experience is most of those guys specialize in Diabetes. I'd be very suspect that they can figure it out.

 

[Nelson Vergel]

Good point Dave. May be soon we can have enough time to put together the top papers to print to bring to physicians about HCG, anastrozole, TRT, etc

 

[SoCalSurfer]

I know an Endo is a hormone doctor but my experience is most of those guys specialize in Diabetes. I'd be very suspect that they can figure it out.

That is exactly how I became his patient; it was for Diabetes and then also Low T. Being that it Loma Linda and a teaching hospital they are somewhat open to new things.

 

[Dave Barry]

Nelson,

I think we need to prepare a "position statement," that covers the basics of TRT, which is backed-up by scientific research. In total, it would need to cover all the bases, within 2-3 pages maximum so that a doctor will read it. It's an uphill battle to convince the average doctor that testosterone gel/inj. is needed, let alone that HCG, and an estrogen-blocker as well.

 

[Gene Devine]

Nelson,

I think we need to prepare a "position statement," that covers the basics of TRT, which is backed-up by scientific research. In total, it would need to cover all the bases, within 2-3 pages maximum so that a doctor will read it. It's an uphill battle to convince the average doctor that testosterone gel/inj. is needed, let alone that HCG, and an estrogen-blocker as well.

Why not just use Dr. Crisler's paper Testosterone: A Receipt for Success?

It was written by a TRT Physician for a Non TRT Physician.

 

[Dave Barry]

Gene,

That would be great as I have never seen Dr. Crisler's paper. Does he include references?

 

[Gene Devine]

Gene,

That would be great as I have never seen Dr. Crisler's paper. Does he include references?

No, it's based on his many years of clinical experience Dave and collaboration with some of the worlds top TRT clinicians, but it's very well written and he takes a very practical approach.

Unfortunately, there is not going to be a ton of research on the use of an aromatase inhibitor or HCG for use in TRT for men.

These drugs have been around for a long time and big pharma just isn't going to fork over the cash for this type or research.

It's why we need to look at what the well trained TRT Physician is seeing and doing on the front lines...these are the folks truly in the know.

I've attached Dr. Crisler's paper in this post Dave.

He even admits that this paper is a bit dated now and he's promised me he is working on an update but when we'll see that is anyone's guess.

Let me know what you think.

View attachment TRT (4).pdf

 

[Nelson Vergel]

I like the way you think, Dave. We are all short on time but I think that is an important goal.

The main HCG reference that anyone can use is one based only on fertility. Not a single study has combined TRT+HCG and measured quality of life and sexual function (or testicular size).

https://www.excelmale.com/forum/thr...sed-HCG-with-Testosterone?highlight=lipshultz

 

[Don]

Hi
I have been on TRT for a while now about 4 months. Still ED issues and no morning wood, no erections without Viagra(which does work). When I first when on TRT for about 2 weeks every morning but now nothing. I have an appointment this week with Endo to go over new labs and wondering what else I should cover during my appointment. He has not tested for E2 and says they normally dont test till there is breast tissue. (Other post on that question).

I am wondering what questions I should bring up.
I will post my labs once I get them.

Did you start any antidepressants? Same thing happened to with Androgel. Could roll out of bed for 2 1/2 weeks then put on Prozac. No erections for two weeks and when I could become erect it took great concentration, and even more concentration to ejaculate(like doing Chinese arithmetic.)
Finally was put on Wellbutrien, and eventually weened off.
Glad to hear Viagra worked for you. There are some supplements and foods that I notice better quality of erection when taken or eaten.
GWTY
Don

 

[blacore]

Could HCG raise Blood Glucose? I started HCG this week and my BS readings have been high, even eating a Low Carb diet.