My regular ED regimen not working + anxiety - advice welcome

[crazyhaha]

Hi everyone. I’m 45 and been on TRT for 6 or 7 years now (Excelmale has been a fantastic resource!!). For the past 5 years I’ve had things dialed in pretty well.

But the last few months I’ve been having anxiety and ED problems even though I have increased my daily Cialis to 15 mg!! (I’m not sure this is even a good idea)

So, I’m wondering if there is something I can add or change that might address my anxiety and/or ED. I take the lowest does of an SSRI, and I hesitate to raise it. But I’m practically having panic attacks before sex sometimes.

My doc had me take anastrozole for a few weeks in May/June to get my Estrogen back down. Not sure if that is part of the problem or a solution. The E still seems high to me (can that be the problem)?

Night time:
Lisinopril 20 mg (high blood pressure)
Citalopram 10 mg (celexa - anxiety)
DHEA 25 mg (Dehydroepiandrosterone - deficiency)
Levociterizine 5 mg (allergies)
Cialis 10 mg (Erectile dysfunction)

Morning:
pantoprazole PPI 20 mg (reflux/Barret’s Esophagus)
DHEA 25 mg

Every other day, at night:
50 mg testosterone cypionate IM injection (0.25 ml testosterone cypionate @ 200 mg/ml)
500 IU HCG (Human chorionic gonadotropin) SQ injection (0.50 ml HCG @ 5,000 IU/5 ml)

Vitamins:
DHA 2 g
Multivitamin, C, D, K7, B complex, probiotic

Amino acids:
Citrulline and Arginine, AM and lunchtime

Labs – August 2021
Test. Total 822
Free Test. 30.5
SHBG 11.3
Estradiol 40.0
Hgb 15.6
Hematocrit 50.6

 

[Vince]

The only thing I can think of, add in 100 mg of Viagra, before sex. That should do the trick.

 

[ajax31]

What does your diet look like? And I would also be concerned about long-term use of a PPI.

Maybe try a course of zinc L-carnosine to try to heal the stomach lining and esophagus. If it works, ask your doc about coming off the pantoprazole.

If the gastrointestinal tract is inflamed or generally messed up (leaky gut), then nothing works properly in the rest of the body.

 

[crazyhaha]

Vince, I like the answer. If the hammer doesn't work, get a bigger hammer.

Ajax31, My diet is pretty good but there is no "healing" my upper GI problems. Hiatal hernia and Barret's aren't fixable without surgery and I've been told the surgery far worse than the risk with PPIs. But thank you for the suggestion! I'll look into zinc L-carnosine, maybe it can still help.

 

[Rago]

Hi everyone. I’m 45 and been on TRT for 6 or 7 years now (Excelmale has been a fantastic resource!!). For the past 5 years I’ve had things dialed in pretty well.

But the last few months I’ve been having anxiety and ED problems even though I have increased my daily Cialis to 15 mg!! (I’m not sure this is even a good idea)

So, I’m wondering if there is something I can add or change that might address my anxiety and/or ED. I take the lowest does of an SSRI, and I hesitate to raise it. But I’m practically having panic attacks before sex sometimes.

My doc had me take anastrozole for a few weeks in May/June to get my Estrogen back down. Not sure if that is part of the problem or a solution. The E still seems high to me (can that be the problem)?

Night time:
Lisinopril 20 mg (high blood pressure)
Citalopram 10 mg (celexa - anxiety)
DHEA 25 mg (Dehydroepiandrosterone - deficiency)
Levociterizine 5 mg (allergies)
Cialis 10 mg (Erectile dysfunction)

Morning:
pantoprazole PPI 20 mg (reflux/Barret’s Esophagus)
DHEA 25 mg

Every other day, at night:
50 mg testosterone cypionate IM injection (0.25 ml testosterone cypionate @ 200 mg/ml)
500 IU HCG (Human chorionic gonadotropin) SQ injection (0.50 ml HCG @ 5,000 IU/5 ml)

Vitamins:
DHA 2 g
Multivitamin, C, D, K7, B complex, probiotic

Amino acids:
Citrulline and Arginine, AM and lunchtime

Labs – August 2021
Test. Total 822
Free Test. 30.5
SHBG 11.3
Estradiol 40.0
Hgb 15.6
Hematocrit 50.6

The Citalopram (Celexa) could be why. I have read that it can kill libido leading to ED. Wellbutrin doesn’t have that side effect and helps with performance anxiety.

 

[crazyhaha]

What does your diet look like? And I would also be concerned about long-term use of a PPI.

Maybe try a course of zinc L-carnosine to try to heal the stomach lining and esophagus. If it works, ask your doc about coming off the pantoprazole.

If the gastrointestinal tract is inflamed or generally messed up (leaky gut), then nothing works properly in the rest of the body.

After looking it up, I'm definitely going to try zinc L-carnosine. Thank you!!

 

[ajax31]

After looking it up, I'm definitely going to try zinc L-carnosine. Thank you!!

My father swears by it. Two days after I started giving it to him, he said his stomach pain and acid reflux was gone.

Good luck.

 

[Golfboy307]

Don't underestimate the mental side when it comes to performance anxiety. It can immediately kill erections before you start. It is hard to deal with, but if your partner is willing, it is worth the time. Mountain Man on this forum can help with some great resources. Cialis and Viagra can't overcome the your brain firing adrenaline and cortisol through your system due to panic attack. Your penis doesn't stand a chance. Trust me, I have been there and don't want to go back.

 

[DixieWrecked]

Don't underestimate the mental side when it comes to performance anxiety. It can immediately kill erections before you start. It is hard to deal with, but if your partner is willing, it is worth the time. Mountain Man on this forum can help with some great resources. Cialis and Viagra can't overcome the your brain firing adrenaline and cortisol through your system due to panic attack. Your penis doesn't stand a chance. Trust me, I have been there and don't want to go back.

Wise words right here.

 

[sammmy]

Possible causes of ED are the antihistamines in general (can cause erection problems) and the antidepressant (these usually affect libido and orgasm, not erection).

Possible causes of anxiety is DHEA and your high weekly dose of testosterone making you hyper. Aromatise inhibitor may make it worse so don't use just for correcting some lab values.

 

[UCFguy01]

If I take anastrozol, nothing works for 3 days. I switched to exemestane which seemed to be somewhat better. If I were you, I'd stay away from both and just roll with the estrogen at 40 (which isn't that high)