Thanks Vince, but I suspect I may not have blood flow problems, but not ruling it out completely. This is why I suspect I don't have that:
1. Sometimes very ocassionally when TRT actually works (say 1 out in 10 weeks), I am horny and I can get an erection easily just with thoughts about sex.
2. I usually get nighttime/morning wood.
So then I guess it goes back to the libido fine tuning with TRT and E2 control. Is there any blood test that can help determine if you may have blood flow problems or bad circulation?
Libido/erectile function and health are complex as many other factors can have a negative impact regardless of having healthy testosterone levels.
Poor cardiovascular/endothelial function, issues with NO production/levels, lack of sleep, excess stress (mental/physical), poor diet, psychological issues (depression/anxiety), underlying health issues, smoking and abuse of alcohol/recreational drugs and so on.....you get the point.
The number one factor regarding erectile function is having a healthy cardiovascular system.
Healthy functioning endothelial cells which line the inside of blood vessels are critical to having good blood flow and NO (nitric oxide) levels play a big role in the optimal function of blood vessels.
Sure testosterone plays a strong role regarding libido/drive and yes even erectile function/health as there are AR (androgen receptors) in penile tissue and testosterone also increase NO (nitric oxide).
Erections start in the bodies most important sex organ.....no not the staff of glory but the brain.
Sure high/low e2 can have negatives effects on ones libido/erectile function as can elevated prolactin and of course low testosterone as we all know but there are so many other factors which can cause problems with libido/erections and it is not always as simple as having healthy total/free t levels along with e2.
One needs to look over other areas which may be contributing to the problem.
