TRT erection issues

[Charliebizz]

I want to piggy back on this post. I've been on TRT for more than a year now and so far the only thing that has been effective for me as far as giving me confidence in the bedroom is taking my antidepressant. Antidepressants usually lower libido, but my libido was as low as it could be before and during TRT. I finally realized that anxiety was giving me massive performance anxiety. The antidepressant was the game changer for me. I actually had sex twice in one week for the first time in years. It's all about feeling relaxed for me. My libido is still the same so I'm really leaning towards ending TRT since I've had no improvement in that department pre-antidepressant anyway. Perhaps losing weight will help in that department, I don't know. I too am worried of what the withdrawal process would be like. I have my 90 day with Defy coming up soon so I'll discuss it with them, however I'd like to hear from guys who did go off cold turkey.

I’m off cold turkey for over a month. When I wasn’t on ssri I had a 2 week period where I feel awful. But without ssri trt lowered my cortisol as low as 6. On ssri I come off trt pretty easy I had a day or two where I was blah but I’m doing fine now.

 

[atlien2488]

Yeah SSRI's destroyed my T levels and libido which were a one of the contributing reasons I got on. DIdn't effect function much at all though once I got it going. I will say that it does wonders for anxiety and depression but for me I started to feel very flatlined and lethargic after a few years on it. Lexapro is prescribed at extremely high doses and is one of the hardest SSRis to get off of besides Paxil or effexor so please be careful! Its basically Celexa on steroids lol. took me a year to get off but TRT definitely helped me in that regard. Sounds like you're dosed pretty low Charliebizz, which is the smart route to go.

 

[atlien2488]

Curious point in this is your time on this forum and your self proclaimed advance knowledge, and much we harp on the proper E testing but youre still getting it wrong, nor working within the accepted bits about low SHBG dosing protocol's.

Vince, yeah the e2 and the e2 sensitive come back in pretty much the exact same range for me I've used them both. I've spoken with quite a few endos and aging clinic doctors who actually argue that the e2 standard test is better. (not saying this is true but for me but both tests always come back in the same range whenever I get both values) I'm not sure if that's what you're referring to....... I know that the consensus on here is to do EOD, 29 gauge, subq shots and not take an AI. I'm not opposed to that, but right now my doctor is, and if the new protocol doesn't work, I probably will anyway. Me "still getting it wrong" is the reason I'm on these forums to find younger guys that have had the same type of issues and how they've dealt with them. Sorry if I sounded arrogant, that wasn't my intention. I just care a lot about my health, try to dive deep on these subjects and gain as much insight from others as possible. Like I said, I don't see a lot of guys past their 50s with the same issues as us young guys on these forums.

Gman- Yup, I'm gonna try the two a week shots and if it doesn't improve I'll probably switch up the regularity to EOD

user-joe- I've tried to go without an AI, and always try to limit what I put in my body but my E2 got pretty damn high and hurt erection quality even more. I was on anastrozole before which destroyed my E2 but aromasin usually keeps me between 25-35 give or take. We'll see how my new dosing protocol works out C:

 

[Charliebizz]

Yeah I’m on lexapro 2.5 mg or 5mg. I never go passed 5. I read using ssri for low cortisol symptoms from dr Mariano. It’s the only thing that helped so far. Hydrocortisone. Didn’t help at All. Felt like is was on a rollercoaster

 

[atlien2488]

That’s good man... some doctors start at 10 and go to 20 which is literally such a high dose...getting off of 5 isn’t too hard. Still took me 6 months tho with the liquid formulation...it’s kind of like a bandaid, it won’t heal large issues you have but it will certainly mask them

 

[Joey786]

I feel for guys that can’t seem to find a protocol that works. I can only speak to my experience on trt. Every time I’ve added an ai, even at a small dose, .25mg, I get erectile dysfunction and low sex drive. Even with estradiol at 78pg/ml taking ai killed my sex drive. Please don’t stop trt. Stop taking ai, lower your dose a bit and split up your injections.

 

[wsj357]

So you believe that TRT is for everyone?

My doctor tells me that the decision to engage in any course of treatment must be weighed against the side effects of the treatment.

Then low t isn’t your issue. With the symptoms I had , my life was going to abruptly end within years or months if I didn’t find a solution. Trt was a must. I had to get fixed regardless of the cost pain anguish length whatever.. if my marriage had to end so be it. I was determined to get fixed. If trt took me 5 years to figure out and 50k I would of stayed with it , because I feel much better than I did 6 months ago.

Solid no.. Folks who are not dying with symptoms due to Low t don’t have to start trt. But there will probably come a time where life jsut sucks. Can’t wake up. Can’t eat. Can’t enjoy your children and take them out to play: can’t stay fit. Can’t think positive. Feel like death upon awakening and until bed time. Can’t pay bills. Can’t work. Can’t focus. The list goes on.

I needed trt. I didn’t want it. there’s zero comparison between myself and a guy who can even consider coming off because he hasn’t been dialed in yet.

I am pretty sure that I’ll probably just end my life before I am forced to go back to my prior state of hell.

 

[Prime]

Then low t isn’t your issue. With the symptoms I had , my life was going to abruptly end within years or months if I didn’t find a solution. Trt was a must. I had to get fixed regardless of the cost pain anguish length whatever.. if my marriage had to end so be it. I was determined to get fixed. If trt took me 5 years to figure out and 50k I would of stayed with it , because I feel much better than I did 6 months ago.

Solid no.. Folks who are not dying with symptoms due to Low t don’t have to start trt. But there will probably come a time where life jsut sucks. Can’t wake up. Can’t eat. Can’t enjoy your children and take them out to play: can’t stay fit. Can’t think positive. Feel like death upon awakening and until bed time. Can’t pay bills. Can’t work. Can’t focus. The list goes on.

I needed trt. I didn’t want it. there’s zero comparison between myself and a guy who can even consider coming off because he hasn’t been dialed in yet.

I am pretty sure that I’ll probably just end my life before I am forced to go back to my prior state of hell.

Ok

 

[wsj357]

We’re obv both right. You’re absolutely right, and I agree, it’s very important to consider the mental aspects that could be causing issues. The brain is way more powerful, and has way more control over things than we’d probably like to admit. Even if it’s on a subconscious level that we’re unaware of.

When I use my personal method, I make sure to only use the same few porn videos, so that there are less variables to consider. And one could argue that maybe those videos get old, and they have less of an effect. But it doesn’t seem to be the case. What controls how I feel about them, and how they effect me, seems to be all related to my hormones. At least for me. And even I could be wrong. Maybe there are mental things going on at a subconscious level that I’m not aware of that’s effecting things.

Even though the mental aspect does play a role obv, it has always just bothered me a little on a personal level, when people chalk things up to it being a mental thing that we can overcome, or will ourselves through. I honestly think I might be coming from a biased perspective, as I’m only basing these things off of my own experiences, but hormones have way more control over things than we realize. Again, in my experience. For instance, while on clomid, my thoughts were completely different, how I treated people was completely different, had extreme depression, anxiety, suicidal thoughts, libido was in the drain, erections gone, energy gone. Just dark thoughts all day. This was while making no mental changes in my life. No added stress, still eating the same, still working out like I always do. Literally changing nothing. It was all from hormones, imo. For me, libido and erections are the same thing. I change literally nothing in my life, and hormones appear to control these things almost entirely.

But again, you’re right. The mental aspect has to be considered as well. Performance anxiety is absolutely a real thing. Level of attraction doesn’t matter too much imo. If you’re hormones aren’t balanced, and you’re with a very attractive girl, you might go from a limp noodle to being able to get a decent erection. But I doubt being attracted to a person and a high level of intimacy is going to take you from low/ no libido and limp noodle, to 16 year old libido and erections. I’ve found that a lot of the mental aspects can help a little, but without the hormonal foundation, you’re still playing with a handicap.

But again, this is just my current opinion. I respect anyone that favors the mental aspect a little more than I do. And obv the world works on a balance system. So the real answer is to focus on balancing out both. Not just focusing on one or the other.

Not a direct attack on you by any means but I feel nobody acknowledges what I’m about to say. It’s like sex is normalized and not a big deal to people anymore.

We have to realize Porn is just outright bad for men. It’s addictive and easy to please oneself. You screw up your hormones and create defeciences if watched too much. The brain changes and the body now behaves differently when aroused. It’s lookint for sex on a screen. Not the smell of a woman or a slight tease. The talk before having a good time.

This causes serious damage and Especially for younger growing men who have not matured yet. It’s a shitty way to learn about sex. It creates unrealistic expectations and ultimately re-wires our brains.

In turn it’s creAted billion dollar industries based on getting men and woman fertile and erectioe dysfunction.

It is a current epedmeic causing serious harm to men and woman across the world. So many men and boys have ED today yet they rarely say “dude lay off the porn”. Instead here is some viagra and some T. That’s what 4-5 docs did for me in my 20s... instead of saying “how much sex are you experiencing daily”.... or “do you watch porn and masturbate too often”.?

I am seriously curious how many guys have considered this as there issue. Like honestly. If one watched porn for ten years it’s not going to be fixed in 3 months or 6 months.

Any how sorry for the rant and I can agree it’s not just porn. You also have the sex culture. Hormonal imbalances and toxicity that’s causing issues.

I hope some young kid googles across this response and it helps him like it helped me. Or parents of young children explain why they should not resort to porn at s young age.

 

[Gman86]

I think you’re spot on with everything you said. I’ve tried quitting porn and masturbation a bunch of times. I know I’m addicted, and I know that the constant dopamine spikes I get from it aren’t healthy. It luckily hasn’t effected how I perform with girls in the real world, but everyone’s different. I’m sure it absolutely has an effect on some guys, especially if they’re not on TRT.

It’s just so difficult to not look at it. And masturbating without it is just too boring. The most I’ve gone is a week I think. If I had a wife, and/ or kids around all day, it would be easy to not do it. But for single guys, it would take a very strong minded person to not do it. I know I’m not strong enough, personally. I’ve tried and failed enough times to know I can’t stop.

 

[wsj357]

I think you’re spot on with everything you said. I’ve tried quitting porn and masturbation a bunch of times. I know I’m addicted, and I know that the constant dopamine spikes I get from it aren’t healthy. It luckily hasn’t effected how I perform with girls in the real world, but everyone’s different. I’m sure it absolutely has an effect on some guys, especially if they’re not on TRT.

It’s just so difficult to not look at it. And masturbating without it is just too boring. The most I’ve gone is a week I think. If I had a wife, and/ or kids around all day, it would be easy to not do it. But for single guys, it would take a very strong minded person to not do it. I know I’m not strong enough, personally. I’ve tried and failed enough times to know I can’t stop.

Yup it’s very hard but habits are what make addictions. You need to change the way you operate. If I think about not smoking or drinking I’m going to smoke and drink. The moment I start thinking about something else; I one day wake up realizing I’ve gotten past it.

The goal is to change the way our brain operates .. Trust me.:: it just takes time and has to be at the right time. There will be a window of opportunity. When it happens run with it ... until then this is the journey your on.

This is where clearing the mind and being in the moment helps.

I was absolutely fearful of losing my ability to have sex and getting it up. That gave me plenty of determination to jsut stop. Many months later I woke up and realized i was attracted to the slightest scent of a woman. I found this to be more satisfying and decided to stick with it.

There’s so mich more to it. But your strong enough to get past it. Especially now that you’ve realized it.

I was exactly where you are and it’s been 10 years since I’ve had this issue.

 

[RoneTone]

atlien2488 - Your SHBG is low. Have you ever been tested for fatty liver or done a insulin/OGTT Kraft survey? Guys with low SHBG might have insulin resistance or be norepinephrine dominate (neurotransmitter imbalance) and this is causing vasoconstriction and endothelial dysfunction (or low SHBG is a sign of inflammation like Dr Chrisler used to say).

I too never got much benefit downstairs from TRT, but got loads of other benefits. The best drugs that have worked for me were those that manipulated my norephinephrine levels (lowering them), blood pressure meds, etc. BTW - I am very lean so it's not an obesity issue.

So far the best drugs that have worked for me, after years of searching, is using metformin/trt/cialis together. The use of metformin makes complete sense for those with insulin resistance/endothelial problems. Diabetics for example have very high rates of ED due to high insulin levels destroying endothelial function.

You can read more about why it works here: Effects of metformin on endothelial health and erectile dysfunction

It's worth a shot to look into how healthy your liver and how your body is handling glucose/insulin. I'm not suggesting that metformin is the drug for you, but it's worth looking into why your SHBG is low.

 

[Mountain Man]

Not a direct attack on you by any means but I feel nobody acknowledges what I’m about to say. It’s like sex is normalized and not a big deal to people anymore.

We have to realize Porn is just outright bad for men. It’s addictive and easy to please oneself. You screw up your hormones and create defeciences if watched too much. The brain changes and the body now behaves differently when aroused. It’s lookint for sex on a screen. Not the smell of a woman or a slight tease. The talk before having a good time.

This causes serious damage and Especially for younger growing men who have not matured yet. It’s a shitty way to learn about sex. It creates unrealistic expectations and ultimately re-wires our brains.

In turn it’s creAted billion dollar industries based on getting men and woman fertile and erectioe dysfunction.

It is a current epedmeic causing serious harm to men and woman across the world. So many men and boys have ED today yet they rarely say “dude lay off the porn”. Instead here is some viagra and some T. That’s what 4-5 docs did for me in my 20s... instead of saying “how much sex are you experiencing daily”.... or “do you watch porn and masturbate too often”.?

I am seriously curious how many guys have considered this as there issue. Like honestly. If one watched porn for ten years it’s not going to be fixed in 3 months or 6 months.

Any how sorry for the rant and I can agree it’s not just porn. You also have the sex culture. Hormonal imbalances and toxicity that’s causing issues.

I hope some young kid googles across this response and it helps him like it helped me. Or parents of young children explain why they should not resort to porn at s young age.

Contact some mental health specialists who specialize in this. You are describing what is an addiction and it is not much different from any other addiction. This is referred to as a process addiction and porn addiction is becoming far more prevalent. It doesn’t have to be this way for you. Google some help and get some therapy. Combine some solid therapy with a 12 step program for sex addiction and attack this disease-and don’t be fooled by what people say, it is a disease- and fight it. There is an emerging part of mental health that specializes in this.

 

[Charliebizz]

Yeah SSRI's destroyed my T levels and libido which were a one of the contributing reasons I got on. DIdn't effect function much at all though once I got it going. I will say that it does wonders for anxiety and depression but for me I started to feel very flatlined and lethargic after a few years on it. Lexapro is prescribed at extremely high doses and is one of the hardest SSRis to get off of besides Paxil or effexor so please be careful! Its basically Celexa on steroids lol. took me a year to get off but TRT definitely helped me in that regard. Sounds like you're dosed pretty low Charliebizz, which is the smart route to go.

So weird though I had a bout of intense panic attacks back in my early 20S. I was on a high dose of Paxil for over a year. I quit that cold turkey and had zero side effects. Then over 10 years later I tried low dose lexapro for helping with low cortisol issues as per dr Mariano. Worked wonders. At a point last year I wanted to see how it was if I came off. I did have some bad brain zaps for a few weeks. Then they went away wasn’t too bad. Only thing is my low cortisol like symptoms came back so I’m back on

 

[wsj357]

Contact some mental health specialists who specialize in this. You are describing what is an addiction and it is not much different from any other addiction. This is referred to as a process addiction and porn addiction is becoming far more prevalent. It doesn’t have to be this way for you. Google some help and get some therapy. Combine some solid therapy with a 12 step program for sex addiction and attack this disease-and don’t be fooled by what people say, it is a disease- and fight it. There is an emerging part of mental health that specializes in this.

That’s exactly right and how one works through any addiction in life.

 

[Joe Sixpack]

So weird though I had a bout of intense panic attacks back in my early 20S. I was on a high dose of Paxil for over a year. I quit that cold turkey and had zero side effects. Then over 10 years later I tried low dose lexapro for helping with low cortisol issues as per dr Mariano. Worked wonders. At a point last year I wanted to see how it was if I came off. I did have some bad brain zaps for a few weeks. Then they went away wasn’t too bad. Only thing is my low cortisol like symptoms came back so I’m back on

You used lexapro for low cortisol? I didn't know Lexapro could do that.

 

[Charliebizz]

Dr Mariano spoke about it years ago. I’m not sure off hand exactly how it works. But it helped a lot for me personally