Dr. Hakky on malleables

[LastHope]

Even doctors fudge up
What chance do students have
I’ve recently been dealing with feeling much less sensation and engorgement during sex

Consider checking with your andrologist about Cabergoline - a dopamine receptor agonist that's prescribed off-label by some for sensation issues.

Did TRT restore your T levels to an appropriate range? I heard you mention about TRT in another thread and I hope it's coming along well for you.

[IndianRasputin]

Even doctors fudge up
What chance do students have
I’ve recently been dealing with feeling much less sensation and engorgement during sex

You can check with your urologist about Cabergoline - a dopamine receptor agonist that's prescribed off label by some for sensation issues.

Did TRT restore your T levels to appropriate range? I heard you mentioning about TRT in another thread.

I will look into that. I have begun 250mg weekly just two weeks, so I’ll get back to you on this shortly. At 250mg testosterone I think it’s a bit above average

[duke_cicero]

Even doctors fudge up
What chance do students have
I’ve recently been dealing with feeling much less sensation and engorgement during sex

You can check with your urologist about Cabergoline - a dopamine receptor agonist that's prescribed off label by some for sensation issues.

Did TRT restore your T levels to appropriate range? I heard you mentioning about TRT in another thread.

I will look into that. I have begun 250mg weekly just two weeks, so I’ll get back to you on this shortly. At 250mg testosterone I think it’s a bit above average

250mg weekly TRT is quite a big dose. For strictly replacement purposes, 200mg is still considered quite high. Most men do fine between 80mg and 140mg, with the vast majority seeing success at 100mg. With 250mg weekly you'll have problems with high hematocrit, which can be a real problem down the line for heart health. If you create too many red blood cells, your blood thickens...not good.

You might have issues with sensation and engorgement because with a 250mg dose of TRT your estrogen conversion is much too high. Taking an aromatase inhibitor doesn't always fix this issue, either, and of course the other issue is that AI's are basically toxic in chronic use.

You can manage your estrogen conversion by lowering your dose, splitting up your dose and dosing more frequently — 2x a week being the sweet spot for most guys, but some even do more frequent smaller doses. I've experimented with daily micro-dosing, which is much less convenient but does show benefits for things like hematopoiesis, estrogen and DHT conversion, and more stable mood levels. And this is what I still do today! I feel great. I take 20mg daily, or 140mg per week.

There's a nice article that goes into even greater detail here: https://themenshealthclinic.co.uk/gold-standard-trt/

This is also a nice short video on the subject with Dr. Peter Attia and someone who is an expert on TRT usage: https://youtu.be/RtpCh6U9v6o?si=zOatDXq3aNHBw5LF

[Mark1974]

You can check with your urologist about Cabergoline - a dopamine receptor agonist that's prescribed off label by some for sensation issues.

Did TRT restore your T levels to appropriate range? I heard you mentioning about TRT in another thread.

I will look into that. I have begun 250mg weekly just two weeks, so I’ll get back to you on this shortly. At 250mg testosterone I think it’s a bit above average

250mg weekly TRT is quite a big dose. For strictly replacement purposes, 200mg is still considered quite high. Most men do fine between 80mg and 140mg, with the vast majority seeing success at 100mg. With 250mg weekly you'll have problems with high hematocrit, which can be a real problem down the line for heart health. If you create too many red blood cells, your blood thickens...not good.

You might have issues with sensation and engorgement because with a 250mg dose of TRT your estrogen conversion is much too high. Taking an aromatase inhibitor doesn't always fix this issue, either, and of course the other issue is that AI's are basically toxic in chronic use.

You can manage your estrogen conversion by lowering your dose, splitting up your dose and dosing more frequently — 2x a week being the sweet spot for most guys, but some even do more frequent smaller doses. I've experimented with daily micro-dosing, which is much less convenient but does show benefits for things like hematopoiesis, estrogen and DHT conversion, and more stable mood levels. And this is what I still do today! I feel great. I take 20mg daily, or 140mg per week.

There's a nice article that goes into even greater detail here: https://themenshealthclinic.co.uk/gold-standard-trt/

This is also a nice short video on the subject with Dr. Peter Attia and someone who is an expert on TRT usage: https://youtu.be/RtpCh6U9v6o?si=zOatDXq3aNHBw5LF

My testosterone runs high naturally. I have no idea why, because I tend to be skinny-fat and don't put on muscle easily. I'm 5'9 145 lbs. The only indication that I have high testosterone is I'm 80% bald.

Anyway my last two check ups my T level ran over 1000ng/dl and 900 ng/dl respectively and nobody said anything to me about this. Now I am worrid.

[duke_cicero]

I will look into that. I have begun 250mg weekly just two weeks, so I’ll get back to you on this shortly. At 250mg testosterone I think it’s a bit above average

250mg weekly TRT is quite a big dose. For strictly replacement purposes, 200mg is still considered quite high. Most men do fine between 80mg and 140mg, with the vast majority seeing success at 100mg. With 250mg weekly you'll have problems with high hematocrit, which can be a real problem down the line for heart health. If you create too many red blood cells, your blood thickens...not good.

You might have issues with sensation and engorgement because with a 250mg dose of TRT your estrogen conversion is much too high. Taking an aromatase inhibitor doesn't always fix this issue, either, and of course the other issue is that AI's are basically toxic in chronic use.

You can manage your estrogen conversion by lowering your dose, splitting up your dose and dosing more frequently — 2x a week being the sweet spot for most guys, but some even do more frequent smaller doses. I've experimented with daily micro-dosing, which is much less convenient but does show benefits for things like hematopoiesis, estrogen and DHT conversion, and more stable mood levels. And this is what I still do today! I feel great. I take 20mg daily, or 140mg per week.

There's a nice article that goes into even greater detail here: https://themenshealthclinic.co.uk/gold-standard-trt/

This is also a nice short video on the subject with Dr. Peter Attia and someone who is an expert on TRT usage: https://youtu.be/RtpCh6U9v6o?si=zOatDXq3aNHBw5LF

My testosterone runs high naturally. I have no idea why, because I tend to be skinny-fat and don't put on muscle easily. I'm 5'9 145 lbs. The only indication that I have high testosterone is I'm 80% bald.

Anyway my last two check ups my T level ran over 1000ng/dl and 900 ng/dl respectively and nobody said anything to me about this. Now I am worrid.

Skinny-fat is largely training and diet related, not necessarily hormones. If you have a total T of over 1,000 I'd wonder what your free testosterone is — maybe it's low. Your body might be making a lot of testosterone, but if it's all bound up in albumin or SHBG (sex hormone binding globulin) then it's like having a lot of money in the bank but not knowing the PIN number to retrieve it.

[SWorks17]

You can check with your urologist about Cabergoline - a dopamine receptor agonist that's prescribed off label by some for sensation issues.

Did TRT restore your T levels to appropriate range? I heard you mentioning about TRT in another thread.

I will look into that. I have begun 250mg weekly just two weeks, so I’ll get back to you on this shortly. At 250mg testosterone I think it’s a bit above average

250mg weekly TRT is quite a big dose. For strictly replacement purposes, 200mg is still considered quite high. Most men do fine between 80mg and 140mg, with the vast majority seeing success at 100mg. With 250mg weekly you'll have problems with high hematocrit, which can be a real problem down the line for heart health. If you create too many red blood cells, your blood thickens...not good.

You might have issues with sensation and engorgement because with a 250mg dose of TRT your estrogen conversion is much too high. Taking an aromatase inhibitor doesn't always fix this issue, either, and of course the other issue is that AI's are basically toxic in chronic use.

You can manage your estrogen conversion by lowering your dose, splitting up your dose and dosing more frequently — 2x a week being the sweet spot for most guys, but some even do more frequent smaller doses. I've experimented with daily micro-dosing, which is much less convenient but does show benefits for things like hematopoiesis, estrogen and DHT conversion, and more stable mood levels. And this is what I still do today! I feel great. I take 20mg daily, or 140mg per week.

There's a nice article that goes into even greater detail here: https://themenshealthclinic.co.uk/gold-standard-trt/

This is also a nice short video on the subject with Dr. Peter Attia and someone who is an expert on TRT usage: https://youtu.be/RtpCh6U9v6o?si=zOatDXq3aNHBw5LF

Duke, you seem to be very knowledgeable about TRT; are you under the care of a wellness clinic for low T?

I have noticed a lower libido this past year than my usual libido/hornyness from a couple years ago. Before I got my implant when I had my prostrate procedure for a benign enlarged prostrate my T was at 860 but I just recently got it checked and it is in the mid 600's. According to my primary care doc, that is still good. I would just like to feel more horny. Even though I'm in my late 60's I've always had a high libido until now. It's not bad now but I would like for it to be better. I don't have any problem having sex with my wife, we have sex at least three times a week, when grandkids or other life doesn't get in the way. lol She's is on TRT for the last year which has been a game changer for our sex life. She gets pellets every 4 months.

If you have any input Duke, I'd appreciate it
SWorks

[cautiouslyoptimistic]

So is the Tactra just completely unbendable? That’s how Hakky makes it sound based on that riding a bike comment. This has me nervous because I’m going in for a revision from the genesis to the tactra. I like the way the malleable feels, but this genesis is not rigid at all. Hangs like a noodle. But i also don’t want something I can’t bend either. The hospital I’m getting the surgery done at doesn’t use Rigicon unfortunately

[LastHope]

I can't comment on Dr. Hakky's sample device. I’ve heard from couple folks recently that their Tactra is bending. For instance, Dr. Ashish Sabharwal from India shared this example on Feb 21, 2025. I don't know if these quality variances are stemming from different batches of production or if Boston Scientific is tweaking things based on patient feedback.

[LastHope]

....but this genesis is not rigid at all. Hangs like a noodle.

Cautiouslyoptimistic, did you get a 2nd opinion to rule out any undersizing issues with your Genesis? What diameter rods did your surgeon fit in?

Here's an example where undersizing can make a malleable floppy and how it's fixed by re-dilatation and correct measurement:

https://x.com/dramjad_79/status/1602978 ... EtDXg&s=19

[easymoney]

I have been undersized with a Rigicon malleable ..feel free to reach out to me be happy to share information and photos of a implant that has been undersized.