Cabergoline or Not?

[Leesto]

Looking for a bit of advice. My own judgment is perhaps clouded by a bit of "desperation" to overcome ED. Perhaps some of you can identify with that situation! I hope to get some objective thoughts from the fine people here at ExcelMale.

I have had ED for many years not helped by viagra or cialis. I've been reading about trimix, PT-141, and cabergoline on the forums and elsewhere. I have no fear of injecting trimix but would like to try cabergoline or another method of getting more natural and spontaneous erections before jumping right to trimix.


Note: I've been on TRT 4 months with some positive results in body composition and energy level but not ED. I was on anastrozole from the beginning and then after 2 months of little change I went through about 6 weeks of hell from (I think) crashed E2. I quit the anastrozole 2 weeks ago and the worst side effects have subsided. No improvement in ED though. At least not yet.


I got a prolactin test Wednesday through Discounted Labs and the results came in this morning. It is not particularly high but then maybe a low dose of Cabergoline would help even so? I have read some glowing reports about caber. I can get a trial packet of 8 x 2.5 mg pills for free.





So the question: should I try a low dose of Cabergoline or try PT-141 or skip both of those and think about trimix? Or should I wait a little longer for E2 to stabilize before trying anything new?


I respect the experience of the people here at Excel Male and so I will listen carefully to your recommendations.

 

[CoastWatcher]

I would be very hesitant to add Cabergoline to your protocol. Your libido, it's heathy? Is it ED you hope to target with Cabergoline? If your sex drive is strong, I'd consider trimix. Cabergoline is a very potent drug with an extended half-life. At the most, given the prolactin level you present with, I'd take no more than .25mg twice weekly and, in doing so, carefully monitor your prolactin levels. Sending your prolactin levels to the basement is yet another way for men to experience some healthy misery.

 

[Vince]

When prolactin gets too high can kill your libido, but if it gets too low can also kill your libido. Cabergoline has a very long half-life of around 60 hours.

 

[Leesto]

Thanks CoastWatcher. Libido has been somewhat low. I guess it is both libido and ED I'm hoping to address but mostly ED.

I appreciate your comments!

 

[Vince Carter]

Prolactin is a tough one. Besides the lab ranges no one really knows or says that X is too low or Y is too high. Best thing that I've seen is Saya/Crisler/ et al., had a video on youtube covering this area in a wide ranging conversation. Crisler stated that he follows Shippen in treating with Dostinex (Caber) with Prolactin @ 5. Saya later stated in the same video 6 or 7. Both stated .25mg 2XW for treatment.
That's really the only time Ive read concrete numbers from authorities. I can tell you ive tested @ 4 and 5 twice and we successfully raised my Prolactin to 11 and it' didn't make any difference to my ED. I then tried Caber .25mg 2XW to go the other way with Prolactin and I don't think I had success with that either.

 

[Leesto]

Thank you very much Vince. I am going to look up that video on YouTube. The more data I can get the better - and I appreciate the time you took to answer.

Sorry to hear that managing prolactin levels didn't help your ED. Did you ever find something that did?

 

[Nelson Vergel]

Leesto

Your prolactin is fine. I would not use cabergoline. Crashing prolactin is not a good thing.

Low Prolactin Is Associated with Sexual Dysfunction & Psychological/Metabolic Issues
Prolactin: Should Men with Erectile Dysfunction Be Tested ?
I would get on daily 10 mg Cialis, 5 grams per day of citrulline, TRT + HCG

 

[Vince Carter]

Thank you very much Vince. I am going to look up that video on YouTube. The more data I can get the better - and I appreciate the time you took to answer.

Sorry to hear that managing prolactin levels didn't help your ED. Did you ever find something that did?

I was really going thru an E problem and I haven't revisited the Prolactin thing while Im working thru the E.

 

[Leesto]

Thank you Nelson. I appreciate your advice!

I am on 10 mg cialis per day and L-Carnitine/L-Citrulline. Actually, I have been on Gene's N.O. stack for about 2 months since reading about it here on ExcelMale. I noticed changes in vascularity and in the gym but no improvement in ED. I'm on TRT and on twice weekly HCG (.25 ml).

Even quadruple doses of cialis/viagra don't work any more for me and libido isn't strong and penile sensitivity is low.

 

[Nelson Vergel]

Leesto

You may want to try Trimix. I know many men are scared of it, but you have tried first and second line treatments already.

 

[CoastWatcher]

Thank you Nelson. I appreciate your advice!

I am on 10 mg cialis per day and L-Carnitine/L-Citrulline. Actually, I have been on Gene's N.O. stack for about 2 months since reading about it here on ExcelMale. I noticed changes in vascularity and in the gym but no improvement in ED. I'm on TRT and on twice weekly HCG (.25 ml).

Even quadruple doses of cialis/viagra don't work any more for me and libido isn't strong and penile sensitivity is low.

What would tip the scale for me, however, is the fact that your prolactin level isn't high. As was noted above, the question of what a "high" and "low" level actually looks like is the cause of some discussion, but I would be astonished if anyone actually thought you were presenting with elevated Cabergoline. I would fear that in a desire to restore function, levels would drop. In that event you'd find yourself having actually lost ground.

This is offered in a spirit of cheerful discussion and hope it is received in that way!

 

[Leesto]

Leesto

You may want to try Trimix. I know many men are scared of it, but you have tried first and second line treatments already.

Thank you Nelson. I will do exactly that. I realize hormone management can be a tricky pursuit so I value your years of experience and I appreciate your expert advice.

 

[Leesto]

What would tip the scale for me, however, is the fact that your prolactin level isn't high. As was noted above, the question of what a "high" and "low" level actually looks like is the cause of some discussion, but I would be astonished if anyone actually thought you were presenting with elevated Cabergoline. I would fear that in a desire to restore function, levels would drop. In that event you'd find yourself having actually lost ground.

This is offered in a spirit of cheerful discussion and hope it is received in that way!

Thank you CoastWatcher. It is definitely received in the way you intended it. As I mentioned, my own judgment may be somewhat clouded by sexual frustration built up over a long number of years with ED. Therefore I appreciate the candid advice!

I would rather take the advice offered here and have a better chance of getting good results than spin my wheels trying every new thing I read about.

 

[Dr Justin Saya MD]

I don't *often* treat prolactin <13-14 with cabergoline unless it is used as a short (8 weeks) therapeutic TRIAL for symptom relief once other stones have been turned over. More commonly used for prolactin >14 without other exacerbating factors present. Starting with lower dose cabergoline (0.125mg BIW or 0.25mg once weekly) would be advised (vs 0.25mg BIW) for lower prolactin levels (i.e. not above 15).

 

[Leesto]

I don't *often* treat prolactin <13-14 with cabergoline unless it is used as a short (8 weeks) therapeutic TRIAL for symptom relief once other stones have been turned over. More commonly used for prolactin >14 without other exacerbating factors present. Starting with lower dose cabergoline (0.125mg BIW or 0.25mg once weekly) would be advised (vs 0.25mg BIW) for lower prolactin levels (i.e. not above 15).

Thank you very much Dr Saya!

I feel lucky to receive input from such good people like you and the others here on ExcelMale. Wish I had started out at your clinic but maybe I will switch in the future.

 

[Vince Carter]

One other thing is make sure you're not having sex ~48hrs priot to a Prolactin test, no orgasm, etc

 

[Leesto]

One other thing is make sure you're not having sex ~48hrs priot to a Prolactin test, no orgasm, etc

Oh! I did not know that. How much effect does an orgasm have on the prolactin level and for how long? Do you know?

Let's say I had an orgasm 24 hours before the test. Any idea how much of an adjustment factor that would warrant?

 

[Vince Carter]

Prolactin goes way up with post orgasm so IMHO ~48hr avoidance is called for.

 

[Vince]

Prolactin goes way up with post orgasm so IMHO ~48hr avoidance is called for.

48 hours..ouch

 

[Vince Carter]

I wish I could find that video I know I've shared it around here before with our great Dr's discussing Prolactin, amongst other things. Video with Nelson/Crisler/Saya/Jasen Bruce