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Hey guys thanks for everything. Short story is I have PSSD from antidepressants. If you are not familiar it can cause permanent issues from just plain Ed, to loss of sensation, some emotions, etc. I basically have ED, still some emotions, but very low sensitivity now and my largest issue is I want sex but I have completely lost my arousal phase. So I’m 38, and I have been using the pills for two years since this all started. At first even though I don’t really get aroused, the pills worked really well, however within the first year I had ended up all the way pretty much at the max dosages to get it to work. This whole second year I was mixing cialis and viagra and doing whatever to get it to work. I think I’m finally ready for injections as I’m still holding out hope I get better so I don’t want to jump to an implant quite yet. So here it goes:

Since I don’t have anything physically wrong with my penis and it appears to be some sort of receptor issue from the meds, would this mean the injections should work forever since I won’t have a declining physical issue?

If I do one of the monomix shots that are less known to scar, do they also have to be refrigerated? Do they make one that’s already loaded in a spring loaded injector?

Will I be able to keep an erection even after orgasm?

The injections just work correct? Their not based on arousal?

Can I fly with these?

How do you guys do this to be as inconspicuous as possible? I’m married and my wife will know about it, but for the sake of trying to keep the mood and sex as Normal as possible? Any tips? Maybe inject prior a little sooner before you even hit the bed and foreplay? Since it lasts a couple hours hard typically? Is that common?

Thanks everyone for all the help. It’s been a struggle and I’m hoping this gives me a part of my life and marriage back.

Markc2008 wrote:
Since I don’t have anything physically wrong with my penis and it appears to be some sort of receptor issue from the meds, would this mean the injections should work forever since I won’t have a declining physical issue?

If I do one of the monomix shots that are less known to scar, do they also have to be refrigerated? Do they make one that’s already loaded in a spring loaded injector?

Will I be able to keep an erection even after orgasm?

The injections just work correct? Their not based on arousal?

Can I fly with these?

How do you guys do this to be as inconspicuous as possible? I’m married and my wife will know about it, but for the sake of trying to keep the mood and sex as Normal as possible. Any tips?

Thanks everyone for all the help. It’s been a struggle and I’m hoping this gives me a part of my life and marriage back.

The best thing you can do is find a urologist that prescribes injection meds for ED often. Some urologists are really more kidney stones and urinary retention. You should try to find one that had men’s sexual health as a significant part of their practice. Other guys here might be familiar with your area and can suggest docs they have used. I’m not a doctor and my answers are simply based on my own experience of injecting for the last 6 years. I’ll try to address you questions on the order you posted them. Your urologist will have answers for you.

If you don’t have arterial insufficiency (poor blood flow in to the penis) or venous leak (a failure to fully keep the blood IN the penis when aroused) then injection meds should work well for you. They are not dependent on arousal and you should be able to use a fairly small dose of mono mix.

Mono mix is prostaglandins and they do need to be refrigerated to keep their strength. Someone posted a research journal article a while ago that seemed to indicate that they lose about 10% strength per day at room temp, so if the vial gets left out for a bit it’s not the end of the world but yes, they need to be refrigerated.

There are spring loaded auto injectors but the ones I’m familiar with require you to draw up the dose in your single use syringe, put that in the auto injector, then hit the trigger button.

The erection sticks around after orgasm until the med is processed by the body. My erection goes down a bit with orgasm but I’m still at least semi for a bit.

The injections just work. It’s not based on arousal.

You can fly with them. Put them in a travel cooler with ice packs and tape a copy of the prescription on the outside in case TSA wonders what it is.

If I know we are going to get right down to sex I inject just before coming into the bedroom. If we start fooling around and foreplay is happening and I didn’t realize we were going to have sex I excuse myself to “use the bathroom” for a moment, and inject quickly then. It doesn’t cause too much disruption.

You might also be a candidate for a medication called MUSE. It’s also a prostaglandin but is a little pellet/suppository that is slipped into the urethra instead of being injected. Some of the guys here have experience with that and it works for them. I’ve never tried it.

So, find a good urologist if you don’t already have one, and pursue the options. You CAN have satisfying erections. This doesn’t need to be a major issue.

Markc2008 wrote:Hey guys thanks for everything. Short story is I have PSSD from antidepressants. If you are not familiar it can cause permanent issues from just plain Ed, to loss of sensation, some emotions, etc. I basically have ED, still some emotions, but very low sensitivity now and my largest issue is I want sex but I have completely lost my arousal phase. So I’m 38, and I have been using the pills for two years since this all started. At first even though I don’t really get aroused, the pills worked really well, however within the first year I had ended up all the way pretty much at the max dosages to get it to work. This whole second year I was mixing cialis and viagra and doing whatever to get it to work. I think I’m finally ready for injections as I’m still holding out hope I get better so I don’t want to jump to an implant quite yet. So here it goes:

Since I don’t have anything physically wrong with my penis and it appears to be some sort of receptor issue from the meds, would this mean the injections should work forever since I won’t have a declining physical issue?

If I do one of the monomix shots that are less known to scar, do they also have to be refrigerated? Do they make one that’s already loaded in a spring loaded injector?

Will I be able to keep an erection even after orgasm?

The injections just work correct? Their not based on arousal?

Can I fly with these?

How do you guys do this to be as inconspicuous as possible? I’m married and my wife will know about it, but for the sake of trying to keep the mood and sex as Normal as possible? Any tips? Maybe inject prior a little sooner before you even hit the bed and foreplay? Since it lasts a couple hours hard typically? Is that common?

Thanks everyone for all the help. It’s been a struggle and I’m hoping this gives me a part of my life and marriage back.

1. Yes i believe injections will work great in your case. Unless you have venous leak they should work very well.
2. Stick to PGE-1 monomix, it's safer agains Peyronie's. Do not get the spring loaded injectors like edex, they're way too expensive. Learn how to inject manually IMO. Get a .31 gauge needle and you barely feel it.
3. Yes you will keep an erection after orgasm
4. You can travel with these, although some countries might be more restrictive
5. Yes, you need to freeze your vial. Check the instructions for the temperature and buy a thermostat for your fridge and freezer.
6. Your body can build up a tolerance to PGE-1. I've found taking breaks helps to reduce that tolerance. Monitoring tolerance, vial temperature and freshness is key to success
6. Have fun

Markc2008 wrote:Hey guys thanks for everything. Short story is I have PSSD from antidepressants. If you are not familiar it can cause permanent issues from just plain Ed, to loss of sensation, some emotions, etc. I basically have ED, still some emotions, but very low sensitivity now and my largest issue is I want sex but I have completely lost my arousal phase. So I’m 38, and I have been using the pills for two years since this all started. At first even though I don’t really get aroused, the pills worked really well, however within the first year I had ended up all the way pretty much at the max dosages to get it to work. This whole second year I was mixing cialis and viagra and doing whatever to get it to work. I think I’m finally ready for injections as I’m still holding out hope I get better so I don’t want to jump to an implant quite yet. So here it goes:

Since I don’t have anything physically wrong with my penis and it appears to be some sort of receptor issue from the meds, would this mean the injections should work forever since I won’t have a declining physical issue?

If I do one of the monomix shots that are less known to scar, do they also have to be refrigerated? Do they make one that’s already loaded in a spring loaded injector?

Will I be able to keep an erection even after orgasm?

The injections just work correct? Their not based on arousal?

Can I fly with these?

How do you guys do this to be as inconspicuous as possible? I’m married and my wife will know about it, but for the sake of trying to keep the mood and sex as Normal as possible? Any tips? Maybe inject prior a little sooner before you even hit the bed and foreplay? Since it lasts a couple hours hard typically? Is that common?

Thanks everyone for all the help. It’s been a struggle and I’m hoping this gives me a part of my life and marriage back.

I think i know you, you are also in PSSD Fourm. I also have PSSD so i know what we are going through. I also going to try PGE1 because trimix is not available here and i have no idea how do i react with these med.

And I m shitting my pants to stick needle in my penis but looks like i don't have choice

I have also millions of questions regarding effectiveness of these med which we can't find until we have try it.

LuisFernandez wrote:6. Your body can build up a tolerance to PGE-1. I've found taking breaks helps to reduce that tolerance. Monitoring tolerance, vial temperature and freshness is key to success

How long breaks do you need to avoid tolerance in your case?

I have no doubt about the validity of Luis's statement about his building tolerance to PGE-1, however that has not been my experience. I've been using the same dose about 3 times a week for years. Obviously there is some variability on the issue.

As a side note, the proprietary alprostadil (PGE-1) mono-mix cartridges like Edex and Caverject (I don't actually have experience with Caverject) are not spring-loaded auto injectors. The are pre-loaded cartridges containing 2 compartments with one of saline and one of dry alprostadil. You push the plunger to mix the dry and saline and then inject manually with the same cartridge. If not covered by insurance they are very expensive. They require no refrigeration when used according to the instructions.

Regular compounded alprostadil mono-mix does need refrigeration and needs to be actually frozen to have any real shelf life. Frozen it will remain potent for at least the better part of a year. Whether it will remain sanitary and sterile for that extended time is a matter to be discussed with the pharmacist and likely depends on what preservatives it contains. I've successfully used mono-mix that had been frozen for over six months many times.

phallus wrote:

LuisFernandez wrote:6. Your body can build up a tolerance to PGE-1. I've found taking breaks helps to reduce that tolerance. Monitoring tolerance, vial temperature and freshness is key to success

How long breaks do you need to avoid tolerance in your case?

So, i was injection ~3 times per week and i felt i was building up a tolerance due to shorter erections.
I took a break for about a month due to a move. Once i re-injected it felt like the first time again.

My ED came from both using Finasteride (funny enough i still use it) and injuring my penis during rough sex.

I will add one optional thing, and that is to do gentle traction with a device like the Penimaster Pro. This will keep any curvature at bay and let any needle punctures heal in an elongated state.

We are very close in age and why we have this darn ed. I have also been put on a damn medicine that has killed my erections. I am new to injections also, and I will tell you this: the first time I took a shot I was at the urologist office and I could have NOT been turned on any LESS, nor did I give myself any encouragement. Yet 30 minuets after let me tell you this stuff works even though I didn't want it to that day! In my little experience yes because the med is placed directly there is less that can go wrong. If the pills have stopped working you should try a shot, it really doesn't hurt. I hate needles, but I am starting to like this kind!

Thanks everyone for all the replies as it means a lot. I had even started thinking about implants and while it would be ok my wife wasn’t super excited about not being able to get any real reaction from my penis if that makes sense. I’m going to try shots first and I hope it works as well as what you guys have experienced. I go to a urologist July 20th. I am sure he will check bloodflow but I really don’t think that’s my problem. It is purely I don’t really get aroused thanks to antidepressants that can apparently block more than anxiety and depression and continue indefinitely even after stopping them. So I don’t have a whole lot of options. Pretty similiar to pfs from finasteride like one stated. I just want it to work and be as little of a disruption to my wife as possible.

So how long do the injections take to start working? And did you guys say I could do a shot before going to the bed and just be hard for the foreplay? I don’t think the wife would prefer too much of a soft one and also I’m usually the one that tries to initiate anyways

I use 100mg sildenafil with 40% of the Trimix I would need if I were using Trimix alone. This is a "standard" treatment which reduces some of the Trimix side effects, like post-sex pain.

If you need anti-depressants, maybe your testosterone is low. If so, it's an easy fix.