Clomid and Cialis

[Clint Lovelace]

Saw a new urologist today who is specialized in low T and ED issues...so thankful to finally find a doc who wanted to get to the bottom of things and agreed at 30 I did not need to just "accept" what was going on and move on.

He is starting me on daily Clomid at 5o mg and a daily use Cialis at 5 mg for 3 moths. He wants to see if he can jumpstart my testicles to start producing testosterone on its own rather than introduce Testosterone through the gels or injections (since I have done gels before and did not see a big difference). I am to see him again in March. He said if Clomid does not work we will move on to a more aggressive approach (injections or pellets--my choice he said). We did talk about HCG and said that was an option as well.

He gave me a free month sample of Cialis and a free month coupon (so 2 months). He said he did not think insurance would cover the cialis so i was looking at $150 out of pocket. He said if after 2 months I did not see any change in my erections (getting it up, keeping it hard/up, orgasm, morning wood, etc) then I could stop the Cialis. Or if i say it working but can't afford the $150 I could split the pill (take half every day) or just take a whole pill every other day. If Cialis does not work he will try the other erection pills and then go to the injections into the penis or a pump, etc. He wanted to see if a daily use pill would help and if not we would get more aggressive as well.

Overall very pleased far beyond what I have been with the past 3 docs I have seen (internist, urologist, endocrinologist).

Getting clomid filled on Monday, but can start the Cialis now. He said I can take it anytime of the day as long as same time each day. Anyone taking Cialis daily and have a recommendation on best time to take it?

 

[Nelson Vergel]

I hope you feel better and you get the results you seek. Clomiphene (Clomid) monotherapy has been shown to raise your testosterone but not your sexual function. You can get cialis covered (sometimes) if your doctor diagnoses you with benign prostatic hyperplasia (BPH) or you can be it online. Daily Cialis on itself can increase sex drive and function. Please report to us how things go!

 

[Clint Lovelace]

The Cialis was working in some sense (it did not make my erections stronger or last or help with the orgasm) but it did make it easier to get an erection and at times feel like I was in puberty again with it sort of wanting to pop an erection at random times. But once it started it was back like before with it not staying hard or being as hard as before all this mess started. With that said, I only had one month free sample pack and that is coming to an end really fast. Insurance won't cover it and its $200 a month so I will be stopping soon.

 

[GettingAnswers]

Are you coming off of a cycle? If not, I have been reading that many people experience great results without the potential for nasty side effects at 12.5 mg every day. Even my doctor prescribes only 50mg clomid 2x/week because he likes to mimic the pulsatile nature of LH and he says that he sees far better results with that than the high daily doses. Obviously listen to your doctor before someone like me on a message board, but just know that if you have issues with that dose, you may still be able to get great results at a much lower dose.

I second what Nelson said - when I was on clomid my libido and erections sucked!

 

[Gene Devine]

Hi Clint - The Cialis is a PDE5 inhibitor and helps with blood flow as it increase NO in the blood stream dilating blood vessels. It will not help with testicular function nor increase in androgen levels.

Low dose daily use of clomid has been successful in raising endogenous testosterone so if your testicles are healthy and functioning this should go to help as well.

You may want to check out this thread as well on how to enhance the effects of your PDE5i as it has helped many here and elsewhere:

https://www.excelmale.com/forum/threads/198-Gene-s-Nitric-Oxide-Stack

I do need to say, however, that a 30 year old otherwise healthy male with low testosterone serum levels is not normal. At your age you should be near peak levels!

There are many medical pathologies that can cause low androgen levels in younger men. There are a wide range of conditions that can cause hypogonadism like testicular disease or malady, hypothalamus or pituitary conditions, other neurological issues, diabetes, past drug or aas use, past head or groin injuries, lifestyle, overall health...and the list goes on and on.

What did your Doctor diagnose you with as for the low serum levels before prescribing drugs for you?

Way too many times have I seen Doctors just throw testosterone or drugs at a young guy without doing the proper diagnostic procedures...FIRST!

If it were me, at your age, I would exhaust every possible reason for your low levels before taking any drug for the rest of your life as there is a reason why your levels are so low.

Remember, HRT is for life and you are only 30 years old!

If you have your blood work, of if you can ask for it, and can post all labs here complete with ranges you will get some pretty knowledgeable guys to help you as well.

 

[Nelson Vergel]

Clint, you may also want to read this:

How to (attempt) reset your HPT axis

 

[SuperDutyDave]

Clint

Gene is right on at 30 assuming no known reasons Doc should trying to fin underlying cause of low T prior to treatment

I had and Endo try very similar course of action basic labs and here try clomid and hope it helps......if not feel lousy and get a penis pump along with some Viagra

Clomid did raise my levels some but did little to help with low T symptoms and definitely very little with ED. The ED pills helped some but hit or miss.

Clomid really isn't for long term use and visual issue can occur.

Personally I would look for another Doc who would first try harder to determine cause of low T and once known would treat accordingly

Ps. If all else fails Tri-Mix will fix your ED issues without fail

 

[Vettester Chris]

Agree with all the above. I'd love to see your baseline serum level, and LH/FSH, just to know what you were/are up against. I'll do some looking to see if you have them posted on another thread, or if by chance you see this quick enough please let me know.


As Gene respectfully elaborated, this is a lifetime venture, and 30yo should be prime! Presuming your physician has diagnosed you as secondary hypo, since Clomid is being prescribed? If it was prescribed without supporting labs, I have other questions ... Again, I'm curious on the numbers, and if your HPTA is suppressed from unknown causes, I hope that an MRI has been established to rule out adenoma or other complications prohibiting your axis from secreting the gonadotropin hormones.

 

[Keith Willse]

I would personally run a clomid challenge prior to trying a 3-month experiment at 50 mg daily. Keep in mind, I am assuming all of your other labs have been viewed, reviewed and addressed at this point. I am also assuming your physician believes you are secondary.

Clomid Challenge
Day 0 – Run a basic set of baseline labs. LH/FSH, Total T, Free T, E2 (U do not need the sensitive essay at this stage) and Prolactin.
Days 1 –thru 7 – take 25mg every night prior to bed.
Day 8 – Run a follow up set of labs. LH/FSH, Total T, Free T, E2 ( U do not need the sensitive essay at this stage)

 

[Clint Lovelace]

My labs were posted not too long ago in another thread. I will find them and copy and paste again. This is the 4th doctor I have seen, and the first one who actually agreed a T level of 300 (my last reading, had been much lower) was not normal for my age and just accepting it and ED issues was not okay (as the last doc suggested).

Others mentioned this...what diagnostic tests should I be asking them about doing? The last doc, an endo, tried to do an MRI but insurance would not approve it becasue my prolactin level was not high enough (it was about a 12 and they wanted it at a 20).

let me look for the labs now.

 

[Clint Lovelace]

Here are my labs that were done in November and I saw the new doc in December. He just went off these labs plus all my labs from the other docs in the past year.

Glucose, 86, range 74-118
BUN, 11, range 8-20
Albumin, 4.2, range 3.5-4.8
Calcium, 9.3, range 8.9-10.3
Calcium Corr, 9.1, range 8.8-10.5
Phosphorus, 3.1, range 2.4-4.7
Sodium, 138, range 136-144
Potassium, 3.9, range 3.6-5.1
Chloride, 101, range 101-111
CO2, 28, range 22-32
AGAP, 9, range 3-15
Creatine, 0.9, range 0.7-1.4
BUN/Creatine Ration, 12
Osmolality, 285, range 275-295
Cholesterol, 177, range 0-200
Triglyceride, 120, range 0-150
HDL, 30, range 27-67
LDL, 123, range 0-100
LDL/HDL ration, 4.1, range 0-3
Cholesterol/HDL Ratio, 5.90
Cortisol, 12.2
FSH, 4.1
Luteinizing Hormone, 4.7
Prolactin, 10.84, range 2.60-13.10
T4 Free, 0.93, range 0.71-1.85
HgB A1c, 5.4, range 4.6-6.2
Glucose Est Avg, 108
Testosterone Total, 309, range 250-1100
Testosterone Free, 51.0, range 35-155

 

[Nelson Vergel]

Clint and all: Please post blood work in http://www.excelmale.com/forums/58-Blood-Test

 

[Vettester Chris]

Clint, I see you also posted them up on the BW forum. All is good, if it comes up again just link your future threads to that one, and any updated labs can just be added to that same thread


Do you by chance have the ranges on your LH & FSH labs? In most cases, 4.7i/UL on the LH isn't what I would call "in the tank", but a point or two higher might not hurt either. Although, I haven't kept track of it statistically over the years, I'd say a good majority of men that I've posted with over the years, who were diagnosed as secondary, and having serum levels in the higher 200's/lower 300's, 'usually' had LH values < 2.5i/UL. Again, there's no science or statistical data backing this, just more of an observational standpoint. I've corresponded with quite a few with similar serum results, sometimes lower, and the LH in the same range +/- a small margin, and some of them turned out to have an issue with one (1) or both testicles. Not saying this is you, just saying ...


Full-on primary hypo usually yields very high LH results, and very low serum levels. Just food for thought ... Stay on the course with your physician, and if the Clomid therapy is successful, you will have both higher gonadotropin levels, and definitely a higher serum level. If you see that your LH jumps up 2 or 3 points or more, but your test serum level is minimal, then you know it might be another factor. Actually, I like Keith's suggestion a lot!! That would tell you real quick about what direction this is going.


I'll tap on another area and hopefully not bog you down ... Your Free T4 has my attention. Again, this is just all conversational, and it's always best to align your decisions with a qualified physician. I'm of the opinion that a healthy FT4 and FT3 level will be in the 50% to 80% value of their respective ranges. Yours is at 19.3%. Now there's really not much more conversation I can make on this, as it's only one piece of the puzzle. T4 is your primary storage hormone produced by the thyroid, which converts downstream to T3. If I had to take a guess, based on the FT4, I'd say there's probably a similar pattern downstream, thus there's probably not much T3, T2, or T1. In other words, this could indicate hypothyroidism.


There's much more that is correlated with this, and even if your T4 is increased, then will it convert adequately, or will your T3 be effective at the cellular level. I stress you to research this further (places like stopthethyroidmadness.com are a great start), and get a complete thyroid panel (FT4, FT3, Reverse T3, TSH, TPO & TgAb Antibodies). There are also indicators like your calcium level of 9.3, which starts questioning areas like your Parathyroid glands. Again, research this deeper you will see what I'm talking about. One last thing then I'll shut up .. Add the other labs on STTM.com (all of them!), and pay close attention to Vitamin D. All indicators are that you are probably Vitamin D deficient, and your free test is just another. Your free testosterone is low at approx. 1.65% (at/around 44nmol/L on SHBG), which again will lead down the path of Vitamin D being a factor.

 

[blacore]

On your last blood work did you get a A1c test?

 

[Clint Lovelace]

What is A1C?

Chris, thank you for all that. I will have to do some research for sure!

Been on the clomid just at a month now and feel like its having some negative side effects on my chest--looks like the area around my nipples is getting "plumpy" if that even makes sense. I have been trying to watch it closely and just noticed it this weekend. May not be a big deal, who knows.

 

[GettingAnswers]

HbA1c is a lab test that shows the average level of blood sugar (glucose) over the previous 3 months. It shows how well you are controlling your diabetes. (it is more accurate than a single glucose reading)

 

[Clint Lovelace]

Does anyone know if taking clomid can cause any changes in a man's nipples or the area around his nipples? Yesterday morning I noticed what looked like a "plump-yer" area around my nipples and it freaked me out.

 

[Excel Male]

By increasing testosterone, Clomid (clomiphene) can increase estradiol. Clomid can cause gynecomastia in a very small group of men using Clomid which do not seem to have full suppression of estradiol receptors in their breast gland tissue by Clomid.

Here is a quote from a doctor:

"As a medication, clomiphene is usually well tolerated by men. In my experience, most patients don't feel anything as their testosterone rises. Those that do feel an increase in energy, sex drive, and muscle mass, especially if they work out. Very rarely I've had patients report that they feel too aggressive, or too angry. Very very rarely (twice in the last 20 years) I've had patients report visual changes. That's worrisome, as the pituitary is near the optic nerve in the brain, and visual changes suggests that the pituitary may be changing in size. Because the skull is a closed space, it's alarming if anything in the brain changes in size. In the last twenty years, I've also had two patients who had breast enlargement (called “gynecomastia”) while using clomiphene. Needless to say, for any of these problematic side effects, the clomiphene is discontinued." http://www.maledoc.com/blog/2010/04/28/how-clomid-works-in-men/

 

[muhusmanguj]

By increasing testosterone, Clomid (clomiphene) can increase estradiol. Clomid can cause gynecomastia in a very small group of men using Clomid which do not seem to have full suppression of estradiol receptors in their breast gland tissue by Clomid.

Here is a quote from a doctor:

"As a medication, clomiphene is usually well tolerated by men. In my experience, most patients don't feel anything as their testosterone rises. Those that do feel an increase in energy, sex drive, and muscle mass, especially if they work out. Very rarely I've had patients report that they feel too aggressive, or too angry. Very very rarely (twice in the last 20 years) I've had patients report visual changes. That's worrisome, as the pituitary is near the optic nerve in the brain, and visual changes suggests that the pituitary may be changing in size. Because the skull is a closed space, it's alarming if anything in the brain changes in size. In the last twenty years, I've also had two patients who had breast enlargement (called “gynecomastia”) while using clomiphene. Needless to say, for any of these problematic side effects, the clomiphene is discontinued." How Clomid Works in Men - Male Health

By increasing testosterone, Clomid (clomiphene) can increase estradiol. Clomid can cause gynecomastia in a very small group of men using Clomid which do not seem to have full suppression of estradiol receptors in their breast gland tissue by Clomid.

Here is a quote from a doctor:

"As a medication, clomiphene is usually well tolerated by men. In my experience, most patients don't feel anything as their testosterone rises. Those that do feel an increase in energy, sex drive, and muscle mass, especially if they work out. Very rarely I've had patients report that they feel too aggressive, or too angry. Very very rarely (twice in the last 20 years) I've had patients report visual changes. That's worrisome, as the pituitary is near the optic nerve in the brain, and visual changes suggests that the pituitary may be changing in size. Because the skull is a closed space, it's alarming if anything in the brain changes in size. In the last twenty years, I've also had two patients who had breast enlargement (called “gynecomastia”) while using clomiphene. Needless to say, for any of these problematic side effects, the clomiphene is discontinued." How Clomid Works in Men - Male Health

 

[muhusmanguj]

Does anyone know if taking clomid can cause any changes in a man's nipples or the area around his nipples? Yesterday morning I noticed what looked like a "plump-yer" area around my nipples and it freaked me out.

Its been 9 years was your problem solved somehow? I am also diagnosed with low testosterone (230) at 30 years of age. Doctor prescribed be Tamoxifen which has similar effect as of Clomid. I am suffering from ED and leg weakness since 2 months before that i was fine