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Hello everyone,

I'm 27 years old and from the UK. My ED problems first began when coming off SSRIs about 8 years ago. I noticed a loss of morning wood, lower libido, and problems keeping erections. I was in denial about the problem for a while (despite this, I often found myself turning women down, as I knew deep down something wasn't right) until I finally approached a private urologist a few years ago. I was prescribed daily cialis and 6 rounds of shockwave therapy. I'm still unconvinced the shockwave therapy had much of an effect but cialis made it somewhat easier to maintain erections during sex (which had been the worst aspect of my predicament by far).

Earlier this year I began suffering from a poorly understood condition known as Hard Flaccid Syndrome (believe to be a particular subtype of CPPS or Chronic Pelvic Pain Syndrome), which has amplified my problem with maintaining erections. Fortunately cialis still seems to work most of the time and I have a normal sex life with my girlfriend, at least for now. I understand though that the efficacy of cialis and other drugs often comes with a time limit and that things might go south in the near-ish future. I currently follow a strengthening routine to try and deal with Hard Flaccid and am trying to find a good pelvic floor physio equipped to deal with the condition.

I'd be interested to hear from any other users struggling with Hard Flaccid who have undergone a penile implant surgery as a solution to their ED.

The effectiveness of PDE5 remain the same if your physical condition remains the same. Most of people experiment a diminished effectiveness of drugs over time cause for example their venous leakage gets worse.
If you have PSSD, you should be fine with cialis. What is the dosage you are using?

Btw have you tried trazodone? It may help with PSSD

confused95 wrote:The effectiveness of PDE5 remain the same if your physical condition remains the same. Most of people experiment a diminished effectiveness of drugs over time cause for example their venous leakage gets worse.

I don't think this is true. For me and many others, the effectiveness of PDE5 inhibitors diminishes over time.
In my case, I was using cialis to help my peyronie. I had to give breaks every month or so, and after the breaks, the effectiveness always returned.

AllHailTed wrote:Hello everyone,

I'm 27 years old and from the UK. My ED problems first began when coming off SSRIs about 8 years ago. I noticed a loss of morning wood, lower libido, and problems keeping erections. I was in denial about the problem for a while (despite this, I often found myself turning women down, as I knew deep down something wasn't right) until I finally approached a private urologist a few years ago. I was prescribed daily cialis and 6 rounds of shockwave therapy. I'm still unconvinced the shockwave therapy had much of an effect but cialis made it somewhat easier to maintain erections during sex (which had been the worst aspect of my predicament by far).

Earlier this year I began suffering from a poorly understood condition known as Hard Flaccid Syndrome (believe to be a particular subtype of CPPS or Chronic Pelvic Pain Syndrome), which has amplified my problem with maintaining erections. Fortunately cialis still seems to work most of the time and I have a normal sex life with my girlfriend, at least for now. I understand though that the efficacy of cialis and other drugs often comes with a time limit and that things might go south in the near-ish future. I currently follow a strengthening routine to try and deal with Hard Flaccid and am trying to find a good pelvic floor physio equipped to deal with the condition.

I'd be interested to hear from any other users struggling with Hard Flaccid who have undergone a penile implant surgery as a solution to their ED.

don't even consider implant bro, def not worth it for your situation. since you have suffered from PSSD and you suggest you are dealing with HF symptoms, look into PF relaxation/therapy (and maybe injections if that doesn't resolve the issue). my friend from south asia (@kalifromamd, who also suffered from PSSD) completely resolved his severe ED issues by using PGE-1 injections (viewtopic.php?f=5&t=17333)

abhishek26 wrote:don't even consider implant bro, def not worth it for your situation. since you have suffered from PSSD and you suggest you are dealing with HF symptoms, look into PF relaxation/therapy (and maybe injections if that doesn't resolve the issue). my friend from south asia (@kalifromamd, who also suffered from PSSD) completely resolved his severe ED issues by using PGE-1 injections (viewtopic.php?f=5&t=17333)

Thanks for your reply man, I'd never considered or even heard of PGE1 previously. I'll look into it

Quick question for you, saw in your signature that you were diagnosed with a severe pelvic floor spasm - who did you see that gave you that diagnosis and what diagnostic tool did they use?

confused95 wrote:Btw have you tried trazodone? It may help with PSSD

Can't say that I have, I'll look into it! Regarding your other question, I was given a prescription for 5mg, but have experimented with 20mg too. I found 5mg was usually enough, maybe I'll start to up the dose in future if the effectiveness wanes.

AllHailTed wrote:

abhishek26 wrote:don't even consider implant bro, def not worth it for your situation. since you have suffered from PSSD and you suggest you are dealing with HF symptoms, look into PF relaxation/therapy (and maybe injections if that doesn't resolve the issue). my friend from south asia (@kalifromamd, who also suffered from PSSD) completely resolved his severe ED issues by using PGE-1 injections (viewtopic.php?f=5&t=17333)

Thanks for your reply man, I'd never considered or even heard of PGE1 previously. I'll look into it

Quick question for you, saw in your signature that you were diagnosed with a severe pelvic floor spasm - who did you see that gave you that diagnosis and what diagnostic tool did they use?

I saw one of the top urologists in FL (for ED-related issues) at UF Urology, who immediately diagnosed me with pelvic floor dysfunction by pointing out my extremely tight pelvic floor muscles, which were in a spasm-like state. This was diagnosed with DRE (sticking finger up the ass to check for PF muscles/prostate area) after I had provided the doctor with my background, symptoms, and what I had tried so far (including exercise, diet, cialis and supplements, none of which made a real difference in my severe ED symptoms, which I had kind of expected since I'm a relatively young, healthy dude otherwise, with no underlying medical conditions/diseases). He strongly recommended pelvic floor therapy to use trigger points/massages and such to relieve and relax the PF muscles so that proper nervous response can be restored. He also noted that he had seen very similar ED symptoms in other patients who had been suffering from hypertonic pelvic floors, and that therapy is an effective way to resolve these issues that result from such a tight PF.

abhishek26 wrote:I saw one of the top urologists in FL (for ED-related issues) at UF Urology, who immediately diagnosed me with pelvic floor dysfunction by pointing out my extremely tight pelvic floor muscles, which were in a spasm-like state. This was diagnosed with DRE (sticking finger up the ass to check for PF muscles/prostate area) after I had provided the doctor with my background, symptoms, and what I had tried so far (including exercise, diet, cialis and supplements, none of which made a real difference in my severe ED symptoms, which I had kind of expected since I'm a relatively young, healthy dude otherwise, with no underlying medical conditions/diseases). He strongly recommended pelvic floor therapy to use trigger points/massages and such to relieve and relax the PF muscles so that proper nervous response can be restored. He also noted that he had seen very similar ED symptoms in other patients who had been suffering from hypertonic pelvic floors, and that therapy is an effective way to resolve these issues that result from such a tight PF.

Gotcha. Do you have any idea what might have triggered your PF spasm? Do you have HF as well? It's crazy how pelvic floor dysfunction isn't more common knowledge, I think it is wildly underdiagnosed in the male population

AllHailTed wrote:

abhishek26 wrote:I saw one of the top urologists in FL (for ED-related issues) at UF Urology, who immediately diagnosed me with pelvic floor dysfunction by pointing out my extremely tight pelvic floor muscles, which were in a spasm-like state. This was diagnosed with DRE (sticking finger up the ass to check for PF muscles/prostate area) after I had provided the doctor with my background, symptoms, and what I had tried so far (including exercise, diet, cialis and supplements, none of which made a real difference in my severe ED symptoms, which I had kind of expected since I'm a relatively young, healthy dude otherwise, with no underlying medical conditions/diseases). He strongly recommended pelvic floor therapy to use trigger points/massages and such to relieve and relax the PF muscles so that proper nervous response can be restored. He also noted that he had seen very similar ED symptoms in other patients who had been suffering from hypertonic pelvic floors, and that therapy is an effective way to resolve these issues that result from such a tight PF.

Gotcha. Do you have any idea what might have triggered your PF spasm? Do you have HF as well? It's crazy how pelvic floor dysfunction isn't more common knowledge, I think it is wildly underdiagnosed in the male population

I'm pretty sure this all happened after holding a tight kegel while being erect, much like how you would normally edge I guess. Definitely fucked me up more than I would have ever imagined. never again!

Funny thing, I was misdiagnosed with prostatitis by another urologist down in south FL before I went to UF Shands. Regardless, I definitely don't have any issues or damage to prostate, bladder, testicles, or rectum areas. my penis isn't suffering from any weird shape, color, or temperature changes that are normally associated with HF/CPPS, and I don't have any pain in my pelvic region 99% of the time. when I do get pain, it's usually just involves a sharp tingling sensation.