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Author Topic: Low Testosterone / Erectile Dysfunction  (Read 410 times)

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thecrookedone

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Low Testosterone / Erectile Dysfunction
« on: January 04, 2021, 04:20:19 AM »

Hi,

Im 35 yrs old, from India. I have a downward penile curve 60-70 degrees.

I have always had problem sustaining erections during intercourse, but i had always assumed they were due my anxiety and inability to penetrate due to my high degree of curvature. i had no problems sustaining erections during masturbation.

I had recently took a health check for testosterone, since i had no morning erections and even when i had a few they were weak. it appears to have started when i took finastride since dec 2019. I had zero libido. no erections and semen was watery. i had updated my doctor and he advised me to stop finastride and the semen became better. erections was still ok but not like before.

Over the last 6 months or so. i have never had morning erections or only weak ones. my testosterone levels were at 352 in dec 2020.
i also went through an old health record in 2018 when my testosterone was at 250.

i was diagnosed with a rare blood disorder in mar 2020 and hence advised to take warfarin for life. Due to this condition my urologist does not prescribe a penile doppler with papaverine, since im at risk of bleeding.

How do i now understand if my Erectile Dysfunction is due to low testosterone or due to some other reason ? im also considering plication surgery for my curvature, but if i have Erectile Dysfunction then the only solution seems to be an implant. there is no point going for a straitening surgery and an implant surgery subsequently.

i used to drink heavily between 2016-2019. i used to be constantly tired, poor sleep. lack of focus at work. no drive for anything in life. i have however stopped and ive remained clean since early 2020.  but my testosterone has improved but no where near the levels for my age.

im very confused how to proceed further ? do i improve my testo levels first before making a choice between plication and implant ? or how do i check for Erectile Dysfunction to know exactly what im going though ?

thanks
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Age : 35
Congenital Penile Curvature. Ventral. 60-70 degrees.
Erectile Dysfunction
Low Libido

Asphyxia

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Re: Low Testosterone / Erectile Dysfunction
« Reply #1 on: January 04, 2021, 06:39:52 AM »

Im not sure what finasteride has done to your body
How is your thyroid? It could be effecting testosterone
Try adding zinc either a supplement or pumpkin seeds
Maybe 1 brazil nut daily for selenium
And cut out flax seed, vegetable oils,and seed oils like canola and sunflower oil or anything too high with omega 6
Also avoid soy
Also try to be at a healthy weight if you are overweight/underweight
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Age:23. Onset of symptoms: september 2020.
Curve mostly semi erect about 60 degrees, slight pain
Tried short & prolonged fasts, keto,carnivore, traction and most of the supplements.
Severe digestive issues, probably an autoimmune disorder

Hawk

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Re: Low Testosterone / Erectile Dysfunction
« Reply #2 on: January 04, 2021, 08:29:57 AM »

You seem to indicate that your testosterone is low.  If that is true, it seems like the logical action would be to take a testosterone replacement.  Then experiment to see how erections are during masturbation.  Either the Erectile Dysfunction will be solved, or it will not be.  If you cannot find a reliable fix for the Erectile Dysfunction, I completely agree that it makes no sense to have a shortening plication surgery that would leave you with a shorter, non-functioning penis.  The solution at that point would be to have an implant that, if done by the right doctor, would preserve or increase your size and give you reliable erections.
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Asphyxia

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Re: Low Testosterone / Erectile Dysfunction
« Reply #3 on: January 04, 2021, 08:49:26 AM »

By the way you can also take adaptogenic herbs to reduce stress
and balance the endocrine system  which might increase testosterone,
 personally i would try the natural route with diet and herbs before taking testosterone replacement.
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Age:23. Onset of symptoms: september 2020.
Curve mostly semi erect about 60 degrees, slight pain
Tried short & prolonged fasts, keto,carnivore, traction and most of the supplements.
Severe digestive issues, probably an autoimmune disorder

pfract

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Re: Low Testosterone / Erectile Dysfunction
« Reply #4 on: January 04, 2021, 09:52:34 PM »

heY crooked one... have you looked into Post finasteride symdrome?

For the low testosterone, it definitely affects your erections, as well as the hair loss medication. Yes, you can have a priapism with the medication that you are taking so be very carefull if you try to push to have a doppler done.

Yes. You are also very correct. If you do have Erectile Dysfunction, then avoid all together having two surgeries when you can solve both problems right away. Just bear in mind that a lot of doctors in India will try to push the 2 piece implant on you. It's easier for them to implant, but it's way inferior the 3 piece. So try to find a doctor that installs those.

There is medication both oral and injectable that you can take to help you with your testosterone levels.But you have to find a urologist that will be willing to help you out first.

thecrookedone

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Re: Low Testosterone / Erectile Dysfunction
« Reply #5 on: January 05, 2021, 06:23:20 AM »

Asphyxia - thanks for your reply. they seem to be within acceptable levels.

thryroid :

TSH               - 1.42         Reference levels - 0.54 to 5.3
Free T4       - 1.54         Reference levels - 0.8 to 1.8
Free T3       - 3.69         Reference levels - 1.4 to 4.4

others
 
Zinc             - 66.3         Reference levels - 54 to 151
Magnesium - 1.9         Reference levels - 1.6 to 2.6
Vit D             - 24.8        Reference levels - 30 to 100

I'm making lifestyle and diet changes as you have suggested. im 6ft tall.  ive come down from 103kgs to 95kgs now.  Im still overweight by about 20 kgs (~ 45 pounds). trying to lose more.

on the natural herbs : I'm taking ashwagandha powder (one tea spoon) every night to reduce stress and help boost testo.

Hawk : Thanks for your reply, I do not know for sure if indian doctors prescribe trt. They seem to prescribe Clomifene to trigger the pituitary gland to secrete testosterone and improve levels. is that a viable option ?  i have an appointment due in a few days with my endocrine specialist. He suggested some tests and will probably advise course of treatment. I will update here post my doctor visit.

pfract : Thanks for your reply. yes i do know about post finastride syndrome. i got some information about it from hair transplant forums. i took finastride only for 90 days (dec 2019 - feb 2020) and i have stopped completely due to side effects. I have mentioned finastride here just to ensure i don't miss anything out. From my old records it appears i have had low testo since mid 2018, a full year before starting to take finastride.

I took the penile doppler in 2011 with Sidenafil ( tablet). I did not have Erectile Dysfunction back then. Was checking for Peyroines / Congenital Curve and degree of curvature.

Now I'm trying to get my hematologist to agree to lower my pt inr levels for a few days so i can take the penile doppler test. i agree with you on priapism, but i have no way of being absolutely sure which direction i need to take on my situation without a penile doppler.

If i do take the implant route.  I do agree with you on 2-piece implants, I will ensure i get 3 pieces if i ever need an implant. While i,m on the lookout for an excellent implant surgeon in India,  i'm considering Dr Eid in New York. Since i have curvature and there is one other member here - curved (he did not have Erectile Dysfunction) - who had a successful peyroines curve fixed by Dr Eid, im strongly leaning towards him. I have a virtual consultation scheduled with him end of this month. Will update post my appointment with him.

thanks a lot guys.

to sum it up :

-> improve testo. Check for Erection quality
-> Check for Erectile Dysfunction (penile doppler with papaverine)
-> If Erectile Dysfunction is present - Implant
-> If Erectile Dysfunction is absent - Plication


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Age : 35
Congenital Penile Curvature. Ventral. 60-70 degrees.
Erectile Dysfunction
Low Libido

Hawk

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Re: Low Testosterone / Erectile Dysfunction
« Reply #6 on: January 05, 2021, 09:19:51 AM »

This very likely has nothing to do with your Erectile Dysfunction, but your vitamin D levels are low. Vitamin D is reported as either as ng/ml or nmol/l

I assume yours was measured in ng/ml.

The reference levels you show are obsolete and outdated.  you are even below these outdated reference level and should be at least 50 ng/ml or 112 nmol/l

Vitamin D is the most important single vitamin, and you can only get it from the sun at mid-day or from a pill. 500iu per day is a good starting point to get your levels up.
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Prostatectomy 2004, radiation 2009, currently 68 yrs old
After pills, injections, VED - Dr Eid, Titan 22cm implant 8/7/18
Hawk - Updated 10/27/18 - Peyronies Society Forums

Asphyxia

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Re: Low Testosterone / Erectile Dysfunction
« Reply #7 on: January 05, 2021, 09:40:56 AM »

I think another option for vitamin D is cod liver oil, although the amount of vitamin A in it might be too high for a regular consumption
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Age:23. Onset of symptoms: september 2020.
Curve mostly semi erect about 60 degrees, slight pain
Tried short & prolonged fasts, keto,carnivore, traction and most of the supplements.
Severe digestive issues, probably an autoimmune disorder

thecrookedone

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Re: Low Testosterone / Erectile Dysfunction
« Reply #8 on: January 05, 2021, 09:50:56 AM »

Hawk : it is ng/ml . My vit d levels were above 60, few months back. And I stopped taking them. But I do not remember that having an effect on my erection quality/libido. I shall definitely try again and observe changes if any.

Does vit d have a directly proportional relationship with erection/libido?

And is clomiphene a viable alternative to trt?

Asphyxia : i have a prescription for vit d and I have started taking it. Once my six weeks cycle is complete I shall check with my doctor about cod liver oil. Thanks
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Age : 35
Congenital Penile Curvature. Ventral. 60-70 degrees.
Erectile Dysfunction
Low Libido

Asphyxia

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Re: Low Testosterone / Erectile Dysfunction
« Reply #9 on: January 05, 2021, 09:57:46 AM »

I forgot to ask, how is your sleep?
In my opinion this can be a huge factor, if you are getting 4-5h of sleep on a regular basis when infact you should get atleast double that amount, then this can cause your whole endocrine system to be out or whack.
Sleep apnea?
Frequent urination at night?
Messed up circadian rhythm?(such as sleeping at daytime, staying awake at night)
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Age:23. Onset of symptoms: september 2020.
Curve mostly semi erect about 60 degrees, slight pain
Tried short & prolonged fasts, keto,carnivore, traction and most of the supplements.
Severe digestive issues, probably an autoimmune disorder

thecrookedone

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Re: Low Testosterone / Erectile Dysfunction
« Reply #10 on: January 05, 2021, 10:53:25 AM »

Sleep is very poor. I'm using the smart watch to track my sleep patterns. Avg deep sleep last month was 1 - 1.5 hours. Light sleep was 3.5 - 4 hours. I get 6 hours of sleep on avg.
I don't frequently urinate. Once probably at night .
Im not sure if circadian rhythm is messed up. But I feel sleepy during the day. Sometimes I nap for 20-30 mins because it's difficult to remain awake. But constantly feeling tired due to poor sleep. Not sure how to fix my sleep patterns.

Any suggestions?
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Age : 35
Congenital Penile Curvature. Ventral. 60-70 degrees.
Erectile Dysfunction
Low Libido

Asphyxia

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Re: Low Testosterone / Erectile Dysfunction
« Reply #11 on: January 05, 2021, 11:26:05 AM »

I dont think napping during daytime is bad.
Avoid caffeine(coffee,black/green/white tea,cacao) before sleep, or any diuretic for that matter.
I made a post where you can find some advices regarding sleep and health in general.
https://www.peyroniesforum.net/index.php/topic,14791.0.html?PHPSESSID=0n3gk2373p1mjgsrp2ga385bh2

Also check this post
https://www.peyroniesforum.net/index.php/topic,14615.0.html?PHPSESSID=2ubffd0msq3cbdeuquqcudu0l4
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Age:23. Onset of symptoms: september 2020.
Curve mostly semi erect about 60 degrees, slight pain
Tried short & prolonged fasts, keto,carnivore, traction and most of the supplements.
Severe digestive issues, probably an autoimmune disorder

Asphyxia

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Re: Low Testosterone / Erectile Dysfunction
« Reply #12 on: January 05, 2021, 11:43:49 AM »

Also you mentioned feeling sleepy  and constantly tired
Have you been tested for adrenal function?
Maybe its adrenal fatigue or something related

https://www.prevention.com/health/a20507737/is-it-your-thyroid-or-adrenal-fatigue/
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Age:23. Onset of symptoms: september 2020.
Curve mostly semi erect about 60 degrees, slight pain
Tried short & prolonged fasts, keto,carnivore, traction and most of the supplements.
Severe digestive issues, probably an autoimmune disorder

thecrookedone

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Re: Low Testosterone / Erectile Dysfunction
« Reply #13 on: January 05, 2021, 12:52:43 PM »

I have an appointment with my endocrine specialist in a couple of days. He has prescribed some tests that includes a thyroid scan. Hopefully those tests might give me an idea about adrenal function.
Kindly let me know if any specific tests need to be taken for adrenal function. I shall check with my doctor. Thanks
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Age : 35
Congenital Penile Curvature. Ventral. 60-70 degrees.
Erectile Dysfunction
Low Libido

Hawk

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Re: Low Testosterone / Erectile Dysfunction
« Reply #14 on: January 05, 2021, 01:00:09 PM »

I think another option for vitamin D is cod liver oil, although the amount of vitamin A in it might be too high for a regular consumption

That is exactly correct.  You would overdose on vitamin A long before you got enough D
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After pills, injections, VED - Dr Eid, Titan 22cm implant 8/7/18
Hawk - Updated 10/27/18 - Peyronies Society Forums

Asphyxia

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Re: Low Testosterone / Erectile Dysfunction
« Reply #15 on: January 05, 2021, 01:11:03 PM »

As mentioned in that link, the test is meant to check for low cortisol, it seems there are multiple way to test for it, when i had a blood test to check for cortisol i asked the nurse : wouldnt my cortisol rise if im nervous about trusting you with a needle in my vein, the answer was yes, but not by much,however in my opinion if you have phobia of blood or needles, and tend to pass out or throw up after blood tests then maybe you should ask for another test method(urine test is recommended in the link)
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Age:23. Onset of symptoms: september 2020.
Curve mostly semi erect about 60 degrees, slight pain
Tried short & prolonged fasts, keto,carnivore, traction and most of the supplements.
Severe digestive issues, probably an autoimmune disorder

Asphyxia

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Re: Low Testosterone / Erectile Dysfunction
« Reply #16 on: January 05, 2021, 05:37:00 PM »

Regarding sleep, i think its worth mentioning that while many people take hot baths to alleviate symptoms of peyronies,
theres a potential here to kill 2 birds with 1 stone

bathing one to two hours — ideally, 90 minutes — before bed in water at 104 to 109°F (40 to 43°C) did the trick to help people get the best quality sleep. Bathing at that time and temperature can help you fall asleep an average of 10 minutes quicker than normal.

The basic idea of warm-water bathing at night is based on the core body temperature fall that occurs which signals the pineal gland to signal the production of melatonin

once we raise the body temperature over 100°F (38°C), it has to fall. That mimics the natural decrease

https://www.healthline.com/health-news/having-trouble-sleeping-try-a-hot-bath-before-bed#Understanding-sleep,-circadian-cycles
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Age:23. Onset of symptoms: september 2020.
Curve mostly semi erect about 60 degrees, slight pain
Tried short & prolonged fasts, keto,carnivore, traction and most of the supplements.
Severe digestive issues, probably an autoimmune disorder

thecrookedone

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Re: Low Testosterone / Erectile Dysfunction
« Reply #17 on: January 09, 2021, 07:22:26 AM »

My endocrine specialist will not prescribe trt or clomiphene to address my issue. He says it will within the range 😔. I'm overweight by about 18 kgs. My bmi is 29. He told me to lose 7-8 kgs in 3 months and asked me to report back to him with new testosterone tests after weight loss. He also said there are too much side effects and he said he will prescribe clomiphene only if I'm going to have a family 🙄. I don't understand his point of view and how it will be useful if I don't have erection and have normal intercourse

I don't know what else to do other than following his advice.

Is there anything else I can do guys? I will focus on my weight reduction though
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Age : 35
Congenital Penile Curvature. Ventral. 60-70 degrees.
Erectile Dysfunction
Low Libido

Asphyxia

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Re: Low Testosterone / Erectile Dysfunction
« Reply #18 on: January 09, 2021, 08:05:50 AM »

im pretty sure that along with the side effects it also causes dependency, so to me it makes sense why he wouldnt prescribe it before making sure you are taking care of the predominant things that may inhibit testosterone production, i suppose all you can do is to follow what we advised you on this post and everything that is generally considered healthy while losing weight, i suggest you dont restrict more than 500 calories a day. in my opinion it is better to fast from time to time, you can try  a ketogenic diet also.
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Age:23. Onset of symptoms: september 2020.
Curve mostly semi erect about 60 degrees, slight pain
Tried short & prolonged fasts, keto,carnivore, traction and most of the supplements.
Severe digestive issues, probably an autoimmune disorder

Hawk

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Re: Low Testosterone / Erectile Dysfunction
« Reply #19 on: January 09, 2021, 11:15:56 AM »

He gave you sound advice.  Your T is in the normal range, and a shot is not the solution to compensate for muscle loss and weight issues.

A loss of lean muscle tissue and an increase in fat tissue also typically occurs with age and metabolic disorders such as obesity and type 2 diabetes. Fat tissue contains aromatase and thus converts testosterone to estrogen. Fat also serves as a reservoir for storing estradiol. Both of these factors lead to increased estrogen levels in men.

Deal with that, and then as he said, get re-evaluated. I would recommend some weight training along with diet because diet alone can eat up muscle if the body senses the muscle is not being used.
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shrunken_dick

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Re: Low Testosterone / Erectile Dysfunction
« Reply #20 on: January 10, 2021, 02:35:54 AM »

@thecrookdone ; I would suggest you check out the T-nation forum.
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thecrookedone

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Re: Low Testosterone / Erectile Dysfunction
« Reply #21 on: January 12, 2021, 04:45:47 AM »

@shrunken_dick : Thanks will do.

another update :

i took an appointment with a different urologist today. he said curvature is present and he prescribed Tadalafil 20mg to be used only "on demand". he also suggested surgery to be the last option and urged me to try for intercourse even with high degree of curvature. he said " vagina will be able to accommodate any shape " and told me not to worry.

I would like to know if taking 20 mg once before sex is better or if a low dosage everyday (2.5 - 5mg ) is better. sometimes due to work and travel constraints i wont be able to plan in advance. I'm also planning to take L Arginine 1000-2000mg per day, can anyone throw light if i can take tadalafil and l arginine together or if i should cycle them and take on different days ?

thanks
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Age : 35
Congenital Penile Curvature. Ventral. 60-70 degrees.
Erectile Dysfunction
Low Libido

Dressa

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Re: Low Testosterone / Erectile Dysfunction
« Reply #22 on: January 12, 2021, 11:12:44 AM »

2.5-5 mg a day works better for me. I get a very sore throat so that's why. Also there is a report on low dose tadalafil daily suggesting it's beneficial in cases of peyronies.
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thecrookedone

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Re: Low Testosterone / Erectile Dysfunction
« Reply #23 on: January 12, 2021, 09:11:51 PM »

@dressa : can you share the report?
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Age : 35
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