UK based 38 year old male, with low T and ED...

[Ken2000]

Hi, I'm a UK based 38 year old male, who generally looks after himself, but have found over the years that I've relied on generic Sildenafil in order to have the confidence to engage in sexual intercourse. Please excuse me jumping the gun a bit, but what are people's thoughts on testosterone levels and ED? For example, I got a test result back to say that my levels were 10.3 nmol/L, which whilst falls in 'normal' levels according to the company who carried out my test, a bit of research suggests it's still pretty low.

I should add a bit more about myself (please excuse the cut and pasted info from various posts below)... I'm 38, pretty fit and healthy, although I have smoked on and off over the years, but have given that up, along with vaping. I don't drink a whole lot and eat fairly well.
Here's what happened the other day: First sexual encounter for a couple of years last night, I took 2x5mg generic tadalafil (Cialis) a few hours before, got hard to begin with, but it didn't last. Tried again this morning, first time, lost my erection again, but managed to stay hard enough for long enough the second time around... But it felt a bit bitter sweet, as I was hoping to stay hard the first time. Needless to say, I feel lost and a bit scared, as I feel quite hopeless... I look after myself, stay fit, don't drink much and have given up smoking (and didn't smoke much in the past anyway).

I even went to the GP the other day and they didn't really do or help much other than suggest it was psychological, which I'm not completely convinced about.

And before that: Here's my story... I'm 37, but ever since I was 20, I've had trouble with maintaining an erection when having sex. I've also used quite a bit of porn over the years, images to begin with, but from the age of about 23, it's been the use of tube style videos.

I didn't make a connection between the two, but to ensure I was confident when having sex, I used generic viagra when having sex. This did work well, although it meant that I had to plan to have sex, rather than it being spontaneous, which I don't think was great for relationships.

Fast forward to more recently, and I've discovered that I may well have been suffering from Porn Induced Erectile Dysfunction and have kicked the porn habit a couple of times, but haven't felt there to be much improvement. I've been using l'arginine in the hope that it would speed up the recovery process, but the results seem to vary and I've not actually had sex to put it to the test. My recent long-term relationship has just gone down the pan and I'm dead-set on giving up porn for good, as well as not masturbating, which I don't think helps either.
I've also read that Horny Goat Weed can work well, although have yet to try it. I suppose that my thoughts are that even before I got into streaming porn, I still didn't feel hugely confident that my erections were hugely reliable.
I exercise regularly, am fit and healthy, but would love a more fulfilling and natural sex-life with whoever I'm with next.

 

[Systemlord]

You'll find a great many doctors get this normal T status wrong, you T levels might be normal just not for anyone your age. Testosterone increases nitric oxide which is needed for good erections.

You qualify for TRT according to the TRT guidelines. I wonder if your doctor tested the free testosterone, you know the active portion of testosterone. If total testosterone was the only biomarker tested, well let's just say I wouldn't go back to this doctor.

Low testosterone can negatively affect a man's psychological make up, basically turning a man into a mental weakling instead of the way a man is supposed to be, confident and appropriately aggressive.

It's common to see doctors with no clue about hormones blame everything on psychological problems, low testosterone can cause psychological problems.

You have the testosterone level of an old man in his 80's. You'll find the majority of doctors just don't know anything about testosterone.

Testosterone: What's a Normal Testosterone Level in Men? | The Art of Manliness

 

[Ken2000]

Thanks for the reply, things are all pointing in a similar direction. The test was done through this company....
https://www.forthwithlife.co.uk

I'm seeing a so-called specialist on Monday, here: Mr C J Shukla | Edinburgh Hospitals, Murrayfield and Shawfair Park | Spire Healthcare and am hoping that he'll be able to cast a bit more light on it all.

Out of interest, I've been taking pine pollen (which supposedly helps) and eating fairly well recently, would that affect any upcoming tests?

 

[Systemlord]

Thanks for the reply, things are all pointing in a similar direction. The test was done through this company....
https://www.forthwithlife.co.uk

I'm seeing a so-called specialist on Monday, here: Mr C J Shukla | Edinburgh Hospitals, Murrayfield and Shawfair Park | Spire Healthcare and am hoping that he'll be able to cast a bit more light on it all.

Out of interest, I've been taking pine pollen (which supposedly helps) and eating fairly well recently, would that affect any upcoming tests?

Urologists don't normally specialize in testosterone, if you pay attention to his bio nowhere does it say sex hormones as a specialty. So common.

I personally think you're wasting your time, you need to locate a doctor that prescribed TRT everyday, one who is educated in sex hormones.

The Men's Health Clinic or Balance My Hormones specialize in testosterone.

 

[Ken2000]

Thanks for the advice. I did a bit more research on the chap (the first reason that I was drawn to him was because of the ED aspect). It does mention testosterone-related stuff here: Men, look after your health! | Edinburgh Hospitals, Murrayfield and Shawfair Park | Spire Healthcare and Mr Chitranjan Shukla: Urology

 

[Ken2000]

I had a more comprehensive test carried out and the results came back as very different. Now I'm a bit confused as to what I should do next.

 

[Cataceous]

If these recent results are typical then low testosterone is likely not your problem. Was the earlier test done at a different time of day? Men can have variation by a factor of two over the course of a day, with a morning peak and an evening trough.

Tru-T calculated free testosterone is 21 ng/dL, putting it within the normal healthy range of 16-31.

For completeness you should have free T3 and reverse T3 measured.

 

[fifty]

Blood tests are a magic 8 ball. Provider gets money. You get a piece of paper with numbers that may or may not be accurate.

If your male parts work well with porn but not with a partner then that suggests a mental aspect of it.

 

[Ken2000]

If these recent results are typical then low testosterone is likely not your problem. Was the earlier test done at a different time of day? Men can have variation by a factor of two over the course of a day, with a morning peak and an evening trough.

Tru-T calculated free testosterone is 21 ng/dL, putting it within the normal healthy range of 16-31.

For completeness you should have free T3 and reverse T3 measured.

Thanks, both tests were done at a similar time of the day, the first was by finger-prick, which I did myself, the second was done at a clinic. Can supplements have much of an affect on this?

Blood tests are a magic 8 ball. Provider gets money. You get a piece of paper with numbers that may or may not be accurate.

If your male parts work well with porn but not with a partner then that suggests a mental aspect of it.

I've avoided porn for some time now, as supposedly PIED is a thing, but a lot of the 'research' on this suggests that after a short while, PIED should disappear. I've certainly not experienced anything along these lines as of yet.

If it is mental, is there much hope?

 

[Cataceous]

Thanks, both tests were done at a similar time of the day, the first was by finger-prick, which I did myself, the second was done at a clinic. Can supplements have much of an affect on this?
...

I might trust the clinic's result a little more, but it would take further tests to see which result is closer to your normal.

It's easier to reduce testosterone than to increase it. Supplements can affect levels, with licorice root coming to mind on the negative side. Alcohol consumption, reduced sleep, and overtraining can also negatively affect testosterone.

You're not on any medications that might cause problems, such as Propecia, correct?

What's your libido like? If strong desire isn't there then that can certainly contribute to ED. Do you notice good erections when waking in the night or in the morning? It sounds like your function is ok, correct?—meaning you probably don't need to investigate penile blood flow issues.

Another hormone to look at if you have further tests is DHT. I don't know if it's common for natural guys to have low levels relative to testosterone and estradiol, but it does happen to some of us on TRT.

 

[Ken2000]

I might trust the clinic's result a little more, but it would take further tests to see which result is closer to your normal.

It's easier to reduce testosterone than to increase it. Supplements can affect levels, with licorice root coming to mind on the negative side. Alcohol consumption, reduced sleep, and overtraining can also negatively affect testosterone.

You're not on any medications that might cause problems, such as Propecia, correct?

What's your libido like? If strong desire isn't there then that can certainly contribute to ED. Do you notice good erections when waking in the night or in the morning? It sounds like your function is ok, correct?—meaning you probably don't need to investigate penile blood flow issues.

Another hormone to look at if you have further tests is DHT. I don't know if it's common for natural guys to have low levels relative to testosterone and estradiol, but it does happen to some of us on TRT.

Thanks for the reply, again! I'm intrigued as to what the next set of test results come back as.

I'm not on any medication and I 'think' that my libido is fairly normal, I.e. I look forward to intimacy. I do get erections at night, but they don't feel quite as firm as they should.