Erectile Dysfunction

[Rico]

ComeBackid,

I have nothing against Levine, I said if you read back a few post that he says that the up and down method is not correct, but once again has no study to back it, it is confusing that all the "doctors" want studies, but they can say what they want....read back about 8 months....the up and down is short periods and repeat, he thinks longer period like 5 minutes for several times a day....this is his opinion and maybe he thinks it is right, so be it....like I said, you have to go with your heart on this one....I will choose the later, the Spievy, which by the way I thank you for showing me...and I thank the Old Man also, his might be a little different, but I like the Old Man's way of thinking, take it slow, be careful, less is better....I myself wouldn't put it on for five minutes the first time.....that is me, I will go more like 5 seconds for several times to I get a feel for it....another thing Levine said in one of his old posts is that the look in the tube is not real because of the blood giving a false imaging of what is happenings, it is filling the tissue and not st recthing the tunica, this to be doesn't make sense, I feel that you are stretching it from the inside out, which is why I feel is better than massage or traction, the scar runs deep and is less suitable to further injury from this approach IMHO, because you are not pulling on the outside of the injured area as much.....

Rico

[ComeBacKid]

Rico,

I'm kind of confused as to what you are saying?  I did not see a post from Dr. Levine saying that holding the VED for longer time periods is the way to go, if he did say that its just his opinion.  I'm saying I don't think it can hurt.  You say Mick, Angus, and Old Man had the common sense to try this, I agree, I think VED therapy is the way to go thats why I'm trying it as well...  Dont forget the many others who have tried it as well... steve, soxfan, ziggy, tim etc...

I kind of lost you in your last three posts man, personally I think Dr. Levine is just trying a new protocol for stretching in doing it for longer period, this may work better, or it may not, we don't know really, Dr. Levine is going to the bat for us and I appreciate his efforts, hes doing more than most doctors who tell us to go stare at our dicks and take vitamin E.  I don't think Dr. Levine is condemning the current protocol by Augusta Medical Systems, if he is please show me the post.  I think you kind of misinterupted what I was posting about.  I hope there will be more studies on the VED therapy andwe can learn even more about it.

ComeBackid

[Rico]

ComeBackid,

Remember that they have been sticking people with needles and drugs for years, this is why now he is saying that the cure is 50% medical and 50% mechanical, how does he know this, or is the a classic CYA, Mick, Old Man, Angus went with 100% Mechanical, or is this a way to not say, OH the Chiropractors figure it out AGAIN!! 

I'm not saying that softening the plaque can't help, I thought of needling the plaque, which again would be more of a mechanical approach, but I have to go back to people like Mich, who had the common sense to say, I have to find out if this works, and thought if he used anything else he wouldn't know, so he did it on a stand alone basis and got results, Thank You Mick and Old Man and Angus...you are the pioneers.... Hero's to us all!!!

Rico.........  if you took the electrical current away from any verapamil treatment...you guess what you would have....

[Rico]

ComeBackid,

Once again, it is up to you...if you want to hold it longer, go for it....the program I read said 5-10 seconds for 10 times once a day, this is 50 seconds to 100 seconds total per day, this is the plan that makes sense to me from a person who has spent years of working with repairing scar tissue, not as a doctor, but patient.....what work for me and what didn't....I'm going with what is believe to be the best method today.....remember there are egos and money to be made out there, this isn't a good will gesture on there part....I don't care what you choose to do, hold it for five minutes if this what you feel you need to do, once again also, you peyronies is not the same as mind, I have to say what I feel is right for someone like myself that has had peyronies now for four months and has a slight curve and hour glass and plaque on the septum....which again, Levine said is the most difficult, which I disagree, because there is more fiber in this area and it is more center, which I feel give ones a better chance to mold the plaque....if someone beats them to the punch, the only way they can capitalize on it is to tweak it.....maybe he was in track twenty years ago....that is how they use to stretched, there are people out there who haven't keep up with the sports community...

Rico

[Rico]

ComeBackid,

That was his last post, and maybe he changed his mind now, or calm it down, try reading all his post on that site, it wasn't long ago that he said that you shouldn't follow the method of short periods, vs the longer, which is find, this is his opinion, I thought it was strange that a Doctor without a study or placebo study that everyone hangs there hat on, can say the longer stretching vs as he says the up and down approach is better, go back and read the whole forum and tell me if I'm wrong....

Rico....slow and steady....the st recthing is my opinion and it is a new and NOW a favor way of stretching by experience people with sport injuries....

I'm not against Doctors, and now they are saying that it is going to be a combination of medical and mechanical approach to peyronies, so they are trying to get 50%..... talk to any chiropractor out there, the medical community treats them like the red headed step child, like I said, there guts turn on the thought of them having DR. on there business card, they don't respect them, so be it....I don't care, but if I catch one talking out of the side of there mouth, I will speak out on them, this is my choice as a American who came to call when his country called.......

As I see it, the only way now that they can get there name on the method is change up the protocol, and maybe they believe in there technique, I DON"T, and most coaches or people in tune with st recthing today wouldn't either, or people decades ago, Like Joseph Pilates, his method which is use by almost anyone who knows what is going on, including the New York City Ballet, NFL football League and every other major sport franchise follows the short bursts and repeated method....Please read the whole post and then post your comment...

God Bless....

Rico

[ComeBacKid]

"Dr. Levine on his web site disagrees with this, he prefers long periods for five minutes a couple of times a day......he did say that there are no studies on the VED which one can stand by as of yet, but he condemns the spivey method?"

Dr. Levines statment:

 The vacuum therapy has been suggested for several years to be a potential treatment for Peyronie's disease to stretch the scar tissue and thereby result in straightening.  Unfortunately, there are only anecdotal, unpublished reports on this approach.  Currently there is a study in Chicago comparing the results of verapamil alone to verapamil plus vacuum therapy, using the three piece vacuum system.  The results of this study are not yet available, but in my opinion, it does seem to make sense to combine medical therapy with the hope that the drug may affect fibroblast behavior, which is responsible for the scarring, as well as applying mechanical forces to stretch the tissue and to encourage further remodeling and straightening of the penis.  The key is that the device needs to be applied daily for no longer than 30 minutes per treatment, but these treatments can be done 2-3 times per day if the time is available to do so.  So far there have been very few reports in the medical literature that a vacuum device would cause Peyronie's disease, but again it is unlikely that the device so much causes it as it does result in an erection which can then be injured activating Peyronie's disease in the susceptible individual.  Currently I am using combination therapy of verapamil injection with external vacuum therapy using the three cylinder VED device.

Rico, I don't think Dr Levine is condemning the current method, he simply states there is no medical literature with studies on this subject that are available at this time, this is something we all know. Most doctors like to do research and produce studies, and don't seem to like to support protocols or treatments without them. Doctors love DATA (just ask Tim, he drinks DATA every morning instead of coffee )  I think its a good thing that Dr. Levine believes in the theory of vacuum therapy and is pursuing research on it. He just basically says the device CAN be used 2 or 3 times a day. I don't see anywhere that Dr. Levine has said you should hold an erection for 5 minutes? He does use the magic number 30 minutes, he must be getting this from all the traditional warnings of not leaving the constriction ring on more than 30 minutes.  I believe it was Angus who told me he did 2 workouts per day, I don't think doing more than 10 pumps per day will hurt, but then again I'm not the doctor.  To me it would seem like holding longer would be better.  When I used to run cross country we would hold our stretches for 20 seconds to get a better stretch, I was so flexible I could palm the ground standing straight up, most people just stretch for about 10 seconds. However it took two or three months to gain that stretching ability.  I think there is no exact protocol for the VED yet, other than what Augusta Medical Systems has produced, it is quite possible that Dr. Levine may develop a different protocol that works just as well, I think the important thing in this arena is just to do some stretching of that tissue, don't let it rest idle and contract even more. 

ComeBackid

[Liam]

ComeBackid,

Good work in getting a doc to clarify.

Answer:  This is an excellent question as you point out some of the misconceptions for the use of Viagra or the other PDE5 inhibitors (i.e. Cialis and Levitra).  All three of the companies who make these drugs have in their package insert a cautionary note regarding using these drugs in men with ED and Peyronie's disease.  This is because the companies did not study ED in men with Peyronie's disease and therefore they cannot make any claims to the FDA resulting in the cautionary note.  On the other hand, a published study examining the effects of Viagra in men with ED and Peyronies Disease demonstrated that it did improve erectile function in 71% of the men receiving the Viagra.  In addition, none of them had worsening of their deformity or new onset of pain.  Furthermore, there is very recent research evidence that Viagra, as well as the others, can increase the amount of circulating nitric oxide (NO) which appears in the research setting to have an anti-fibrotic effect.

    IOW, We got something right.  ::::feeling pride in our forum::::   

The key point to remember is that if you use Viagra or the other agents to enhance your erections in the presence of Peyronie's disease it is possible that you could reinjure the penis during sex.

So, use ED drugs to improve your erection.  It's perfectly safe.  But, any sexual relations you have (due to your new improved erection) may make it worse.  CYA at its very best.

Watch those CYA words:  may, could, is Possible, when used correctly, etc...
The list goes on.

Liam

[ComeBacKid]

Well I submitted a bunch of questions to the world peyronies expert, finally they answered one of my questions, and one we have debated on this forum.

 When I take Viagra I notice that it gives me a full erection and improves my “weak” erection from my Peyronie's disease.  I only took it a couple of times and then heard not to take Viagra and stopped.  It seems to help my erection and makes sex possible for me.  Can Viagra make the disease worse or do damage? 

 Answer:  This is an excellent question as you point out some of the misconceptions for the use of Viagra or the other PDE5 inhibitors (i.e. Cialis and Levitra).  All three of the companies who make these drugs have in their package insert a cautionary note regarding using these drugs in men with ED and Peyronie's disease.  This is because the companies did not study ED in men with Peyronie's disease and therefore they cannot make any claims to the FDA resulting in the cautionary note.  On the other hand, a published study examining the effects of Viagra in men with ED and Peyronies Disease demonstrated that it did improve erectile function in 71% of the men receiving the Viagra.  In addition, none of them had worsening of their deformity or new onset of pain.  Furthermore, there is very recent research evidence that Viagra, as well as the others, can increase the amount of circulating nitric oxide (NO) which appears in the research setting to have an anti-fibrotic effect. 
            The key point to remember is that if you use Viagra or the other agents to enhance your erections in the presence of Peyronie's disease it is possible that you could reinjure the penis during sex.  It is therefore wise to be careful about one’s sexual activity so as to reduce the likelihood recurrent trauma and reactivation of the Peyronie’s process.  So far this has not been a problem for my patients.

So taking viagra according to Dr. Levine is actually a good thing, man I wish someone would of just came clean with an answer like this awhile ago.

ComeBackid

[Rico]

Mr BlBC,

I know some talk about jeling(sp), which is a form of massage, the Old Man posted he could provide information on it. I thought about it, but I ordered the VED and will do the 26 protocol that is the shorter version of duration of holding the vacuum 5-10 seconds for 10 times. Dr. Levine on his web site disagrees with this, he prefers long periods for five minutes a couple of times a day......he did say that there are no studies on the VED which one can stand by as of yet, but he condemns the spivey method?
My only reasoning on short periods comes from studying under a Russian trainer who started a new regimen for stretching, he use to train the KGB special forces and now trains martial artist all over the world, Pavlica is his name, I went to his seminar and then did some training with him and became friends. His method work, and especially on scar torn areas, short burst of low intensity stretch, held release and held release. I notice great improvement, and after a short period and had for years did the hold and strain approach.....the hold and strain approach actually tears the muscle or tissue, wear the other method stretches and it come to learn memory...warm up is important also, or condition, like going from the small to medium cylinders.....so this is my reason to go with this, plus the OLD MAN agrees and he is my New Sensi and I do believe the old wise one, I will swing my sword again is my battle cry!!

The massage IMHO is or would be harder to control the symmetrical shaping of your penis, you might massage the scar to thin in one area or not enough in another, and get a lope sided dick, or more lop sided....I think that the vacuum gives one more control and quality and consistency in the pressure over a even surface, I think of the same as with traction, especially if you are also going for girth, and the warm blood is a big asset, once again this is why I think ved is better than traction or massage...IMHO:).....remember I only have one dick, so anything I do is a one study:).... I did hear of this two pecker billy goat in Kansas, maybe we can get him:)!!!

I just went to the APDA site and read the VED comment on the holding the long period five minutes, and Levine's comment on that the company that is producing the three cylinder ved HAS(not in his opinion, but has) the wrong protocol.....I find this to be talking out of his side of his mouth, how can he say that everything is hear-say because there are not enough studies and then say that?? Then he says he is going to use the three cylinder......I feel anyone who follows the long pump method is asking for problems....I will say that, because I care about people and I wouldn't want anyone to injure there peyronies more....I'm sorry, because I don't have a study to back it, but I have been around the block a couple of times and I believe it....

When It comes to the VED, well Angus and the Old Man are ahead of the curve In my opinion.....

I didn't want to get on a tangen here Mr. BLBC, or go the long way around the barn to your question, but I would go with the three tube and follow the 26 week protocol, and like Angus and the Old Man says, it is like cooking ribs, slow and long........

RICE....rest...Ice....compression....rest.....is best used in the early stages of a injury....if you think you over use the unit and it is re injury and inflammation sets in, then yes, I would ice it, or if you want to add circulation, then I would go from hot to cold, use a shower massager, one minute hot, one minute cold for 14 minutes total time....as the Old Man stated when you start, take your time, maybe only pump for a minute, get use to it....the first few times, weeks is so important to condition your scar tissue and surrounding area to the treatment, most athletes can't control their desire to get back in the game, walk before you run I think would be the right approach with the ved and mine is order, I might add I got the information from SOMAcorrect fts(this stands for fit to size), the new improvements are nothing really, mostly for ED, more rings to put on your unit, more sizes ect...maybe the seal is better?? most of the kit I won't use, so I don't think the new one is anybetter than the old model three cylinder for peyronies....I already ordered it and have to wait for it to come the first week of sept....my gut is you will be seeing other ved suppliers coming out with a three cylinder, and maybe a doctor backing it also, with his own protocol.....I know if Joseph Pilates where asked which one he would choose he would pick the short holding period of the stretch, he was so far ahead of his time, just like the Old Man, and you know why, because he actually use it hisself...isn't that a brilliant way to figure something out:)!.....

Rico

[Mr BLBC]

Zig,

I'm not taking it, the 50mg I think is double what people are taking that are not looking for a anti depressant. I think they are taking 25mg. I have read that you will feel dozy for the first couple of hours in the morning, but it should go away. Also your body will adjust to it after several weeks.

Mixing and matching a whole bunch of supplements? I think we can go over board with them. It is hard to tell also what is working and what isn't. There have been too many positive reports with alc, arginine and over all good diet to discount these in my opinion.

I thought about taking the tazadone also, thought it might be good for depression and erections. I have night time ones, so I decided to go the route of exercise, it always puts me in a good mood, endorphins.

I had to back off the dmso, it burnt my skin after six applications. So I'm taking a step to the left and adjusting.

So far for me what seems to work is.....a good arginine, alc, glutamine sports mix, a well thought out and consistent diet, epsom salt baths, and lots of sleep....this is where the trazodone might help some people, the stress of this or when life gets in the way....you need sleep to heal....my self, if I go for a three mile run, do some weight training ect.....I get the same results, the epsom salt baths also induce sleep for me....

This weekend instead of soaking my self in thacker, I made a tee time, I going to play 18 and get some fresh air....a good dinner...movie and a warm bath...maybe a cold beer afterwars at the 19th hole....

Every time I think of a new supplement, the first thing I do is look for foods with this in it, and it to my shopping list for groceries, natural is better....

The first several months is hard with peyronies, you become anxious, question your mascunity and become depress and stressed out...then start looking for the magic pill.....

I have only had this now for four months, I can have sex if I choose, I'm a lucky one.

I take now cq10/vit e(it comes in the same pill) msm, fish oil(omega three) along with the arginine, alc sport mix......serrapeptase(trying this).......The only reason I'm doing this enzyme is the lady at the store said she seen results in four weeks on her c section scars, I'm very doubtful, it doesn't dissolve the same plaque, but she could really care less if I bought it or not, the live testimony and the cost was 17 dollars for a month I added it to my list.

I was told and believe you have to limited the number of supplements, try to get it down to under six, some say four, I count my sport mix as one, this is because they have been put together to work hand in hand, and fish oil(omega three), I don't count, but do believe this is one of the most important supplement to take, I don't see it working against anything. Hard drugs, pentox, trazadone ect...put  together by your doctor for a specific condition, well then if this is your choice I would talk to him about your other supplements....

One has to look at there age also and general eating habits and health condition. I take a prostate vitamin, I'm over 50, no prostate problems, but prevention is the best medicine, it is really a condense tomato paste...I eat a steam beet every night, great for your colon health....

ALC l believe is more needed for someone over 40.....

I know for myself, you can read on post on this forum or somewhere on the net, like I took capro and my peyronies went away, and we all want to be saved also...I'm just as guilty, I had a bad experience with burning and taste on the dmso years ago, but kept reading post on it, pretty soon I had it on, now I have a sun burnt looking penis, and back to the drawing board.....I'm talking as you can all see to myself again on here:)....but I'm sticking now to the diet I have put together, this I can tell is helping me with all aspects of my life, and is the life style one should lead, peyronies free or not, plenty of fresh air and exercise, humor, pray, and some supplements, once again the only one I'm taking that I wouldn't take anyway is serrapeptase, the ALC I found because of peyronies, and I would take this anyway.....

I checked into the ved, my insurance won't cover it....the new model should be out in several weeks, I talked to the rep at soma, and gave him my urologist name to get the prescriptson I need....since most of my program is leaning towards a physical approach to this, the VED seems to make sense to me at this point in the game.....Take care and God Bless...

Rico

Rico,
I like the same kind of lifesytle too, healthy food, exercise, sleep....etc

I'm taking the supplements that most here are taking along with vitamins, I also take 25mg of trazadone, I  get the "fuller" size during the day.....

I went through 15 ultrasounds and 4/5 iono treatments, my doc did'nt know what settings to use so I treated myself and did the treatments at 4 amps, it took 4 minutes...

As you know my loving wife is creating a VED for me, hoping to share with everyone when she finishes it.....

An avenue we have thought about is strong manual massage followed by icing......any thoughts

Mr.BLBC

[Hawk]

I have taken Cialis and specifically noticed it does NOT make my penis fuller or cause spontaneous erections.  Every ED drug indicated that it will work only with stimulated erections (psychological or physical stimulation.

[ComeBacKid]

Anyone who has taken this, did you notice your penis was more pumped and fuller when flaccid throughout the day?  Seems like it could give one spontaneous erections.

ComeBackid

[Rico]

Hopefull,

I had tried to send you a message(pm) several days ago, you mail box is or was full. I don't know if soaking your unit in a warm wash rag with epsom salts will do much. Epsom salts won't dissolve the plaque, this is more for inflammation and to relax. Hot and cold therapy is also good for circulation, run warm water on the scar for one minute and then cold, do this seven times for each 14 total minutes. Arginine/ornithine/glutamine is something I would also take for wound healing. Taking MSM orally also along with some fish oil.....take care..Rico

Zig,

If you are having head aches, make sure you are drinking lots of water, start with 12oz as soon as you get up, put a large glass next to your bed also. If one becomes thirsty, this means he is already becoming dehydrated, you should never feel like you need a drink. Also don't drink tap water....filter or best is distilled, regular water is full of rock minerals, these we don't digest, cause of kidney stones ect...you need to get you minerals from plants(veggies/fruits, raw)....take care...

Rico

[zigwyth]

Thanks guys. Actually I have noticed taking a little longer to ejaculate as well since starting the Trazadone. It is helping me to sleep however. Have pretty bad insomnia. The Bath soaks definitely help. I actually ordered Dead Sea Salt online for other skin issues originally. Headaches are probably due to Stress.
Zigwyth

[hopeful]

[Kimo- are you stil on Androgel?- and how much does it cost- and what are the side effects.


Thank you,

Hopeful

[hopeful]

Hi Rico,,

This is Hopeful.. I have trouble with the baths- mainly because - I feel weaker- and my heart arrythmia.. What about just soakling a wash cloth with warm eposm salt- and applying to th penis... do you think it works- I have the Epsom Salt creme which I am using as well.

Hopeful

Zig,

So far for me what seems to work is.....a good arginine, alc, glutamine sports mix, a well thought out and consistent diet, epsom salt baths, and lots of sleep....this is where the trazodone might help some people, the stress of this or when life gets in the way....you need sleep to heal....my self, if I go for a three mile run, do some weight training ect.....I get the same results, the epsom salt baths also induce sleep for me.

[Hawk]

The ONLY side effect I have experienced is that if I am real sleepy, (like now) and take 25 mg it will make me more sleepy.  I never felt tired in the mornings, never drained, groggy, or dehydrated (I drink 6 - 8 glasses of water per day).  I certainly never felt any pain and I do not think pain is even a listed rare side effect.

[ComeBacKid]

Zig,

Yes the first few times taking trazodone, I got real drowsy, this effect will go away over time, try taking only a half of the 50mg dosage, I think this is what most of us are on.  The only side effects I've noticed are some dehydration, and aching feet in the morning, along with that drowsiness.  The effects seem to be lessening now that I've been on the drug consistently for awhile. 

I still have the "fuller," feeling penis when flaccid, but have noticied a delay time in ejaculation, similar to what I experienced while on lexapro, then it was even harder to ejaculate.  I will keep you posted if I notice any other side effects.

ComeBackid

[Rico]

Zig,

I'm not taking it, the 50mg I think is double what people are taking that are not looking for a anti depressant. I think they are taking 25mg. I have read that you will feel dozy for the first couple of hours in the morning, but it should go away. Also your body will adjust to it after several weeks.

Mixing and matching a whole bunch of supplements? I think we can go over board with them. It is hard to tell also what is working and what isn't. There have been too many positive reports with alc, arginine and over all good diet to discount these in my opinion.

I thought about taking the tazadone also, thought it might be good for depression and erections. I have night time ones, so I decided to go the route of exercise, it always puts me in a good mood, endorphins.

I had to back off the dmso, it burnt my skin after six applications. So I'm taking a step to the left and adjusting.

So far for me what seems to work is.....a good arginine, alc, glutamine sports mix, a well thought out and consistent diet, epsom salt baths, and lots of sleep....this is where the trazodone might help some people, the stress of this or when life gets in the way....you need sleep to heal....my self, if I go for a three mile run, do some weight training ect.....I get the same results, the epsom salt baths also induce sleep for me....

This weekend instead of soaking my self in thacker, I made a tee time, I going to play 18 and get some fresh air....a good dinner...movie and a warm bath...maybe a cold beer afterwars at the 19th hole....

Every time I think of a new supplement, the first thing I do is look for foods with this in it, and it to my shopping list for groceries, natural is better....

The first several months is hard with peyronies, you become anxious, question your mascunity and become depress and stressed out...then start looking for the magic pill.....

I have only had this now for four months, I can have sex if I choose, I'm a lucky one.

I take now cq10/vit e(it comes in the same pill) msm, fish oil(omega three) along with the arginine, alc sport mix......serrapeptase(trying this).......The only reason I'm doing this enzyme is the lady at the store said she seen results in four weeks on her c section scars, I'm very doubtful, it doesn't dissolve the same plaque, but she could really care less if I bought it or not, the live testimony and the cost was 17 dollars for a month I added it to my list.

I was told and believe you have to limited the number of supplements, try to get it down to under six, some say four, I count my sport mix as one, this is because they have been put together to work hand in hand, and fish oil(omega three), I don't count, but do believe this is one of the most important supplement to take, I don't see it working against anything. Hard drugs, pentox, trazadone ect...put  together by your doctor for a specific condition, well then if this is your choice I would talk to him about your other supplements....

One has to look at there age also and general eating habits and health condition. I take a prostate vitamin, I'm over 50, no prostate problems, but prevention is the best medicine, it is really a condense tomato paste...I eat a steam beet every night, great for your colon health....

ALC l believe is more needed for someone over 40.....

I know for myself, you can read on post on this forum or somewhere on the net, like I took capro and my peyronies went away, and we all want to be saved also...I'm just as guilty, I had a bad experience with burning and taste on the dmso years ago, but kept reading post on it, pretty soon I had it on, now I have a sun burnt looking penis, and back to the drawing board.....I'm talking as you can all see to myself again on here:)....but I'm sticking now to the diet I have put together, this I can tell is helping me with all aspects of my life, and is the life style one should lead, peyronies free or not, plenty of fresh air and exercise, humor, pray, and some supplements, once again the only one I'm taking that I wouldn't take anyway is serrapeptase, the ALC I found because of peyronies, and I would take this anyway.....

I checked into the ved, my insurance won't cover it....the new model should be out in several weeks, I talked to the rep at soma, and gave him my urologist name to get the prescriptson I need....since most of my program is leaning towards a physical approach to this, the VED seems to make sense to me at this point in the game.....Take care and God Bless...

Rico

[zigwyth]

Just got trazadone at 50mg. prescribed. Is anybody here real drowzy through the day with headaches after taking this? I'm on so many sups with Trazadone and Pentox, not sure what's causing this. Any Thoughts?
Zigwyth the Twiggith

[Liam]

Scott,

Tried Remeron for 2 months.  I gained almost 20 lb.  I started having edema in my ankles and feet.

I changed to Wellbutrin and the edema went away.  The weight is coming off much more slowly than I put it on, though.  No sexual side effects except maybe some improvement.  I can't give the credit to the Wellbutrin.  But, at least it hasn't hurt.

[Kimo]

ComeBackid,,,At about 45 yrs old i started loosing all my libido and was that way for a few yrs,,,it was not from taking any meds, my body just quit making  testosterone, it was about 10yrs before i found a good URO who tested me and said it could be fixed..He put me on ANDROGEL, it looks like KY Jelly and you just rub it on twice a day on your shoulders,,,WOW, what a difference it made for me,,matter of fact it took my testosterone levels too high for and old fart like me,,,,As for numbers go 200 is considered 0 and 800 is considered normal for a 20 to 30 yr old,,,it brought mine up to 831 and let me tell ya,,i was climbing the walls, man i was hornier than i could stand,,so he lowered the dosage and it was better....Anyways,,you might think about having your testosterone level checked out,,,,it's just my thoughts....

Malamapono,,,,,Kimo

[ComeBacKid]

Scott,

I tried both celexa and lexapro, my doctor told me that lexapro was a newer and more refined version of celexa with less side effects.  Nonetheless I noticed with the lexapro it was extremely hard to ejaculate, this is the common side effect from it.  I also slowly lost my libido, which now seems to be totally gone, even being off of the drug for a year.  I'm trying to find a medication to restore that libido and random daytime erections. 

The Wellbutrin will increase your sex drive, this is what my doctor has told me, I didn't ask him about trazodone, but have noticed erections at night, and increased bloodflow during the day, making for an increase in size due to blood vessel dialation.  My doctor to confirmed that the SSRI's usually have some kind of sexual side effects. 

The viagra seems to give me more full and solid erections, I'm just undecided whether I should be taking it daily when I'm already on Iono, VED, ALC, L Arginine, and trazodone. 

ComeBackid

[Blink]

Scott, wow! you said a mouthful there. That was some interesting stuff. BTW :LOL means Laugh Out Loud! BTW means BY THE WAY  Keep the Faith...Blink

[scott]

I've just finished reading through all the communications from the beginning of this forum, and have learned quite a bit.  The importance of nocturnal erections and trazadone was especially intriguing, and I will be pursuing that with my doctor day after tomorrow.

Trazadone aside, I want to convey some experiences I have had with antidepressants over the last few months:

SSRI=selective serotonin reuptake inhibitor
SNRI=selective serotonin and norepinephrine reuptake inhibitor

(All the antidepressants I'm going to discuss list possible sexual side effects, although these are usually minimized by physicians, who frequently downplay side effects to avoid self-fulfilling prophecies on the part of their patients.  Personally, I think I can handle that information up front, and have made it a point to become much more educated about the drugs I've been prescribed.)

Cymbalta (duloxetine) (SNRI): I experienced gradual loss of erectile ability and libido.  After two weeks I was unable to ejaculate.  I had tremors in my hands which persisted as long as I was on the drug.

Lexapro (escitalopram) (SSRI): Loss of libido and lack of ability to ejaculate.

Prozac (also known as Sarafem) (SSRI): TOTAL loss of libido, diminished erectile ability, and ability to ejaculate.  I remember telling my doctor, you don't even want to bother to try.

Remeron (mirtazapine) (SSRI): Diminished libido, inability to ejaculate.  You also want to eat everything in sight.  Interestingly, I later learned that this drug was widely used in nursing homes as an appetite stimulant, certainly an off-label use.

Celexa (citalopram) (SSRI): I could keep an erection, but could not ejaculate no matter how hard I tried.  This one is a close chemical cousin of Lexapro.  Celexa was developed first, but the patent expired, so Lexapro was developed as a mirror-image drug to attempt to recapture market share.

DISCUSSION: Depression is a real problem, and I would not discourage anyone from pursuing any avenue to help to alleviate that problem.  In my case, we were trying these as an adjunct to Neurontin for neuropathy pain in my legs.  I also suffered from mild (sub-clinical) depression.  HOWEVER, this is a case where the cure was worse than the problem.  In each instance, my erections improved and I was once again able to ejaculate when I discontinued the drug.  I agreed to continue to try drugs because of the pain in my legs, but finally decided antidepressants aren't for me.  Since many Peyronie's sufferers probably suffer from depression over their situation, it is not unlikely that some of them are on antidepressants.  If so, they should take a look at antidepressants as a potential source of at least part of the problem.  And to save you some time and money, I have since learned that if one SSRI affects you negatively in a sexual way, they probably all do.  I reserve comments on Wellbutrin, which is not a SSRI, but rather works on norepinephrine and dopamine.  I haven't tried that one, because it appeared that my tremors on Cymbalta had to do with norepinephrine.

Hope this is helpful to someone, and thanks for all the information in this and other forums.

By the way, as a novice computer person, could someone please inform me as to the mean of lol and LOL?  Thanks.

[Liam]

LOL

[Tim468]

Now Liam, hang on. They use electro-stimulation to make the rats get little rat erections, because it's just so hard to find good rodent porn they can read.

Tim

[Liam]

Hawk,

I whole heartedly agree.  I had to read through the article a couple of times to make sure I was reading it right.  The electro-stimulation sounded especially bad.

Liam

[Hawk]

While I have not thoroughly looked at this information (I am falling a sleep at the wheel),  I would be VERY hesitant to allow the administration of growth hormone after any form of cancer surgery.

[Liam]

I found this and thought it was interesting.  Make sure to see the source web page.

Regeneration of Cavernous Nerves after Neurostomy
As growth hormone has been reported to improve nerve regeneration, we studied the effect of rat growth hormone (GH) on the regeneration of nitric oxide synthase (NOS)-containing penile nerves and the neurons in the pelvic ganglia after unilateral cavernous nerve neurotomy in rats. The results show that GH injection significantly enhances the regeneration of NOS-containing fibers in the dorsal and intracavernosal nerves after unilateral cavernous nerve injury. Electrostimulation in the GH-treated group revealed a greater maximal intracavernosal pressure and a shorter latency period. We believe that GH administration may present a new and more physiologic approach to the treatment of erectile dysfunction after radical pelvic surgery.

Source:  http://urology.ucsf.edu/faculty/facLue_Interest.html

[Blink]

I was immediately drawn to the trazadone discussion. I had taken trazadone after the death of my daughter. I remember the effect it had on my sex drive. When I got an erection during sex, it was by far harder and lasted longer. I can recall telling a friend that I felt like a kid again, it lasted much longer during sex!  When I saw the posts on trazadone, I remembered the good stuff that happened. I was taking a much higher dose than in the discussions. I did contact my family doc and asked for a perscription of 50mg trazadone. He gave it to me without a visit, which saved me money in gas and the visit copay, and the stuff costs less than $4.00  for a script. I asked for a months supply @ one pill per day. I'm cutting the pills in half, so I'm getting two months supply for the cost of one. Add me to the list of satisfied customers, Hawk. The results are the same as the other four. That's Five outta Five, a perfect score!

                                      ComeBackid: I don't know why there would be a problem using a VED while taking the stuff, I used to be like a rabbit in the sex department when I was taking it before, and at a lot higher doseage! I've been under a lot of stress lately, and this stuff works great restoring sleep patterns. After seeing all of the expensive treatments and scams out there, it's great to find an inexpensive pill that does what we are looking for it to do! Keep the Faith, Blink

[ComeBacKid]

Hawk and others taking trazodone,

Did anyone notice besides nightime erections, that during the day their flaccid penis is more "pumped," and hangs bigger?  I read that it dialates blood vessels.  I was wondering if its ok to be on a drug like this while doing the VED and pumping blood through those dialated blood vessels.  Trazodone seems to have helped me a lot when I take it, Hawk you hit a home run when you found that drug.

ComeBackid

[Liam]

Found this summery on these two drugs and their effect on ED.  There are others on the website.

Trazodone A mild antidepressant with a rare incidence of priapism. Its effect on penile erection is thought to be the result of serotonergic and (a -adrenolytic activity. Clinical trials have shown a positive effect on nocturnal penile erection (Saenz de Tejada et al., 1991) and sexually stimulated erection (Lal et al., 1987). A combination of trazodone and yohimbine has also been reported to improve erectile function in some patients (Montorsi, 1994). The major problem of trazodone is its marked sedative effect, which may render sexual activity more difficult.

Pentoxifylline 400 mg t.i.d. was shown to be effective in improving penile brachial pressure index and erection in a placebo controlled trial.

http://www.apsir.org/html/kualalumpur97.htm

[Hawk]

Actually, Joshua also reported (in this thread) that he had immediate results as well, and a man on the old APDA forum reported the same.  The response is undeniable in 4 out of 4 people that I can document trying it.  As ComeBackid knows, but did not go into detail, this is a 1/2 of a 50 mg tablet is minuscule fraction of the dose for anti-depression and trazadone is non-habit forming.

[ComeBacKid]

Power,

Your question comes just in time as we have been discussing, trazodone, half of a 50mg pill taken at night.  Hawk intitally told me about this, saying that it gave him nighttime erections, which we know are healthy for the penis, because at night while sleeping for some reason the blood has the highest oxygen content.  These nighttime erections keep the penis healthy, check our resource library under the collagen/oxygen I believe it is.  Anyway, Hawk told me this drug helped him, so I tried it.  The very first night I took it, I became a little sleepy and dozed off kind of and awoke with a solid erection, probably the most solid I've had in about a year.  I then awoke later that night with another solid hard on.  When I woke up the next day my penis was hanging bigger due to increased bloodflow, I was stunned.  Lately trazodone has been discussed and apparently there are some studies going on with it.  Here is a table breakdown of anti depressants I found.  I was worried that while trazodone may increase nighttime erections, for some reason it won't give you daytime erections, and I thought maybe it would have a decreased libido effect like most anti depressants, however this doesn't appear to be the case.

Anti depressant study

This site is a writeup on anti depressants and effect on your sex drive.  Table 1 downt he page has a good breakdown.  It lists trazodone has having an increase on ones sex drive.

Here is another study done just on trazodone for erectile dysfunction.  They couldn't reach a solid conclusion but that doesn't mean trazodone will or won't work, they need a bigger study and more of them.  To me the fact that I saw an increase in my nightime erections and Hawk did as well, combined with the fact that they are doing studies on trazodone increasing libidio tells me others must have seen the same effect and reported it to their doctor.  This new interest in trazodone(which is very cheap) is exciting, hopefully they can conduct some more solid studies.

Trazodone Study

[Power]

Has anyone in this forum had any success using nightly viagra to overcome ED? Did erection quality improve after discontinuing use of the drug? There was a 2004 study that suggested it works. Thanks for any replies.

Power

[Liam]

Due to renewed interest I am reposting this PubMed piece.

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=1984101&dopt=Abstract

[Liam]

mmmmmmm Maca beer  ::::ala Homer::::::

[George999]

http://en.wikipedia.org/wiki/Maca

[ComeBacKid]

Is this stuff safe or doctor recomended?  Did it increase erections for you guys noticeably?  It sounds like an anti-depressant almost to me if it makes you feel good.  I just have some skepticism because if it boosts your libido well, why aren't more people using it, or are they?  So its a powder you put in your food and eat it with meals?  Tim any thoughts on this?

[George999]

The great thing about maca is that it is actually a food.  People eat it in significant quantities like potatoes or rice.  So the only damage you are likely to see from it would be to your pocket book.  For me one gram does the job.  But I didn't have an ED problem going in.  So for some folks it might take more.  And for those who are wanting to have children and can't, research has proven that maca raises fertility, at least in men.  Additionally, I think you will find that it just makes you feel better.  Personally, I take it in tablet form (even those can be chewed), but it has a pleasant flavor and you can even cook good things out of the powder just like you would with flour.  Thats the way they use it in Peru.

[Fighter]

George999
I heard good things about Maca so I just order some over the net. I have order it in the powder form. It recommends to take 5 to 15 grams per day. Do you think that would be too much? I see you only take 1 gram per day. I lift weights and work out 4 days a week so I thought maybe I should take 5 grams every other day until my body gets use to it then maybe 5 grams per day. What do you think?

[George999]

Elsewhere on this forum, I have mentioned maca.  I just want to mention it again here as it has done good things for me without any of the side effects that some of the other solutions have.  Incidentally, maca works for both men and women.  Basically it seems to work by making the body more sensitive to available hormones.  So while not raising testosterone levels, it nevertheless increases the effect of the available testosterone.  Its effect is very subtle and very smooth, gradually increasing over a period of weeks.  For me it has been very satisfying.  I have been taking 500mg twice a day now for probably three of four months and my wife is taking it two.  Its really very cool in my opinion.

[Rico]

I would like to say that l-arginine is used by almost all the fighters in the UFC(cage fighters), it along with nox and amino acids, there are many blends you can buy at GNC or other health stores, You can buy it in bulk. The brand I like is expensive, but when I do use it, even before the french dick doctor's condition, I got some hard wood, plus great pumps in the gym. Trac was one brand I used and also my favroite(because of taste ect..)was xyience. There are many on these blends out there, and if you don't like to take pills and want a complete blend: They have three arginine in them hci, ketoisocaproate and alpha-ketoglutarate along with three creatines and three glutamine, most of you are pretty well informed on here and I hope I don't offend anyone with maybe already know knowledge. God Bless you.

Rico

[Liam]

ComeBackid,

I can give you an educated guess in the form of a syllogism.  Men with Peyronies Disease have painful erections.  Viagra gives you an erection.  Therefore Viagra gives men with Peyronies Disease pain.

This is the logic of a law suit.   

It's the same reason the FDA says VEDs should not be used by men who have Peyronies Disease.

If they didn't put the warning, they could face legal action.

Stupidity.  This is one reason for the slow advances in medical research.

[Hawk]

Man if everyone listed what they got here worthwhile, I am sure it would be a huge list.  I got nothing from the doctor, I got it all here.  Besides support and satisfaction of seeing others find support, the biggest for me were:

Trazodone
ALC
L- Arginine

[ComeBacKid]

Hawk,

Your missing my point though,I know some on here take viagra, however how do they know it didn't make their condition worse?  My question is, why does it say on the label don't take if you have peyronies?  Who determined this, someone didn't just make it up, there must be some valid reason they have it there, and I"m trying to figure out why.

[Liam]

Hawk,  I am highly encouraged.  It is 12:52 am my time.  This is one year. 

Yes, it's a little skinnier than before and not quite as long.  But, there is something to work with.  I still can't sustain the erection very well.  Thats OK for now.

When I had the surgery, I prepared myself to die and if I lived, to have ED (positive thinking at its worst).  Everyday and every erection (no matter the quality) is a blessing.  I have learned and am still learning to appreciate the things I have.

I'll stop before the violins start playing.  Before I do, I'll just say, all you guys have done more than almost anyone :::nodding to my wife::: to keep me focused on recovery instead of wallowing in misery. 

I am also convinced finding out about l- arginine has facilitated the improvements I have experienced in the last month and a half.  I learned about it here..

[Hawk]

I thought Viagra is not supposed to be taken for patients with peyronies?  I actually have some hwere and I'm wondering if continued usage could help to restore daytime erections?

ComeBackid, No disrespect but there are hundreds of posts here about members taking Viagra and we all have Peyronies Disease.  Dr. Mulhall insisted I keep injecting Bimix.  I refused so he said take Viagra at least 2 or 3 times a week.  He also had me on 25 mg every night for months before Peyronies Disease.

PS: to Liam.  If you are getting 3/4 erections at one year, you are home free as far as your surgery is concerned and your nerve function.  You regain most the 2nd year.  Your only concern is Peyronies Disease with its many symptoms from here on out.

[Liam]

There is a study about taking it daily.  I'll try to find and post it.

[ComeBacKid]

I thought viagra is not supposed to be taken for patients with peyronies?  I actually have some here and I'm wondering if continued usage could help to restore daytime erections?

ComeBackid

[Liam]

I am getting about 75% success from Viagra.  My erection is painful, but, tolerable.  I get the blue haze and my face gets flushed.  My Dr. prescribed 100 mg.  I cut them in half so I can take it twice as many days.  I get almost nothing from 25 mg.  I have a fair response at 50 mg.

I am wondering about other experiences with our little blue friend. 

[Liam]

ComeBackid,  MUSE is designed for that.  How well it works is another question.  Cialis is desined to do what Viagra does.  It just lasts longer (up to 36 hrs).  It will allow you to have an erection when stimulated.   The idea of allowing "natural erections to happen for 36 hrs sounds good.  The problem is, the side effects last for up to 36 hrs. (up tp 24 hrs. for Levitra).

The only instant erection I know of is the injection (tri mix).

[Hawk]

ComeBackid,

The short answer is NO. 

All oral ED drugs require physical or at least psychological stimulation.  There may be an exception taken at night since night-time erections have more to do with sleep cycles than sex related dreams.  I personally would never take an expensive ED drug with their many side effects for night-time erections when 1/2 of a 3 cent trazadone works better and has no side effects, except possibly a slightly better nights rest.

I refer you back to a more detailed post on comparing these drugs.  Click below on the header below.

[ComeBacKid]

Will Cialis just give you random erections?  Does anyone know about this?  Is there any ED drug besides injections that will give one random erectiosn without stimulation?

ComeBackid

[ComeBacKid]

Soxfan,

What is andogren treatment?  My doctor tells me testosterone and these things will only boost your sex drive while your on them, and because your getting the testosterone from the pill, your testis quit producing as much, so in the end when you get off the pill your body may not produce as much testosterone.

Any comments? 

[Kimo]

Liam,,i tried that too,, before i went on testosterone,,didn't do anything for me,,,,,just my opinion,,,,kimo

[Liam]

Has anyone used DHEA?  I have read several articles about the benefit for sex drive.  Now I will bring it to the real experts.   You guys.

http://www.mayoclinic.com/health/dhea/NS_patient-dhea  -Mayo Clinic's DHEA page

[Kimo]

I thought i'd write a post on this subject..I was always a high energy person, never realized it was because i had a high testosterone level...When i was about 45yrs old i started going down hill, no energy, depression, no drive, loss of erections and sexual desire...This went on for about 7 yrs and the uro i had at the time said i was normal for my age..I didn't like that answer and so finally changed Uro's...He said my test level was way down @ 300, and we should and could do something about it...He started me out on androgel, worked great for about a year and then my level started going down,,,so he changed me over to the androderm patch, which i've been on now for about 6yrs...When my testosterone level was brought back up,,,i started feeling great again,,no depression,,regained sexual drive and i didn't have to use as much viagra.....

I do have my PSA checked about every 6 months,,,,and i know that i cannot survive without having this test...replacement..It didn't make my breasts any bigger but it has given me a lot more body hair,,my wife liked that,,HA !

note;  that first year on the androgel drove my level back up to 831,,,and i had to tell the doc to lower it some how as it made me climb the walls,,to high for me at my age, i was so horny and couldn't do much about it,,,lol
So, he lowered my doseage and it helped...Since being on the patch it has always stayed very level without changing...I still use viagra about 75% of the time, but have even cut back on the amount to 50mg...

I do agree and know that you have to keep check on your levels and your PSA,,its very important....each person's body reacts differently....Everything that Hawk has said in the last post is right on, he has given great advise..

kimo

[Hawk]

SoxFan,

Good to see you again.

I appreciate your remarks and your intent.

For brevity, and because this is not a general men's health or prostate cancer forum, I won't debate the pros and cons of an estrogen link to enlarged prostates and prostate cancer.  I am familiar with estrogen matabolites, but what is absolutely undeniable, is that once prostate cancer is present that it is fueled by testosterone.  Clinical studies conclusively demonstrated PC to be fueled by testosterone in a test tube, conclusively demonstrated in mice infected with human PC, and conclusively demonstrated in many thousands of men.  In fact, I believe it to be testosterone fed with even greater consistency than breast cancer is estrogen fed.  Testosterone suppression abruptly suppresses its growth, testosterone supplementation fuels its growth.  Once testosterone supply is cut off, PC will eventually (how soon, depends on factors such as Gleason score or grade of PC) become testosterone independent and is virtually unstopable once it is out of the prostate capsule.

I know of no research institution that would refute this, and not a single clinical study that would suggest otherwise.  If I sound adamant, it is the result investigation at a rate of 60 hours a week over a period of months on traditional, non-traditional, and alternative treatment methods.  It included many hours or face to face dialog with urological surgeons and urological oncologist at Memorial Slone-Kettering Cancer Center.  Appointments at Columbia University Center for wholelistic Urology, and many books. That is just as starters. 

We must keep in mind that unlike Peyronies Disease, this is a life and death issue for men.  Speculation that is in error, is a deadly error.

[soxfan]

Hi Gents,

I thought that I would interject here. I feel that the link between testosterone and prostate cancer is false. Think about it, most men contract the disease late in life when there test levels are very low. If raging high levels of test were the culprit then pc would be epidemic amongst 18-19 year old boys, but it isn't. Rather, I believe that the true culprit is excess ESTROGEN which increases exponetially as a man ages.

I have started my own androgen therapy to help combat my Peyronies Disease. I am only one week in and I alraedy have seen a big incraese in energy, libido and better erections and incresed bloodflow to little Elvis!

Cheers.

[ComeBacKid]

My daytime erections vanished rapidly after taking lexapro, and it would take me forever to reach orgasm.  Most of this went away after Ig ot off it, but the erections didn't come back like they normally were before the medicine.  In april when my peyronies acted up again, I lost all daytime erections, I think the combination of both of these effects is causing the problem.  I may try wellabutren in the future , but for now I'm sticking to some treatments and more treatments I have lined up next.

ComeBackid

[Old Man]

Note to all from a guy who has been there and done that!

I WANT TO ECHO THE STATEMENTS BY HAWK'S POST BELOW (CAPS FOR EMPHASIS).

WHEN A DOCTOR PRESCRIBES TESTOSTERONE FOR HELPING WITH ED, THE PATIENT SURELY SHOULD BE GETTING A PSA LEVEL CHECK AT LEAST EVERY 6 MONTHS. FAILURE TO DO IS WHAT HAWK SAYS --PLAYING WITH FIRE!

MY PSA LEVEL ROSE VERY RAPIDLY FROM ONE YEARLY PSA TO THE NEXT BY DOUBLING ITSELF. A DIGITAL RECTAL EXAM REVEALED TUMORS IN MY PROSTATE, AND AN ULTRASOUND CONFIRMED THIS, THEN THE BIOPSY CONFIRMED PROSTATE CANCER OF AN AGRESSIVE FORM.

MY TESTOSTERONE LEVELS HAD ALWAYS BEEN HIGH AND MY URO STATED THAT ALTHOUGH HE HAD NO CLINICAL PROOF, THE CANCER RESULTED FROM THOSE HIGH LEVELS.

SO, BOTTOM LINE, BE EXTREMELY CAREFUL ABOUT USING TESTOSTERONE AFTER THE AGE OF 40 LIKE HAWK SAYS. IT CAN BE VERY DANGEROUS TO YOUR HEALTH!

BEST REGARDS TO ALL, OLD MAN

[Liam]

At the age of 56, quite a few years ago, my father went to the doctor with severe back pains.  After several visits, over a period of a few months, the doctor told my dad he was getting old and it was normal to have pain .  My father died of colorectal cancer within a year.

Age, itself is not a disease and has no symptoms.  If a doctor blames a condition on age, start looking for another opinion.

Having said that, I recognize the correlation between age, certain physiological events and the likelihood of developing certain diseases or conditions.  For example, many men lose hair as they get older.  Age, however, is not the cause.  If that were true, all adult males would be bald.  Apply that logic to ED.

[Hawk]

ComeBackid,

I may not be a doctor but I have some very strong opinions on this topic.

For a doctor to tell a 22 year old guy he is loosing erections because he is getting older, is beyond stupidity.  If it were not so sad it would be hilarious.  I saw no slight loss of daytime erections between 15 and 40 and had  regular (but less) daytime erections at 52 just prior to prostate surgery.  While this may be a bit more than normal, I am positive that any 22 year old male not having any day time erections is a symptom that something is wrong.  It could be medication, nerve injury, Peyronies Disease, diabetes, depression, stress, hormone imbalance, or several other things, but it certainly is not age related.

Foot note on testosterone: Forget all the other side effects of testosterone. Prostate cancer is the most common cancer in men and far more common than breast cancer in women.  There is no doubt that many men on this forum have prostate cancer in some quantity that is either non-aggressive or very aggressive and they do not even know it.  Some statistic indicate that before a man dies there is a 50% chance he will have prostate cancer.  Much of this is low grade and it is further slowed down by the fact that he fortunately develops it at an age when his testosterone has naturally dropped.  Testosterone is like gasoline to prostate cancer.  Prostate cancer is testosterone fed.  For anyone (especially over 40) to take testosterone without a clear confirmation of low testosterone levels and a clear and very regular prostate evaluation is like playing Russian Roulette.  Even then I would have a base level PSA check and recheck my PSA every 6 months.  I would not be looking for a high PSA reading, I would be looking for any significant rise even at a low reading (for example: from 1.5 to 2.1 in 6 months).  If another quick test confirmed this rise I would be flushing testosterone.  I would also be having a prostate exam by someone that knew what they were feeling for.  I have no interest in being a hairy guy laying in a bed with a lid.

Thanks for the time on the soap box.

[Liam]

I started back on Welbutrin a month ago.  My ED is getting better.  You can't conclude the Welbutrin is helping.   But, it hasn't hurt, either .

[ComeBacKid]

Kimo,

I didn't say erections would make the plaque worse, I think not having them makes the plaque worse or encourages the plaque to contract more.

Thanks for the reply though on testosterone.  I'm already hairy and don't need body hair dude.  I may get blood work done to see what my testosterone is at.  The lexapro I took did things with my seratonin uptake abilities, and so my phsyciatrist doesn't think testosterone will even do much for my erections.  My phsyciatrist was pale and losing his hair from his KIMO therapy for bladder cancer.  He had a successful removal of his bladder but flatout looked bad.  Now hes recovering, he said he wouldn't even trade the cancer for peyronies after I asked him about it. 

ComeBackid

[Kimo]

ComeBackid,,,,i've been on testosterone now for about 7 yrs and my breast's have not gotten larger,,thats BS......But i have gotten a lot more body hair, and thats what my wife has always wanted,ha!....And my daytime erections never went down until i was 45,,,I think its your meds that is effecting that.

And i don't believe that having an erection is going to make your peyronies any worse,,,if anything you need the erections to help stretch the plaque and thats what a VED helps do for you,,,,stretch....

kimo

[ComeBacKid]

I talked with my doctor today about my loss of daytime erections since taking Lexapro.  He doesn't think taking testosterone would be a good idea for me because it can have side effects like enlarging a mans breasts and increased hair growth, and the effects only occur while your on the medicine.  He told me that Lexapro effects seratonin, and that is probably what effected my lack of erections.  However, now hes telling me I'm probably just losing erections cause I'm getting older (22).  I don't know if I buy this because I used to get a lot of daytime spontaneous erections before taking Lexapro.  He said I could try Wellbutren, which raises yoru dopamine levels and actually increases sex drive and erections, but I'm going to wait on that.

Anyone with any comments on this?  Perhaps lack of daytime erections doesn't have any effect on peyronies disease and it will get worse if you have erections or not.

ComeBackid

[Liam]

Today, for the first time since prostate surgery, I took Viagra and it worked ( about 75% erection).  Thats the good news.  The bad news is I got an idea of how bad and painful the Peyronies Disease is. 

I am keeping a positive attitude, though.  I was not sure if I would ever get any kind of erection without a VED.  Now we can hope and pray for the day Peyronies Disease can be treated with some success.  It can happen!

One more thought.  I am thinking the supplements I am taking for Peyronies Disease may be helping the ED.  Hey, it couldn't hoit.

[Liam]

Welbutrin has been blamed in court for causing spontaneous random orgasms in women.

Would that be a bad thing?  I took Welbutrin to quit smoking.  Might have the opposite effect on women :Q
Was it good for you?

[Hawk]

One of the more knowledgeable people I ever knew on the forums clued me in on this.  Priapism (erection that lasts for hours and is a mediacal emergency) is a listed possible side-effect of a full dose of this drug.  While I think priapism is rare, 3 out of three people I know have gotten great results with 1/2 of a 50mg trazodone with food before bed.  There are also clinical studies combining trazodone and yohimbe (sp).  My family doctor prescribed upon hearing my explanation of why I wanted to try it.  It is not an unknown issue and it is the cheapest drug I have ever heard of for any ailment.

PS: not all antidepressants cause sexual dysfunction.  Cymbalta has a very low risk of sexual side effects and Welbutrin has been blamed in court for cause spontaneous random orasms in women.
 

[ComeBacKid]

Hawk,

The thing I can't figure out with trazodone is the fact that its in the class of anti depressants, which decrease sex drive and daytime erections.  However I do realize that taking it at the 25 mg dosage level would not have this effect but it seems like it should still kill erection a little.  But as you have reported it gives nightime erections. Was this medication made aware to you by Dr. Mulhall?  Did he say it will give you nightime erections, or did you discover it on your own?

ComeBackid

[ComeBacKid]

Hawk,

I only need to do one injection in front of the doctor, my proposal or idea was to simply use the suppasatory to give me the erection, instead of injecting the medicine in.

ComeBackid

[Hawk]

Hawk,

I thought those injections is what gave you plaque nodules and gave you peyronies.... I have plaque surrounding my whole corpus cavernosum and can't inject into the plaque itself.

Injections did give me Peyronies Disease but that was 75 injections.  Personally I would not be too hyper about one injection but I do think injecting into scar tissue is a significant concern.

[ComeBacKid]

Hawk,

I thought those injections is what gave you plaque nodules and gave you peyronies, I just don't want to get more plaque, I only need to do one injection, thats it, seems like this shouldn't give someone plaque, however I have plaque surrounding my whole corpus cavernosum and can't inject into the plaque itself.

ComeBackid

[Hawk]

ComeBackid,

I think you may find muse to be unreliable but it may work.  As one that stuck about 70 needles in my penis I would not worry too much about one administered by a nurse (or doctor).  If you do it, follow the advice to apply direct pressure to the injection site for 10 minutes to prevent any bleeding and I would take nothing that would thin my blood for several days prior to the injection.

They will inject in the base 1/3 of the penis in a i to 3 oclock position on the right or a 9 to 11 oclock on the left avoiding any visible vein.  If you are aware of any scar tissue, direct them away from it.

You will find the injection to be very painless compared to an injection elsewhere on the body.

[Liam]

The med is alprostadil.  The brand is MUSE.  Here is the link to WebMD's MUSE info  page.

http://www.webmd.com/drugs/drug-77981-Alprostadil+Urth.aspx?drugid=77981&drugname=Alprostadil+Urth

[ComeBacKid]

I'm looking to see if anyone knows the name of the little pill you put in your urethra at the end of your penis where you pee at and this gives you an erection.  I'm trying to find a way to give myself an instant erection without having to inject, as I believe injecting will make peyronies worse or cause more plaque.  I'm trying to find out the name of this pill and can't do so, anyone know?

ComeBackid

[Liam]

Here is a link to there site. 

http://www.caverject.com/

Hope this helps.

[ComeBacKid]

Does anyone know anything about caverjet?  I need to have this injected into my penis one time.  Will one injection hurt my penis or cause any damage?  Is there anyway to give me an erection without giving me an injection? 

ComeBackid

[Liam]

Here is another link to an article about new drugs for ED including the gene therapy which will last up to 6 months  .

http://webcenter.health.webmd.netscape.com/content/article/122/114814.htm

This is a copy of the first few paragraphs.  However, the whole two page article is worth reading.

New ED Drugs on Horizon

Faster Acting, Longer Lasting Treatments for Erectile Dysfunction By Daniel DeNoon
WebMD Medical News  Reviewed By Louise Chang, MD
on Wednesday, May 24, 2006 

 
More From WebMD


 Is Hypertension Affecting Your Sex Life?

 ED: Warning Sign of Early Artery Disease?

 Erectile Dysfunction: A Woman's Point of View

 
 
 
May 24, 2006 -- New treatments for erectile dysfunctionerectile dysfunction are on the way. One works fast. One lasts long. And another promises to be the next best thing to a cure.

The new drugs aren't here yet. They don't even have official brand names. But they promise to give men with erectile dysfunction even more options than they now get from Viagra, Cialis, and Levitra.

"We have a chance to glimpse the future of treatment in sexual dysfunction," says James Barada, MD, director of the Center for Sexual Health in Albany, N.Y. Barada moderated a news conference in which researchers discussed new findings reported at this week's annual meeting of the American Urological Association in Atlanta.

Nearly a Cure for ED?

[Liam]

I found several references to hMaxi-K.  It claims to work for up to 6 months.  Google search provides many quality hits.  Looks promising.

http://www.medscape.com/viewarticle/491836

Link added by Hawk

[Old Man]

Tim:

You are 100% right about individuals using the current popular ED drugs. Since they can now be bought overseas off the Internet at cheaper prices than in the USA, they are being abused by many who do not research the contraindication portions of the patient brochure to learn of adverse side effects.

The ED drugs may provide some increase in blood flow to the penile chambers, but it should be done only in individuals healthy enough overall to take such drugs. The risk is not really worth it.

Since Viagra, Cialis and Levitra lowers blood pressure significantly, patients with heart problems should not take them, etc. Any and all heart patients especially should not experiment with them. Having have a triple bypass done, I know first hand about the dangers of meds that affect heart conditions.

Thanks for your valuable input to this forum. That is the kind of support we need from the medical community to help those in need.

Regards, Old Man

[Hawk]

Hawk......

You may be quite right that your injections made your condition worse I'm puzzled that the leading urologist in the world in dealing with peyronies disease did not know this?

ComeBackid, Injections did not make my Peyronie's Disease worse, I think the evidence is clear that bimix injections caused my Peyronies Disease.  This is not just a cause/effect case of: I injected; I got Peyronies Disease. 

The initial site of the Peyronies Disease, the timing, studies and warnings about papaverine causing fibrosis in a greater number of patients than other injectable ED drugs, the theory about micro-trauma, all point to the injections as the cause.

I don't know that I would refer to my doctor as the leading Peyronie's Disease doctor in the world but he is one of the very well known Peyronies Disease doctors.  Also, I do not think it is a matter of him not knowing.  When I mentioned it and offered him a printout of a study on the topic, he showed no interest in the printout and stated there is no evidence associating penile injections with Peyronie's Disease.  I could have more easily accepted the phrase, "no proof", but to suggest there is not even any evidence is a rather strong statement considering that I was not given any evidence or facts to counter the study in my hand, or to counter the many pharmaceutical warnings.  These are in fact evidence. 

Also see 2nd paragraph under "papaverine" in a paper by Tom Lue http://www.cmj.org/Periodical/PaperList.asp?id=LW8235

The fibrotic change may be due to tunical hematomas at the injection site followed by clot reabsorption and fibrosis. Fibrosis also appears to be dose-dependent and cumulative, although significant fibrosis after only a few injections has been reported. The natural course of the fibrosis is unpredictable, with some cases resolving several months after discontinuation of injection therapy, and others persisting.

What is your question about Trazodone?

[Tim468]

In reading recommendations for or against drugs, it is important to understand the rationale behind them.

Viagra is not recommended routinely for those illnesses, primarily because those conditions fall into the category of processes that require thoughtfulness before treating. In other words, Viagra is not a known treatment for Peyronies Disease, so it should not be used for such a cause of ED without first investigating other issues.

That is not to say that Viagra might not be of value for some people - it is the routine (and perhaps mindless) use of drugs that the warnings aim to prevent. And investigational use of Viagra is completely different - it is the use of a drug (not routinely recommended) because it *may* be of help to an individual. All such drug warnings have to be taken in context.

Tim

[ComeBacKid]

Guys,

I've read online that if you have peyronies disease you should not use viagra, has anyone else encountered this?

Hawk-I also found this

Who should NOT use injection therapy?

Some conditions rule out the use of injection therapy.

Allergy to alprostadil.
Abnormally formed penis.
Peyronie's disease or penis angulation.
Carvernosal fibrosis.
Diseases that might result in prolonged erection, such as sickle cell anemia

You may be quite right that your injections made your condition worse I'm puzzled that the leading urologist in the world in dealing with peyronies disease did not know this?

Anyone know much information on Trazodone?

ComeBackid

[Liam]

Hawk,  I just finished reading your posts.  Thank you for sharing them.  My experience is similar.  I am 10 months post op and am getting night time erections to some degree.  I also get some response to Viagra, Levitra, and probably Cialis.  I tried Cialis to soon after surgery to tell.  Viagra gives me the blues (vision) and a flushed face.  I get the stuffy nose with Levitra which often gives me a terrible sinus headache that lasts all day.  I use a VED to obtain a daytime erection.  My urologist prescribed it to prevent post op shinkage.  I'm not sure if the constriction bands exacerbated the Peyronies Disease.
I am very interested in the Trazodone 25 mg.   Is it a common treatment for ED?  I plan to talk to my urologist about it during the next visit.  Also, if you don't mind me asking, how long since your RPP?  Some of the things you said are giving me hope.  Thanks for including this topic.

[dcaptain]

Hey guys, I feel bad asking questions after being off board for awhile.  Can I beg forgiveness? 

Okay, here goes.  I have a few ED questions for anyone who has experience with ED medication, VEDs, or both.  Any assistance is greatly appreciated:

I've noticed recently again that my erections are more like on a 7.5 scale out of 10 (10 being hardest), where 10 used to be the norm.  Whether this is due to Peyronies Disease or not, I cannot tell, but I must assume it is.  As such, I've been wondering about next steps.  Assuming my doc would go either route, I'm wondering:

1)  Does anyone have experience with VEDs AND medication, who can speak to which one might be better to improve specifically the firmness of an erection?

2)  Also, and forgive my ignorance here, but do VEDs and/or medication create any sort of "reliance" on them?  By that, I mean I can get an erection now generally without a problem.  The issue is the firmness, or lack thereof.  However, if I were to go on medication (Viagra, etc), or to use a VED, would this in any way diminish my ability to get an erection without using either medication or a VED?  Like, would I be "training" myself so that I would need these to get an erection?

Any insight is greatly appreciated, as always.  And have a great long weekend everybody.

dcaptain

[Hawk]

Hawk,

When you took these, does it make your erections more firm and solid?  Or does it just give you the ability to achieve an erection from sexual stimulation like a normal one that you would have?

If by "these" you mean Viagra etc, they will enhance the firmness of your erections assuming you don't already get diamond cutters.

If you mean trazodone, it generates nocturnal erections far superior to any stimulated day time erection with the aid of Viagra.  Keep in mind I sustained nerve damage from a radical prostatectomy but others have had similar experiences.

[ComeBacKid]

Hawk,

When you took these, does it make your erections more firm and solid?  Or does it just give you the ability to achieve an erection from sexual stimulation like a normal one that you would have?  I don't think these drugs could make peyronies worse as your getting erections.  Perhaps they could help stop progression or help cure peyronies to some extent.  It would be good for the doctors to do more research in this area.

ComeBackid

[Hawk]

I have taken prescriptions of all 3;Levitra, Cialis, Viagra.  Their mechanisms of action are very similar.  I see absolutely no discernible difference in the ability to produce an erection.  All three require physical or psychological stimulation to produce an erection even in a normal healthy male.  I took all 3 at maximum dosage.

Cialis has a much longer half-life than the other two so it is on-board and ready when you are, over a longer period.  One of the listed side effect for Cialis is a delayed onset back ache that can occur days after taking the drug.  I always got these in the lower back and they are no fun.  I have no clue what the direct cause is but due to the area, I wonder if it involves the kidneys in some way.  If it made the difference between sex and no sex I would endure them but not week in and week out.  I am sure many people do not get these or the drug would be a flop.

Levitra Much like Viagra from a patient stand point. Half-life is the same as Viagra as is the manner and ability of producing an erection.  The one advantage is that it is less effected by eating a couple hours before taking the pill.

Viagra - One difference that makes Viagra a draw back is that any dietary fat interferes with absorption so it is best to be fasting for 4-6 hours before taking.  If you can find a zero fat snack, that is OK.  I had a few more side effects with Viagra than Levitra but these were minimal (2 head aches, 1 blue haze vision out of dozens of doses).

Finally, They all tend to cause a bit of a stuffy nose (for me).  This is caused by increased blood flow to the membranes.  None of these caused any side effects in minimal doses such as 1/4 of a Viagra every night.

The most important thing that I can offer, but which others seem to show little interest in. For less than 2 cents a day, half of a 50mg (smallest tablet) Trazodone at night before bed will cause solid nocturnal erections increasing blood flow all through the night.  It is absorbed better if taken with food.  This is only a fourth to a half of what is prescribed for sleep.  I have zero side effect from it and it is non-habit forming at this tiny dose.  I often skip a night or two and sleep soundly, only with no erections.  This is also a case in which more is not better.  The effect seems as strong or stronger at 25 mg than at 50mg.  Nocturnal erections are not as well understood as once thought.  They seem to not be dependent on the same nerve pathways as stimulated erections so I am not sure trazodone impacts a daytime stimulated erection and I am also unsure of how trazodone works to cause erections.  But it works very well.

I have known of 3 people that tried this and all 3 got the same positive effect.  It is also a listed side effect of trazodone. If you have a doctor that will work with you, discuss this with him.  It was the best tip I ever got off of a forum.

Finally, Adrenalin, sudafed, and neosynephrine bind to adrenalin receptor cells and kill erections.  They also unstuff your nose, just the opposite of ED drugs.  Performance anxiety kills erections both by taking your mind off the psychological aspects of sex and by producing adrenalin which is a certain erection killer.

[ComeBacKid]

Maybe someone can comment on this.

I have a prescription sitting here in front of me for viagra, does this act in the same way as cialis, it seems like cialis lasts for a long time while viagra you still need to get stimulation for it to work.  Do these two drugs basically work in the same way?

ComeBackid

[Tim468]

Will,

I think that there would be no benefit to applying a vacuum to only part of your erection, and it would not be easy to do anyway. I agree with Hawks comments.

It sounds like you may have a generalized fibrotic process, without a specific area of plaque. That is how it is for me - I have never had a hard induration or nodule that could be palpated. That suggests that something like iontophoresis of verapamil (IF it could penetrate to the area of fibrotic change) would be better than "targetted" therapy with a needle.

One thing that emerges from my reading of men's experience here is that vascular supply or blood flow is an issue frequently. It may be reduced because of stress and adrenaline and fear reactions - but more often it seems to be impaired a bit.

One thing that many very good urologists do is to determine the vasular function of the arteries and veins, to see if there might be a vascular basis of the ED component of Peyronies Disease.

It makes me think that it would be VERY NICE, if the urologic ommunity could come up with a consensus on how to *evaluate* Peyronies Disease - what studies are to be done, and how, and when. In my own medical community (lung disease) we are constantly trying to see what works best, and to simultaneously strive to USE the best practices for our patients - across the board. This may be irrelevant, but I think many of you would find this article interesting. It is about how doctors decide what to do, and how patients find out how "good" their doctors are. It relates to my own area, but you may find it stimulating to what could be done in this field.

I may just have to do something about this myself (s)...

Tim

http://www.newyorker.com/fact/content/?041206fa_fact

[Hawk]

If your plaque is in the  spongiosum, you would no doubt have a downward curve as I had.  In response to your question about only using the VED on the distal half, I doubt that you could get a seal.

Have you ever used the large cylinder?  Can you remove the VED and milk blood into the distal half?

[Will]

Thanks very much for the valuable advice ComeBackid, Tim, and Hawk - your sincere information has triggered me to think deeper with this issue, and also to get a second opinion before electing for surgery.  One question about the ved...I have been using the soma correct for 1 year now...the bottom half of my penis when erect is fine...it is the distal end that is narrowing  - what is your opinion in just using the pump on the distal end (not against the abdomen since the bottom half is fine) and just pump that area up?  Also, as of recent, my uro came to the conclusion my Peyronies Disease orginated from being catherized for a long period of time.  I forgot to ask him this, and I have never seen any information in reference to where the scar tissue is from peyronie's disease if from a catherator?  Would the scar tissue just be located in the ureatha?  I believe there is a smaller area of corpus spongiosum, which has a small role in absorbing blood for erection, and to, the ureatha goes through this area.  Is it possible, that since my uro can barely find a peyronie's lesion, could the majority of the lesions be in the ureatha area?
Thanks.

[Hawk]

Will,

First, I will probably move these posts to the "Erectile Dysfunction" topic since that is primarily what they deal with.

It seems to me that you are saying that ED has always been a problem and Peyronies Disease is secondary.  The only advice I can give is to read every word of our ED topic.  I have a pretty good knowledge of ED from first hand experience after my radical prostatectomy.   If you ever inject, be very gentle, meaning steady hand, no tilting of the syringe after entry, and  above all, apply pressure to the injection site for a full 10 minutes after the injection.  If you have a wife or steady, understanding partner, I recommend a VED for erection and intercourse instead of injections.  I also suggest you ask your doctor to try trazodone in very low doses (see earlier posts in this topic) to see if it contributes to night time erections.

Finally, nocturnal erections are different than erections from physical or psychological stimulation and are not fully understood.  It used to be thought that if you got night-time erections that it meant day-time erections were possible unless there were some underlying psychological triggers that interfere.  That is now being considered to be inaccurate. 

All day-time erections do use the same nerve pathways regardless of how they are achieved (psychological stimulation, masturbation, foreplay).  If you could get an erection from masturbation but not with a female partner there could be no strictly physical reason to explain that.  Keep in mind that adrenalin is a very powerful anti-erection agent.  Adrenalin is released due to fear, stress, and anxiety.  At the same time those same emotions take your focus off of the sexually stimulating psychological aspects that help cause an erection.

I would not consider surgery until I exhausted every psychological, pharmaceutical, and divice (VED) option available with a sexual medicine MD and a psychologist.  Also, you don't mention if you are on any meds that could contribute to this problem,

[Tim468]

Dear Will,

Your past medical history of having been able to acheive erections when masturbating, but not with women, suggests that - at that point - there was an emotional component. To whatever extent that such a psychologic component can still be present, it is probably worth investigating further.

FWIW, I think almost ALL of us could benefit from psychological counseling at some point - I know that I certainly have. Having a "physiological reason" for ED does not mean that the mind cannot kick in and make it worse. Given the territory we are talking about, not having a psychologic component to ED would be the exception.

The current failure to respond to therapy that should make it all work is very confusing, and suggests a vascular problem. You have detailed so much, it is hard to imagine that you have not looked into this completely, but be sure that blood flow is evaluated. I would also see if you have nocturnal erections as well.

It sounds like part of the problem is that you have a minor Peyronies Disease related deformity (or at least a small lesion), but without erections, how can you even tell if it is better, worse or unchanged? But I do not believe that it is likely that Peyronies Disease is causing the worsening of your erectile function.

I too would be quite leery of taking a surgical option yet.

Tim

[ComeBacKid]

Will,

I would recomend Ionotophoresis and the VED, if you read the section on VED's youll find much good information. For some cases the VED can straighten the penis out and help to cure ED.  Also there have been some promising studies done on the Iontophoresis, as it is proven to drive verapamil into the target tissue.  And on another note I know that most people on this forum question topical verapamil, however I have been using it and I can tell it definately increases blood flow while in the flaccid state, this I believe can't be a bad thing.  I wouldn't go to surgery just yet, your going to lose some length, and possible rigidity in your erections depending on the surgery choice you make.  Also you may lose sensetivity, as anytime they cut into your penis your going to damage some nerves.  Some will regrow but it will never be the same, and this in turn could lead to future Erectile Function.  The IONO treatment is not cheapt but definately worth a try in my opinion.  The medical studies back it up.  You just need a prescription and you can get the machine and the liquid medications from www.physion.com- I'm not trying to advertise for them just trying to direct you without searches and hassles.  Old Man has a great deal of knowledge dealing with the VED treatment as well.  In my opinion would should exhaust all possible options before attempting surgery.

ComeBackid

[Will]

Hello everyone...I would greatly appreciate some advice on the following:  As I have stated before on this forum, I am curently 34 years of age and have been impotent since the age of 18.  It is noted, that I went through a normal stage of puberty and got erections all the time, which included strong nighttime erections.  At the age of 18, for some unknown reason, I became impotent, however, I could still attain strong erections when I masterbatedwith strong erections, but never upon wakening in the morning or when attempting sex with a female.  Years went by...still could attain erections when masterbating, but none with a female.  Waited and waited until viagra came along...I was cured...felt like a normal man again.  However, one night when masterbating, I attained a very strong erection without viagra, and a very distorted penis appeared with a dent on top of the shaft.  I have never been able to obtain an erection again, even if masterbating - potency is gone.  This was 3 years ago and am being treated for peyronie's disease, and have been for the last 3 years, however, only a very small peyronie's area was found - it can not be felt with the hand - it is only seen with ultrasound - V injections are not an option for the area being so small, the uro feels it will not help.  Nothing worked...the uro mentioned trimix - it worked awesome!  This trimix worked wonderfully each and every time, but after 3 months, it not longer gave me an erection...just a semi-response and a bigger flacid penis for about 2 days.  My optimal dosage which worked great was .05 to .07.  I then increased it to 1cc and still no usable erection.  Today, I even tried 75mg. of viagra and 1.5cc's of trimix and STILL no usable erection.  What's going on here??  I am so confused!  Everywhere I read on the internet, it seems as if everyone responds well to trimix!  Do men sometimes use more than 1.5cc?  The medication was not expired and was refrigerated.  Can someone please give some advice on what I might be doing wrong?  I follow all directions on how to inject; however, I have read where most men insert the needle in the penis, and then push hard to gurantee it gets to the right tissue...I dont usually push very hard after I insert the needle...I figure since it does hurt, it is at its right depth.  The uro states I am a good candidate for penile ligation surgery...but wanted me to try these very non-invasive medications.  Regarding penile ligation surgery, I have read this may not be a long-term cure, but I figure if it works well for 5 years and symptoms of leaking  appears, my opinion is that the leak will not be as bad as now, therefore would respond very well to the oral and injectible medications again.  And, if I am hearing correctly either gene therapy and/or regrowing of smooth muscle for the penis will "possibly" start being offered to the public in about that time frame.  Any thoughts for my justification for having the ligation surgery, or would you keep trying higher doses of trimix?  Thanks.