Anyone here has no erection at all? Nothing?

[Motorheadrulz]

Ditto here. I had my RPP in Jan '20 and am still in recovery mode. I have a VED and use Cialis daily, but no good results to brag about. Once I take off the pump, the rings are painful and it's a limp noodle.
I am considering injections after my 1 year follow up.

[Simbarn]

Hi Simbarn,
It is not easy to find a good urologist in my country. The ones I had don't explain anything and don't really care about their patients.

I don't really understand the difference between primary and secondary hypogonadism. But it is a pity that testosterone levels are not checked throughout life before ED happens.

If I can go back 10 years in time, I would probably start with life style changes instead of TRT.

I have NO nocturnal erections (nor morning woods) for at least 10 years. This and the slow deterioration for the last 10 years is why I don't think my problem is psychological.
I use TRT for 7 years now, I don't think it is possible to stop it now, because my body will not resume the natural testosterone creation.
The "good" thing about Nebido injection is that there are no high peaks. The release of the testosterone is more or less constant over a period of 3 months.
.

Benny,

So I gather from that: The urologist you saw did not explain the tests you had done and what the result was from your tests? Was it the Urologist that prescribed your hormone therapy?
When you saw the urologist did he perform a test using an injection into the penis to see if this stimulated your penis to become erect and then used an ultrasound device to check for blood flow and venous leakage? If this occurred you would have seen it!
It would be quite clear to any urologist now, when it was explained to them that you have absolutely no erectile function whatsoever in any circumstance, that your issue is not psychological. Tests need to be done!

I do agree with what you said about testosterone level checks for young men. It is something that all young men should do so they have a benchmark for later on in life, or if other problems occur earlier.

An endocrinologist will usually try and determine whether you have primary or secondary hypogonadism. Primary hypogonadism is when the testicles are the problem, they are not producing adequate T when there is sufficient stimulation coming from the Pituitary. Secondary is when the Pituitary or the Hypothalamus is the problem in which levels of LH and FSH are very low. In young men it seems to be secondary hypogonadism which is the most common and is the one which lifestyle changes may help for some with this cause. I say some, as many men do not respond and require T replacement for life.
If Enclomiphene citrate (Androxal) had been approved by the FDA it would have helped a considerable amount of men with secondary hypogonadism a great deal and many would have not needed to take exogenous T. It may have even stimulated and reset the HPTA for some, who would then been able to DC the therapy and maintain natural levels going forward, especially those who have abused anabolic steroids.

Nebido administers a very large amount of Testosterone into the body when it is injected, 1000mgs. They say this does not produce initial supraphysiologic levels of T, but it does for many men. There is an initial high peak of the hormone and gradually this wanes over the period of 3 months. Some men complain of feeling quite bad again for the last few weeks. This medication is very difficult to titrate and cannot be adjusted during treatment as it is designed to last for 3 months! It has what I call a “cookie cutter” approach, meaning that all men require the same amount. An experienced TRT doctor knows that this method just does not work. Everyone is different and has different genetic levels where their T level is optimal. Nebido cannot emulate this.
I tried the preparation and it caused problems sexually for me, I also began to experience nipple issues, I knew my body was converting too much T into E2. I stopped the medication, let my body go back to natural levels so that the increase in aromatase enzyme it had created was reduced and I recommenced T replacement a number of months later with T Enanthate at 40mgs injected bi weekly. Nipple issues did not return and sexual function improved including libido. I could titrate the amount of T on a weekly basis if need be. You cannot do this with Nebido.
This is why the testosterone gels can be the best form of T replacement if they are absorbed correctly (they are not for some men) as they mimic the body’s diurnal rhythm of T better than all other forms of hormone replacement.
Have you had your estrogen levels checked? Have you also had prolactin checked to make sure you are not producing too much of this hormone too? The sensitive E2 test is required to see if this hormone is contributing to your erectile dysfunction problems.

If T replacement is administered well at a level that does not cause issues with other hormones and is not excessive at any point, it is more often the case that if it is discontinued, natural levels will return to what they were before therapy was started. Dr John Crisler said this many times.
It has been my experience that this is completely true for myself. I have stopped T replacement a number of times over the years (for one reason or another) and my natural T levels returned to exactly what they were prior to starting such therapy. This I know from testing.
To hasten the process, HCG can be used as this medication will give the testes a strong kick-start, as they can be the slowest to respond once shut down, compared to the Pituitary. Some men use HCG alongside their T replacement. This keeps the testes running on low and it is even easier to restart natural production form this point if exogenous T is discontinued.
Anabolic steroid abuse is another story, as long term abuse can cause the pituitary to alter its “feedback” mechanism (the HPTA becomes dysfunctional) so that when AS are finally stopped natural levels do not return to what they were prior to when the AS use was started. This requires special treatment protocols to try and restart and encourage the pituitary to produce higher levels of gonadotropins as it once did.

If testosterone replacement is not administered correctly by someone who has good knowledge of its pitfalls, erectile function can suffer greatly. I am not suggesting that the replacement therapy is causing your ED. However, it may not be helping it.
As you have provided so little information as to what any testing by the urologist you may have done has revealed, it is very difficult to say where the origins of your problems lie. I would suggest that it is not psychological.

[Simbarn]

[...] Flavio, I suppose you do realise you are “messing with your hormones” with taking Dutasteride? [...]

Yes, you are absolutely right. I agree that these drugs are dangerous but today I have a full head of hair thanks to these treatments. I would never recommend them to anyone, though.

I know, my friend who uses finasteride also still has a full head of hair. I on the other hand have lost most of mine. I am quite ok with this as I clipper to a zero and it looks fine. To be honest its so easy now and I never pay for a haircut as I do it myself. I have actually found there is a strong cohort of people who are attracted to my almost shaved head!
I have had many issues with hormones over the past 20 years, so I would never take something that would negatively affect this or reduce my masculinity, which finasteride does.
I will always suggest nicely as a friend that using these drugs is not a great idea.

[KenJ1947]

Hi Guys,

(1) I just found this wonderful forum. I have a lot of to read to catch up. ...

(2) I am on TRT (Nebido) for 6 years because of very low testosterone. According to blood test, the TRT restored my testosterone to normal levels but libido never came back. ...

(3) Most probably I have also very bad blood flow. ...

(4) As I mentioned, today I have no erections at all. No morning wood, not with porn... My penis doesn't change in size even a millimeter.

(5) I have been reading randomly through the topics here and I read the stories of the brave men that did a penile implant (I envy these men for their courage).

(6) So I would like to hear from men that are in the same boat as me.
And also, do you think that something can be fixed after not having an erection for more that a year?

(7) My penis has not changed size in more than a year, no orgasm in more than year.
I read some where that the penis may shorten if there is no erection for so long.

Thank you,
Benny

Hey, Benny,

(1) Welcome to the forum. I'm relatively new and there is lots to take in.

(2) I think I've had low T most of my life. At one time when I was doing a lot of weight lifting and aerobics, I told a workout buddy my T level (around 350 I think). He said I should be carrying a purse. I could still outlift and outrun him. That was 30 years ago and I still have low T levels, but my libido has always been great. I have been taking a compounding pharmacy herbal mix that raised my T level to 557 but it is a cycling process. My latest reading was back down to 328 after an off-cycle.

(3) Since the beginning of the year, my wife (6 years older than than my 73) has had a renewed interest in sex, so I've done many things to try to take care of my ED which I've had for over 5 years. I had 14 sessions of acoustic wave (Gainswave) therapy--no success. However, the urologist said I had sufficient blood flow to have an erection, but I've wondered about venous leakage.

(4) I did extensive kegel training (still doing some in my routine)--no success other than getting off Flomax and conquering dribbling. Recently, I started Trimix injections--so far, no success.

(5) So, without pumps, I don't have erections, morning wood, only flaccid ejaculation... It sucks. Since my injections don't seem to be working, I'm going to talk to my uro about an implant when I visit him in December. Not bravery, just want to have sex again with my wife.

(6) Can this be fixed? Depends on how "brave" you are. You didn't mention what oral meds you've tried or if you have tried injections.

(7) I've been doing PE for several months to regain the size I had before. I was just a tad under 8 with a girth of 5.75. The use of a VED, air pump, Bathmate, stretches, etc., has gotten me back to 7+ with a girth of 6.25 depending on when I measure. PE works.

That's some of my experience. I hope it's not too disjointed. There's lots you can do to try to eliminate ED. Good luck on your journey.

Ken J

[benny1940]

Hi Simbarn,

You have an extensive knowledge. Thanks for sharing you knowledge. Are you a doctor?

As I wrote, it is difficult to find a good urologist in my country (with public health system).
I have seen 2 urologists in the last years and none of them has ever done a physical test on me.
Come to think on that, none of them has even seen my penis. And of course there was no injection and no ultrasound.
I once asked the urologist about doing these physical tests and he responded that whether I have venous leak or not, the possible treatments are the same.
They just give pills, TRT, and perform prostate checks once a year.
Pathetic, I know. Sorry for my rant.

Like you wrote, I also considered some time ago the possibility that the TRT has the opposite effect on me. It never restored my libido. Though it never caused bad things either.
Blood tests show that TRT indeed raised my testosterone level to the higher limit and I think it does help me with my training. I am very muscular (I train 2 hours each day, so maybe I would have been muscular even without TRT, but who knows).

Thanks,
Benny