Urologist goes ballistic on my T / Nandralone protocol! Halp!

[masfield]

So, I went to see the head of urology at a big California hospital about this problem I've been having with tons of pre-ejeculate leaking out before a sadly underwhelming final finish. He and his sexual-health specialist had never heard of such a thing and were baffled. Then as a pair they looked at my Defy-given protocol, blanched, and said, "This is crazy! You're going to have a heart attack if you keep this up. Seriously. Or you might go into some manic phase and who knows what happens then? And there's no way I can diagnose your pre-ej problem, when you've got all these crazy things coursing through your system."
Naturally, this freaked me out.
They thought my T dose was okay but that it should be injected only once a week. Didn't know much about Nandralone, except that it also causes T to rise. Thought HCG also caused T to rise and in my case wasn't needed, because I'm not trying to have children. Too much T altogether, they thought. Also, I'm not due to have another Defy labs screening done until this summer, which also made them nervous. They want me to have them done again next month. Etc.

But what freaked me out the most is there being no solution to the pre-ej issue, which is what's really bothering me right now. I'm sixty two. A heart attack takes me out tomorrow, fine. Manic phase would be worse, but I've been on the protocol for about six months now, with the only mood effect being greatly increased happiness (and an unfortunately tendency to get too excited over girls). But the pre-ej issue is making me miserable, seriously.

My protocol is based on a muscle-wasting disease I have (and that Nelson has too, in one of his hands, sad to say). A list of my protocol is appended below.
Any thoughts about what the urologist said?
Hopefully, Dr. Saya will weigh in regarding the pre-ej issue, either here or in a PM. I don't know where to turn next.
(I posted about the pre-ej biz in a different thread under a different user name, because I didn't want to get all my various things too linked up, but, I'm thinking now, what the hell.)
(Nelson, if this post would be better off in a diff forum or with a diff title, obviously feel free to move and retool.)
Thanks for any thoughts you might have!

Testosterone Cyp. 200mg/ml to 0.25ml twice a week. (Tues./Sat.)
Nandrolone 200mg/ml 0.3ml twice a week. (same day as T shot)
Anastrozole 0.25mg twice a week.
HCG 300iu subcutaneous twice a week.
DHEA 20mg/Pregnenolone 25mg daily
-------------
Sertaline HCL 100 -- 1/2 of one, once a day
Buproprion HCL XL 300 -- one a day
Levothyroxine 150 -- one a day
Adderall -- 5 mg -- one a day
Pantoprazole -- 40 mg -- one a day

Quetiapine Fumarate 2 x 25mg at bedtime
Alprazolam -- .25 mg -- as needed and no it is not what's effecting my ejac.

cialis: 5 mg daily

btw / this is a complete list of the meds I'm on. Only the top part is my Defy protocol. The five drugs listed, starting with the Sertaline and ending with the Adderall, I've been taking almost forever, so I don't see how they could be part of the pre-ej issue.

What a pickle. Sigh.

 

[Vince Carter]

It's never a good idea to go to Endos and Urologists and divulge HRT to them, I'm not saying you made a mistake this is just another demonstrable incidence of they're little to no knowledge. I'd sure defer to Dr Saya on this and avoid these others like the plague.

 

[Will Brink]

So, I went to see the head of urology at a big California hospital about this problem I've been having with tons of pre-ejeculate leaking out before a sadly underwhelming final finish. He and his sexual-health specialist had never heard of such a thing and were baffled. Then as a pair they looked at my Defy-given protocol, blanched, and said, "This is crazy! You're going to have a heart attack if you keep this up. Seriously. Or you might go into some manic phase and who knows what happens then? And there's no way I can diagnose your pre-ej problem, when you've got all these crazy things coursing through your system."
Naturally, this freaked me out.
They thought my T dose was okay but that it should be injected only once a week. Didn't know much about Nandralone, except that it also causes T to rise. Thought HCG also caused T to rise and in my case wasn't needed, because I'm not trying to have children. Too much T altogether, they thought. Also, I'm not due to have another Defy labs screening done until this summer, which also made them nervous. They want me to have them done again next month. Etc.

But what freaked me out the most is there being no solution to the pre-ej issue, which is what's really bothering me right now. I'm sixty two. A heart attack takes me out tomorrow, fine. Manic phase would be worse, but I've been on the protocol for about six months now, with the only mood effect being greatly increased happiness (and an unfortunately tendency to get too excited over girls). But the pre-ej issue is making me miserable, seriously.

My protocol is based on a muscle-wasting disease I have (and that Nelson has too, in one of his hands, sad to say). A list of my protocol is appended below.
Any thoughts about what the urologist said?
Hopefully, Dr. Saya will weigh in regarding the pre-ej issue, either here or in a PM. I don't know where to turn next.
(I posted about the pre-ej biz in a different thread under a different user name, because I didn't want to get all my various things too linked up, but, I'm thinking now, what the hell.)
(Nelson, if this post would be better off in a diff forum or with a diff title, obviously feel free to move and retool.)
Thanks for any thoughts you might have!

Testosterone Cyp. 200mg/ml to 0.25ml twice a week. (Tues./Sat.)
Nandrolone 200mg/ml 0.3ml twice a week. (same day as T shot)
Anastrozole 0.25mg twice a week.
HCG 300iu subcutaneous twice a week.
DHEA 20mg/Pregnenolone 25mg daily
-------------
Sertaline HCL 100 -- 1/2 of one, once a day
Buproprion HCL XL 300 -- one a day
Levothyroxine 150 -- one a day
Adderall -- 5 mg -- one a day
Pantoprazole -- 40 mg -- one a day

Quetiapine Fumarate 2 x 25mg at bedtime
Alprazolam -- .25 mg -- as needed and no it is not what's effecting my ejac.

cialis: 5 mg daily

btw / this is a complete list of the meds I'm on. Only the top part is my Defy protocol. The five drugs listed, starting with the Sertaline and ending with the Adderall, I've been taking almost forever, so I don't see how they could be part of the pre-ej issue.

What a pickle. Sigh.

If they thought what's in bold, they are even more clueless than usual docs. It does not raise T, it lowers T. For those on TRT as you are, does not matter, but used alone, crashes T hard. Two, I suspect your issue is coming from the non TRT/HRT meds, but wait forDr. Saya to comment there.

 

[masfield]

Thanks, guys. Yup, they did think what's in bold, very strongly. Hopefully, Dr. Saya will weigh in shortly ...

btw/ the doc did do a prostate exam and found nothing unusual. when I first posted about the pre-ej issues, Dr. Saya thought the cause could be prostate related and suggested i go to a urologist, but these docs say nope.

 

[Will Brink]

Thanks, guys. Yup, they did think what's in bold, very strongly. Hopefully, Dr. Saya will weigh in shortly ...

btw/ the doc did do a prostate exam and found nothing unusual. when I first posted about the pre-ej issues, Dr. Saya thought the cause could be prostate related and suggested i go to a urologist, but these docs say nope.

No one can know everything nor should they be expected to, but that's just laziness and hubris. 5 second search on Google turns up various studies. All I ask from anyone, doc or otherwise, when presented with something they are not familiar with is "I don't know, but let me look into it and get back to you." That' all it takes. I, as well as anyone, know the pressure of being expected to know everything about X topic, and the toughest three words a professional answer person has to give is "I Don't Know."

99% of them will pretend they do know the answer as their ego will not allow the alternative, to admit they simply don't know, and you end up with terrible advice like that. A person who is genuinely comfortable and confident with what the do know, will be the first to admit to what they don't know.

- Will @ BrinkZone.com

 

[CoastWatcher]

No one cab know everything nor should they be expected to, but that's just laziness and hubris. 5 second search on Google turns up various studies. All I ask from anyone, doc or otherwise, when presented with something they are not familiar with is "I don't know, but let me look into it and get back to you." That' all it takes. I, as well as anyone, know the pressure of being expected to know everything about X topic, and the toughest three words a professional answer person has to give is "I Don't Know."

99% of them will pretend they do know the answer as their ego will not allow the alternative, to admit they simply don't know, and you end up with terrible advice like that. A person who is genuinely comfortable and confident with what the do know, will be the first to admit to what they don't know.

Years and years ago, decades, a doctor told me that she wasn't sure of her initial response to my concerns and excused herself from the exam. Pre-Internet days, she came back with a stack of books and spent a good bit of time confirming her first answer actually was correct. I was impressed, and she laughed and said better to be a humble realist than a malpractice defendant.

 

[Will Brink]

Years and years ago, decades, a doctor told me that she wasn't sure of her initial response to my concerns and excused herself from the exam. Pre-Internet days, she came back with a stack of books and spent a good bit of time confirming her first answer actually was correct. I was impressed, and she laughed and said better to be a humble realist than a malpractice defendant.

I have had excellent experiences with female doctors, so much so, I tend to choose them over male docs given the choice. They tend to be more open minded and faster to admit when they don't know something. They tend to suffer the classic arrogance & ignorance doc syndrome far less often than male docs in my experience. They also have empathy most men simply don't.

 

[CoastWatcher]

I have had excellent experiences with female doctors, so much so, I tend to choose them over male docs given the choice. They tend to be more open minded and faster to admit when they don't know something. They tend to suffer the classic arrogance & ignorance doc syndrome far less often than male docs in my experience. They also have empathy most men simply don't.

My primary care MD is a woman and she manages my TRT as well. She told me a few years ago she wondered why all, every single man she sent to endocrinologists or urologists with low androgen levels, failed to enjoy any real improvement in their quality of life. She sat down and started reading, talking to other doctors, and a year later started managing TRT cases. She's first rate.

The key point in this little vignette is that she noticed how those she sent out were not responding. All of them. Then she asked a critical question -"Why?" Too many doctors fail to observe and have lost any sense of curiosity. I have asked her to join EM, but so far she just lurks and reads.

 

[PAUL-E]

Your protocol looks perfectly acceptable those urologist clearly do not know what they're talking about when it comes to HRT and frankly seemed a little unprofessional as far as the pre-ejaculate my best guess and I mean guess would be to try cutting out the Cialis for a short time and see if there's a difference.

 

[masfield]

Thanks for the thought about Cialis. I can't remember whether this predates my daily dose or not, so I will give that a go and see. Have any remote idea how long one would have to be off it for a test like this to be meaningful?

 

[Mountain Man]

You may want to check with whomever is prescribing those psych meds. They are more likely to be the problem than the TR protocol. And, a expert on TRT may be better than the stupidity of doctor's that think TRT = heart problem. The head of the clinic I go to, Dr. Morgantaler in Boston, has refuted these studies quite well.

 

[masfield]

Nah, it's not the psych meds. i've been on em for decades with no problems. Buproprion has no sexual side effects. And the sertaline dose is minimal. the urologists also said they play no part in it. then again, you never know for sure, do you?

what a pickle my pickle is in!

 

[CoastWatcher]

Nah, it's not the psych meds. i've been on em for decades with no problems. Buproprion has no sexual side effects. And the sertaline dose is minimal. the urologists also said they play no part in it. then again, you never know for sure, do you?

what a pickle my pickle is in!

I'm not saying this is true in your case, but if we had a dollar for every time a doctor - incorrectly, but with great confidence - told a patient that a drug was totally safe, nothing to worry about, only to find they were dead wrong...trust but verify.

 

[masfield]

Buproprion aka Wellbutrin has been around for a while and its properties have been fairly well studied. That doesn't mean you're wrong, however.

 

[FeelingLost]

Hi linter, I don't have any advice but I wanted to post I another 60 year old is rooting for you.

 

[Mountain Man]

Lot of 60 year olds rooting for you Buddy. You'll get this figured out!

 

[Mcmarkert]

At the big hospitals, all they know about health and wellness is SSRis, Statins and Diabetes Management.