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I recently got 2 penile dopplers, one yesterday the other one last week. 10 mcg PGE1 was used in each test, first test showed venous leak, other one showed normal arterial and venous flow; in other words no venous leak.

IMO penile dopplers are just useless and dont impact the treatment, if your ED gets worse you just get a upper level of treatment but thats another topic, i had to to do penile dopplers because my urologist wanted so.

At both tests, with 10 mcg alprostadil, i only got little engorgement. With 100 mg viagra, and stimulation i get a good erection but cant maintain it for a long time, or lose it when changing positions etc. I want to ask, isnt alprostadil supposed to be much stronger than 100 mg viagra? Or 10 mcg alprostadil is a low dose and high dose pills are more potent than that dose of alprostadil?
Is there anyone who had opposite situation; minimal results with pills but good response with 10 mcg alprostadil?

I was thinking using injections as next step, but surprised i had minimal response to 10 mcg PGE1 at both tests, when Viagra still works to some degree.

Thanks

My test injections were also 10 mcg of alprostadil. This produced an erection that seemed to impress the attractive PA but were what I would describe as like 80% of ideal. I was subsequently prescribed Trimix and am using 17 units. This produces a very firm long lasting erection. I can still get plenty hard with the pills however I don’t enjoy the side effects or losing my erection in the middle of the deed.

Comparison to Viagra: 100mg of viagra is a huge dose for me. Lots of flushing, probable headache and a general malaise feeling. My normal dose of viagra was 20 mg before Peyroines and 60 mg after. At 60 mg I get a nice erection similar to Trimix however with Trimix I stay hard throughout the Deed, last longer before ejaculation and have much larger orgasms ( the difference in orgasms is substantial, almost like a cum-in-mouth orgasm every time)

The downside of Trimix: sometimes my erection are not as girthy , not sure why this is the case. The 2 hour chubby afterwards can be annoying eg at the gym or swimming pool.

Positives compared to Viagra: more stable erection has eliminated the stress and worry of losing it during the Deed. No bright red face during a romantic dinner not to mention the stuffy nose, headache and generally shitty feeling.

I still use Viagra when injecting is impractical ( eg going to a massage parlor or going out of town with spouse) . Having a choice is awesome.

Good luck and be patient with finding the right dosage.

Honestly I don't understand it.

As I understood it injections worked regardless of mental state, but it appears you still need stimulation?

The issue with pills is that if your problem is purely blood flow related they work well but for me with extreme stress anxiety and nerve issues due to cpps they either work well or not that well depending on how I feel.

I can sometimes get as good an erection naturally as with pills, and a low dose of aprostadil - 2.5 did absolutely nothing.

I have been finding. That 10mg cialis 2 to 3 .hours before and 25 mg Viagra 30 mins before is better.

Yes, the injections will work without mental or physical stimulation. However, I find they work better with stimulation and the overall experience is better. As I’ve mentioned in other posts my routine is to inject, then massage to distribute the medication, then watch 5 minutes or so of porn on my iPad to get the blood flowing optimally and get pre-cum leaking. Then I alert my spouse and try to time insertion for about 20 minutes post injection. My wife is aware of my inclination towards visual stimulation so she will often get into fishnets and/or put on a dildo show.