My story and whether I should consider an implant

[Markc2008]

At some point I will have to be able to do something to move past this horrible time in my life where all I dwell on is my struggles with sex.

[Old Guy]

Yes check around for a good surgeon who specializes in ED. That is going to be you best starting point. They may do an injection in the office to see the reaction, if it works then prescribe some formula for you.
When I started Trimix the thought of putting a needle into my penis was enough to say "NO WAY JOSE". When I did get injected it wasn't anywhere near as bad as what I thought. I was lucky enough to have it work for me for 6-7 years.
Yes the implant is great, but try options first because it's a forever change.

[Markc2008]

Yeah I definitely understand it’s a forever change. The pills still currently work just subpar, but I’m also not maxed out on dosage. I usually do 10-15mg of cialis or 50mg viagra. They initially helped with PE as well which was nice but now they do not at all. Do the injections help with PE at all as well? Yeah the thought of an injection there is terrifying and definitely not allowing for spontaneous sex is the only downside. How long will an erection last with injection? What happens if it doesn’t go down? It is appealing to hold out as long as possible for better technology like that new implant that stimulates nerves for natural erection being studied. But who knows if it ever hits the market at the same time..

[stephen54]

Yeah I definitely understand it’s a forever change. The pills still currently work just subpar, but I’m also not maxed out on dosage. I usually do 10-15mg of cialis or 50mg viagra. They initially helped with PE as well which was nice but now they do not at all. Do the injections help with PE at all as well? Yeah the thought of an injection there is terrifying and definitely not allowing for spontaneous sex is the only downside. How long will an erection last with injection? What happens if it doesn’t go down? It is appealing to hold out as long as possible for better technology like that new implant that stimulates nerves for natural erection being studied. But who knows if it ever hits the market at the same time..

To answer one of your questions:

With a properly and assertively titrated TriMix injection, you can most likely easily have erections for 1.5 - 2.0 hours...and they can be like absolute iron bars that just don't quit. I started injecting in my early 40s. Had almost 9 years of absolutely crazy sex thanks to TriMix and thanks to a doc and a compounding pharmacy who really knew their shit. You're right - injecting is...a...process. It requires steps that natural erections and PDE5s and implants do not require, and it isn't always a lot of fun to find yourself caught up in thinking ahead, planning where and how to carry around a vial, a syringe, alcohol wipes. and all that. Absolutely. But yeah...the hardons it delivers are absolutely ridiculous.

As far as holding out for new technology...I don't know. I'm in the medical device industry and can only advise you that many, many, many devices of all types get talked up and talked about and everyone is all excited and then very frequently the "we hope to have this approved and available in 2-3 years" turns into 10. Like - all the time.

[Old Guy]

Yeah I definitely understand it’s a forever change. The pills still currently work just subpar, but I’m also not maxed out on dosage. I usually do 10-15mg of cialis or 50mg viagra. They initially helped with PE as well which was nice but now they do not at all. Do the injections help with PE at all as well? Yeah the thought of an injection there is terrifying and definitely not allowing for spontaneous sex is the only downside. How long will an erection last with injection? What happens if it doesn’t go down? It is appealing to hold out as long as possible for better technology like that new implant that stimulates nerves for natural erection being studied. But who knows if it ever hits the market at the same time..

At this point my suggestion is keep implant in the back of your mind. Discuss with your doctor about an increased dosage of Viagra/Cialis and see if that helps. Higher doses gave me migraines though, a bad side effect.
Trimix injections would be the next step if higher doses don't work well. Trimix will give you a good solid erection for 1-2 hours or more. Just a hassle to interrupt fun time to go inject. It would only take me 10-15 minutes after injecting to get a good stiff erection. The other hassle with Trimix is it needs to be kept refrigerated. That makes travelling with it difficult, and if it gets too warm it just won't work. Shelf life is limited too. By 30 days in the fridge I'd note a decrease in effects, open a new vial from the freezer and better results, for a while. Sudafed will make your erection go down if it lasts too long, not sure dosage anymore but like 5-8 pills at once.
As far as PE that's never been an issue for me but I did notice it was taking longer (most times anyway) to get off after injecting. But even if I shot off quick I'd still be quite stiff to give the wife more.
Insurances will probably want to see what you've tried before they consider paying for the surgery. You know how that goes, take every darn test to prove you need the procedure.

[Markc2008]

Thanks for the details guys. So it sounds like the injections can be helpful but requires planning for sure. I don’t guess there is any way at all to take them if your going on vacation and flying which would suck. Yeah I never had a problem with PE either until these antidepressants when I stopped them it made some sort of imbalance I suppose because it’s been an issue for quite a while now yet desire has gone down which is odd. Good to know that even if I finished quicker I could keep going with it. I do think that an implant will end up being best option down the road as far as being able to move on with my life without worry. I do get though for insurance I’ll probably have to atleast try the injections. It’s just a mess to have to go through shots in that area to work. Talk about killing the mood..but if that’s what I have to do. And the Sudafed deal is crazy is that what they recommend to do lol? That sounds like I’d fall asleep before anything happened with that much.

[stephen54]

Thanks for the details guys. So it sounds like the injections can be helpful but requires planning for sure. I don’t guess there is any way at all to take them if your going on vacation and flying which would suck. Yeah I never had a problem with PE either until these antidepressants when I stopped them it made some sort of imbalance I suppose because it’s been an issue for quite a while now yet desire has gone down which is odd. Good to know that even if I finished quicker I could keep going with it. I do think that an implant will end up being best option down the road as far as being able to move on with my life without worry. I do get though for insurance I’ll probably have to atleast try the injections. It’s just a mess to have to go through shots in that area to work. Talk about killing the mood..but if that’s what I have to do. And the Sudafed deal is crazy is that what they recommend to do lol? That sounds like I’d fall asleep before anything happened with that much.

No, don't even worry about that part. We flew all the time with TriMix with us. Zero problems ever.

Purchased a small insulated travel pack designed for transporting insulin. $25. I added a $4 thermometer I stowed inside it to check. Kit came with those little blue gel freezer packs, I found they had too limited a time frame so I searched for and swapped them out with little packs of something called Black Ice packs. Big difference.

Have flown overseas with TriMix in this kit several times - last year went an hour to our airport here, then 12.5 hrs in the air, then 2.5 to destination, so about 16 hours on ice packs in this kit. Worked perfectly. Was 46 degrees F after all that time. Which is entirely fine. Fridge at home is 37. Never once had a TSA or any kind of issue. I'd proactively tell them "fyi there's a prescription Rx with syringes in my backpack" etc and it was easy. Don't worry at all about this part.

As to the mood killing...it depends. It doesn't have to be that way, don't assume that. We got to a point where it was just part of who we were and what we did and it was honestly about as much part of the evening as anything else. This was before we were married, but we were committed/together and just wide open about everything. For me, after I injected, the iron hardon arrived FAST. I know some guys say it can take 10-15 mins. I don't know. I feel like I was probably maximally hard sometimes in 2-3 maybe 4 minutes or something. Also, if you know you're going to play...or you're pretty sure you will...or you just think fuck it, I'm going to attack her...then just inject and roll with it. You'll be very hard for a long time. Let fun time unfold...

[Old Guy]

Yea forgot I bought an insulin travel pack to travel with Trimix. It worked ok for me.
But I still say the time to go inject really sucked for the mood. My wife would not watch me, nor could I even be in the same room. The times we were in a hotel I had to go lock myself in the bathroom. When I moved up to Quadmix I would be stiff before I got back to bed.

[Markc2008]

Thanks guys for sharing your experiences. Do the injections always wear off after years or do some people use them forever? Are there negative side effects? Pain, scar tissue? Does it make things worse with time? Have you personally had one that wouldn’t go down?

[Simbarn]

Hey guys, so I am 37 years old— on the brink of 38. Up until a year and a half ago I had never had any sexual problems other than some slight PE from time to time. I had been on an antidepressant for probably five years with no issues. About a year and a half ago I decided I didn’t need the antidepressant anymore and didn’t refill the prescription and just stopped. My dr had never warned me about tapering off and I had no idea it was a big deal.

I am sorry to hear about your sudden deterioration of erectile function.
I will say firstly please listen to the guys who suggested that you do not jump into thoughts of getting an implant. This is the absolute last resort.
If there is a chance that injections will work for you and all other options have failed, this is the best way forward in my opinion too. Your real penis will always feel better than an artificial one, especially when you are a young man.

Since reading your post a few days ago, I have been giving it some thought.
In all your posts you do not give any information as to how your erections work when you are on your own? How difficult it is to get an erection when you are masturbating? How long this lasts for? Nocturnal erections and their frequency in the morning?

For such a sudden loss of erectile function we could rule out things like deterioration of the erectile tissues, fibrosis, or loss of endothelial function. However these things may start to occur if nocturnal erections are lost for too long a period.
As this has not been mentioned so far and you have nothing to lose; I would investigate pelvic floor issues. This can present itself with a varying degree of symptoms. Some get the hard flaccid syndrome others not. Some just get the loss of sensation, ED and penile shrinkage while flaccid as you have.
There will also be a strong psychological component to your ED now after all this time since your issues began. This complicates the issue and adds more symptoms. I could be completely wrong suggesting the above, but given that nothing has helped thus far, I would be looking into anything that might yield an answer.
IMO, forget consulting with urologists for something like this. I would be looking for a good sexual health specialist and a pelvic floor specialist with experience with male sexual issues and hard flaccid syndrome. The moderator on this forum should be able to help with this.

Are you experiencing any other symptoms?
Bowel issues?
Pain?
Have your anxiety levels increased?
Do you have more difficulty relaxing since stopping the AD.
Do you feel the flight and fight mechanism is engaged more so in your body now that you are not taking the AD, and or during sex?

Do you think that since stopping your antidepressants, that your mental condition has deteriorated? Has your depression crept back? Depression can also cause loss of libido and erectile dysfunction issues as well. This is worth considering also.

It was a complete lapse of professional care that your prescribing doctor did not inform you of the need to gradually come of these drugs slowly after 5 years of prescribing this medication. The drug you mention has not been approved in Australia, which always sets of alarm bells for me.

It is also worth mentioning that some form of an autonomic nervous system dysfunction may have developed since abruptly stopping the AD.

In the meantime you could discuss with a sexual health doctor about the benefits of using a low dose of Cialis every day. This will help with preventing deterioration in the penis from a possible lack of nocturnal erections, improve blood flow in the penis 24/7 and help to reduce oxidative stress in the erectile tissues. It will also possibly enable you to be more spontaneous for sex as the drug will be constantly in your system. The benefits of this sometimes take a number of months to start showing effect. This protocol has helped me substantially.
PDE5 inhibitors used chronically in this manner work in a different way than the higher dose on demand use. They perform restorative actions in the tissues that enable the blood vessels to dilate and contract. I say this without going into specific detail.