Hi everyone,
I need help figuring out what are my options and which treatments I should try next.
First of all, I've been experiencing a drop in libido since summer 2020. It's better now than it used to be but it comes and it goes. Testosterone levels are good and overall blood results are excellent.
Here's the thing: I'm in a new, healthy relationship and I'm experiencing issues regarding ED.
Even though I'm aroused, I can't get an erection. It's probably mainly psychological but I also think that Peyronie's disease does play a role in making it more difficult for the blood to flow. Since I've been diagnosed with Peyronies's, my erections haven't been as strong as before but I was still able to be hard enough to have sex up until now. I haven't always experienced ED. Maybe the plaque is getting worse? Who knows.
I've been taking Cialis (10 mg) on an on-demand basis since January. It used to work well but it's a gamble now: sometimes it does, sometimes it doesn't. Most of the times, the erections are there but are not hard enough or don't last long enough. It's been that way for the last couple weeks. It's been taking a massive toll on my mental health and anxiety and I need help deciding what to do next. I'm scared I will always be this way.
My options are:
1) Try Cialis 20 mg instead of 10 mg
2) Try a Cialis daily dose instead of on-demand
3) Try a new drug
4) Other?
What do you think? Any advice would be greatly appreciated. Thank you very much.
Well, you won't "always be that way". You would get an implant if it were the only way to have sex that satisfied you and your partner.
There are a lot of other things to consider first.
Do you get NTE's
are there ever situations where you get a rock-hard erection?
Have you taken L-Arginine?
I am curious as to what made you say it is psychological?
Why do you think your libido is down?
First, breath a little deeper. There's (almost) always a solution for things.
How bad is your Peyronie? How many degrees bent?
Have you done a doppler exam with your penis hard? This is the best way to see plaques and test your erectile function. If I were you, I'd consult a doctor that does this exam. From there, you both can discuss what's best for you.
Personally, I advise against using tadalafil daily. Generally, it loses its efficacy quite fast.
If PDE5i drugs (viagra, tadalafil) stop working, you can start with injections. It probably is a pain in the ass, I've never used them. But this is generally the next route after PDE5i's.
Quote from: Hawk on March 18, 2021, 09:29:22 AM
Well, you won't "always be that way". You would get an implant if it were the only way to have sex that satisfied you and your partner.
There are a lot of other things to consider first.
Do you get NTE's
are there ever situations where you get a rock-hard erection?
Have you taken L-Arginine?
I am curious as to what made you say it is psychological?
Why do you think your libido is down?
Hi Hawk,
Thank you for taking the time to reply.
You're absolutely right about the implant. It's something I strongly consider.
Here are the answers to your questions:
- I get NTE's some nights (not all) but they're not frequent. Whenever I do get them, my erections aren't really strong. I'd say maybe 60 % of what they "should" be. Morning woods are rare and aren't strong either.
- Without Cialis, there isn't any situation where I get a rock-hard erection anymore. However, it happened a few times weeks ago when I took Cialis and had sex with my girlfriend.
- I haven't taken L-Arginine but I'm open to it! Would you recommend the same dosage as in the survival guide (3 grams per day)?
- The reason I'm thinking it's more psychological than physical (although I think it's a combination of both honestly) is because I haven't always experienced ED. From 2017 to 2020, I was able to have satisfying intercourse with my ex-girlfriend. I can't say the curvature caused by Peyronie's has worsened since then (at least not yet) but I do feel pain from time to time now. As a result I'm much more worried about Peyronie's worsening and ED than I used to be. That being said, it's entirely possible the plaque has worsened or is worsening and is the cause of my ED. That's something that really scares me: besides an implant, is there even a cure for ED caused by Peyronies's?
- I think my libido is down because 2020 has been a particularly rough year (it has been for most of us anyway) and I've been experiencing way more anxiety than usual. I'm in therapy. The anxiety is slowly getting better but I still have a long way to go.
Quote from: Tortão Pra Direita on March 18, 2021, 09:34:11 AM
First, breath a little deeper. There's (almost) always a solution for things.
How bad is your Peyronie? How many degrees bent?
Have you done a doppler exam with your penis hard? This is the best way to see plaques and test your erectile function. If I were you, I'd consult a doctor that does this exam. From there, you both can discuss what's best for you.
Personally, I advise against using tadalafil daily. Generally, it loses its efficacy quite fast.
If PDE5i drugs (viagra, tadalafil) stop working, you can start with injections. It probably is a pain in the ass, I've never used them. But this is generally the next route after PDE5i's.
Hi Tortão Pra Direita,
Thank you for taking the time to write your message.
I'd say my Peyronie's is not that bad. Could definitely be worse. I have a plaque on the left at approximately 1 inch from the base. The curve is around 25 to 30 degrees. It hasn't prevented me from having satisfying intercourse in the past.
I haven't done a doppler exam. I've talked about it with my urologist recently and she said the best course of action would be to try medication and RestoreX first. If things haven't improved when I see her next, then she would consider doing the exam and researching other treatments. My next appointment is in August. I can't say I wasn't disappointed as I think doing the exam now would give me/us valuable info. Do you think a GP would be able to do it or should I try and find another urologist in the meantime?
Thank you for your advice regarding the drugs. Maybe I should try a higher dosage of Cialis then or try another one (I have a prescription for Levitra).
Is the plaque hard to the touch for you, MauvaisCoton?
Seems like your approach is the way to go for you, btw.
Quote from: Godisreal on March 18, 2021, 10:20:50 AM
Is the plaque hard to the touch for you, MauvaisCoton?
Seems like your approach is the way to go for you, btw.
Nope! Not really. Even my urologist seemed to have trouble feeling it as it appears to be located more on the inside (if that makes sense). Hurts when I touch it though.
I think you mentioned you thought you had good blood flow. Peyronies Disease seldom restricts arterial blood flow into the penis. Instead, plaque prevents the swollen erection from properly squeezing and constricting the veins that drain the blood from the penis. As Tortão Pra Direita advised, a Doppler ultrasound while erect would reveal any venous leak. That would help settle an important question about the psychological vs. vascular cause of the Erectile Dysfunction.
I'm afraid I have to disagree that injections are a natural next step. A man has some very serious consideration before he jumps to something that can trigger another round of Peyronies Disease that can take a tole in penile size and health. Many men here have Peyronies Disease as a direct result of Erectile Dysfunction injections of BiMix or TriMix.
I would take the L-Arginine as indicated in the survival guide. You could also consider taking 1/2 of a 50 Mg Trazadone at night before bed (with a light snack for absorption). This is a sub-minimal dose, and then it would likely cause 1. NTE's healthy for your penis, and 2) help you sleep if that happens to be an issue. In the U.S., that is a prescription drug, but most doctors will prescribe it if you ask for it for sleep, especially at that dose. It is extremely cheap, usually only pennies per pill.
BTW - I know of NO data that suggests, much less establish that men build up a tolerance to daily Cialis. What sometimes happens is that the cause of his Erectile Dysfunction worsens, and men think they built up a tolerance. I will be interested if anyone has a study to the contrary.
Quote from: MauvaisCoton on March 18, 2021, 09:01:00 AM
Hi everyone,
?
What do you think? Any advice would be greatly appreciated. Thank you very much.
Hello,
Vacuums erection device or VED worked excellently for me. I'v only just began using it for peyronie's. The following morning my erections are as good as they were when I was in my 20's!
Read the protocols under the VED heading. It's just 1 or 2 10 minute sessions daily. Be careful not to over pump. You can do yourself an injury.
It stands to reason to buy a medical device like soma, but as long as you have a pressure gauge on your pump and the cylinders are the proper size. (See protocols for further details). You can get away with penis enlargement cylinders. Personally, I wouldn't buy a cylinder that is tapered in shape. Go for a cylinder that has equal circumfrance on top and bottom.
It's a good treatment option. All the best.
I always used a single-cylinder Vacurect. I would highly recommend it if you are also going to use it for erections to oxygenate the tissue, size retention, and sex since it is compact can be used with one hand, and has a superior system to the bands that others use to snap onto the penis for sex.
If your primary concern is treating a bend, then you might want a 3 cylinder Agusta Soma Correct.
Also, if you are over 5 1/2 inches in girth, you might not want the Vacurect, but I think it is great.
Tortao, injections cause scaring and in my case Peroynes, plus injections are contradicted for Peroynes
Thank you all for your suggestions, I greatly appreciate you taking the time to help me figure out my options.
By the way, is a Doppler ultrasound while erect the only test I can undergo to find out if my ED is caused by a physical issue?
I'd really like to know if my difficulties having or maintaining an erection is caused by a physical issue, psychological factors or a combination of both.
It is the only test I know that measures penis blood flow. That is one huge physical component of an erection but not everything.
There can be nerve issues not shown by a Doppler. Those are usually a factor associated with, surgery, an accident, or at least serious pinched nerves that you would likely know about.