Soft / No Erections

[StevoDevo]

Hi Guys,

I'm a 45 year old, fit male that works out 4 - 5 days a week and am on TRT. I'm on a 0.4ml of 200mg TestCyp dosage twice a week and have been for the past 3-4 years. Recently I've started having a rough time with erections! I'm married and have tried Tadalafil with various success. I was prescribed a 20mg dosage and was told to take 10mg at a time (it's a troche not a pill) so I split it and take it.

I've had very varied success with it to the point that it's just not reliable! I took one last night for example about an hour or two before going to bed. I was completely unable to get an erection - got a little hard, but not hard enough for penetration.

So I'm a little lost as to what to do. Next time I might try taking the full 20mg dosage and see what happens. Those on ED medicine, have you found the different types work differently? Like should I try Viagra or Lavitra? Or are the pills more effective than the troches?

The other thing I've seen on here is people going with a 5mg daily dosage.

I'm just kinda lost for ideas - I want to be able to reliably have sex without having to worry about if I'm going to be able to get up!!

Thanks for the help / advice!!
Steve

 

[Systemlord]

Have you had your estrogen tested lately using the LS/MS/MS method? Elevated estrogen could cause erections to become erratic and difficult to maintain, surprised you're not on an arimidex. Elevated prolactin can also cause problems.

What does your thyroid lab look like?

 

[StevoDevo]

Have you had your estrogen tested lately using the LS/MS/MS method? Elevated estrogen could cause erections to become erratic and difficult to maintain, surprised you're not on an arimidex. Elevated prolactin can also cause problems.

What does your thyroid lab look like?

Good questions - I did do a Estradiol Sensitive Lab last and it came in low at 5.4 - is that the LC/MS/MS estrogen test you were referring too?

I do have regular Thyroid labs and they all come back normal range (TSH = 3.48, Free T4 = 1.25 and Thyroid Peroxidase AB = 10).

What can I do about the low estradiol? I'm ready to do whatever it takes! I see the Defy people so if Arimidex is then I'll talk with them about that too!!

 

[Systemlord]

More testosterone will create more estrogen, yes the LC/MS/MS is the only test you should concern yourself with.

 

[captain]

You let a troche dissolve in your mouth you do not swallow it. Try using it sooner to make sure its there when you need it. It can last for 3 days so your not going to be taking it too soon. If that don't do it there is a combo Sildenafil/Tadalafil that works well.

 

[Mountain Man]

You may want to split pills. I am a patient at Abraham Morgantaler's clinic in Boston and the protocol they have me on is 5 mg cialis daily in the morning and 20 added when sex is planned. Works like a charm every time. Of course, his caveat is that it depends on your heart, BP, and extent of ED. You also may want to consider the source of your med. I use Ceebis, which I get from All Day Chemist. Anything that comes from Cooper Pharma is great. I get the 20 mg pills and split them

I am not a personal patient of Morgantaler, but I do get to see him when he fills in when one of his PAs are out. They run everything by him. I did meet with him and mentioned the exact same problem. He said that I should gradually adjust the dose up until it worked as I wanted. After that, that's the dose for sex. He also said that it can be combined with viagra before sex. I find viagra gives a little stronger erection but is very inconsistent due to the need to plan around meals.

To put this in perspective, I told Morgantaler that I was having trouble with sustaining erections some of the time and he asked me how often I was having sex and I said 2-3 times per week when actually it was more like 4-5. He said “Wow, that's great. Most guys your age have sex once per week and they are ecstatic. Take the higher dose”

You also are at that age, mid 40s, where a marriage can struggle sexually for a lot of reasons that aren't necessarily all due to you. You and the wife can panic, making it a huge problem, or you can accept that there is an ebb and flo to a long term monogamous marriage and just have fun. Sex can't be a competition, it should be a fun healthy way to stay connected to the woman you are in love with. I have gone through similar periods, I am 64 married for 31 years and haven't been with anyone else since 1987.

Take a higher dose of a pill, not a trouche, you and the wife keep yourselves fit and healthy, and enjoy the security of knowing you have someone you can have great sex with multiple times per week. Pretty simple actually.

 

[Vince Carter]

Many of us find that contrary to what the manufacturer claims, Cialis in particular is not effective taken 30-60 min prior to sex. Even 10-20mg I notice its hours like 6-8 before it seems to be effective. Using 5mg twice per day is a very good strategy you can try. Also as MM says Viagra needs a strategy around meals, you want to use that 3-4 hours after eating and an empty stomach is best. You can also pair Cialis with Viagra but again as also noted go low and slow and see your tolerance for combining them.

 

[buggies100]

I am just turning 55 and a couple years back starting having trouble finishing. Getting up and running was no problem. OI have been on TRT for 5 1/2 years now. My E2 is fine as well as thyroid values. Free T could be a bit higher, but is in range. Problem was not overly consistent in not finishing, just sometimes. Which created this small level of trepadation in me each time we had sex, so that then added to the problem. I tried viagra and boom problem fixed. However, as others have stated food timing issues is a problem. So I moved to 5 mg claims, or Ceebis or ......, each morning and no problems. I had tried a ring and that did not work for me. Maybe it was not tight enough. However, the 5 mg daily is not always enough if we are going at it midweek late evening. I say it is because I am up at 4 am and in the gym at 5 and not home from work until 6-7. So if we are going at a midweek run, I take a 10 mg viagra as well. I can keep it up for long time, so wife is very happy, i may however, still not finish. I guess it is still a bit physiological and psychological. Be aware that when you start daily dosing that you may have pretty bad back pain for a week or so at first. Mine felt like I was just super tight. I did roller and stretches in evening and that helped.

 

[StevoDevo]

Many of us find that contrary to what the manufacturer claims, Cialis in particular is not effective taken 30-60 min prior to sex. Even 10-20mg I notice its hours like 6-8 before it seems to be effective. Using 5mg twice per day is a very good strategy you can try. Also as MM says Viagra needs a strategy around meals, you want to use that 3-4 hours after eating and an empty stomach is best. You can also pair Cialis with Viagra but again as also noted go low and slow and see your tolerance for combining them.

When I was prescribed the troches they told me they would be effective more quickly than the pills which (the more I use them) seems NOT to be the case. Maybe it's just Cialis like you said! Interestingly enough, we tried again last night (and I haven't taken anything since the 10mg the night before) and bingo - it took a bit of work but eventually I had a nice, hard erection!

I'll see if I can get a prescription from Defy for some Viagra pills to supplement with. Why do they have to be take on an empty stomach?

 

[Vince Carter]

Pfizer(?) states V is less effective on a high fat meal I think that's how they say it, has absorption issues.

 

[Zooka15]

The best way for “viagra” is to have your doctor write you a prescription for 20mg sildenafil generic for revatio. You can get 30 tabs at sams club for $10

 

[Bob1974]

Last time I bought some 100mg generic Viagra from pharmstore I got 88 tablets for less then $45. I bite them in half so I'm really taking 50mg which works out to about 25 cents a dose. Generic 20mg Cialis is like $58 for 88 tablets

 

[bigpappa160]

If any of the pills don't work, your last options are, getting a pump put in or going with A shot of Edex in the penis. The Edex works wonders. I've tried Viagra and Cialis! Cialis I should've stuck with, didn't know any better, but I went with Viagra but you had to take it on a empty stomach for it to work and my chest was pounding so hard I thought I was having a heart attack, then eventually Viagra didn't work until the next day, walking around the house with a erection and hoping it goes down before going to the gym. But Edex, I take 40mg and it already comes in a kit! Well, Edex has 3 different dosage 10mg, 20mg, 40mg. I went with the full 40mg. The needle is as small has a insulin needle. Don't even feel the needle. Then tell your significant other bam hold. I suggest not to take edex and Viagra at the same time because when edex wears off viagra will kick in and you'll be hurting in the morning!

 

[Leesto]

At my age (63) my wife and I find that late in the day is not a good time. We did some experimentation and found I can usually get and maintain an erection before about 5 pm but afterward it is more like a 20% chance. By 8 or 9 PM it drops to almost no chance. After switching to late morning or early afternoon sex things are good. I don't know why this is nor whether it's just me, but perhaps the info will help others experiment and learn what works best.

 

[GeauxBears]

Good questions - I did do a Estradiol Sensitive Lab last and it came in low at 5.4 - is that the LC/MS/MS estrogen test you were referring too?

I do have regular Thyroid labs and they all come back normal range (TSH = 3.48, Free T4 = 1.25 and Thyroid Peroxidase AB = 10).

What can I do about the low estradiol? I'm ready to do whatever it takes! I see the Defy people so if Arimidex is then I'll talk with them about that too!!

If you are at 5.4 for E2, that is 100% why you have erectile issues. The worst sexual dysfunction I have ever had is when E2 is too low.

 

[Starplex]

Everyone is different, I take a daily 5mg Tadafil dose in the morning and in the afternoon I take 1 gram of L-arginine. After adding the L-Arginine I saw a Huge difference in erection quality and sensitivity. I only take it on work out days and when I miss about 4 days of workouts and don't take it, I can definitely tell a difference. Note: I also take a pre-work out that has 6 grams of L-Citrullene, and maybe it is the combination of the two doing something, but I know the effect wasn't there when I only took the pre-workout. Only occurred after adding the L-Arginine.

Very odd that your E2 numbers are so low on 200mg of Tcyp, and no AI. I would have expected them to be way on the other direction.