injections in younger guys with mild/moderate ED - next step if PDE5i fail?

[Implant_Curious]

having success on 5mg tadalafil daily, thinking of supplementing with sildenafil 25-50mg as needed, or in time trying levitra. My problem is mainly related to prior SSRI (PSSD). I heard levitra is a good option for both ED and PE, so that might be an option if sildenafil/tadalafil fail.

I am very comfortable with the idea of ICI/injections, but have never used before. Was at urologist, hormone panel normal, and responding to PDE5i. I am interested in down the line using injections so I can stay hard after I cum, and not have to worry about losing erection or PE.

Do guys usually start with monomix and then move on to bimix, trimix etc? How long do the erections last, and how do they compare to the erections on PDE5i? is it cost-effective? side-effects?

[bldoink]

Do guys usually start with monomix and then move on to bimix, trimix etc? How long do the erections last, and how do they compare to the erections on PDE5i? is it cost-effective? side-effects?

I'm sorry but there are no correct answers to your questions.

You will likely start with mono-mix in the form of Caverject or Edex or a Tri-mix. It depends on your location and your doctor. I think the Tri-mix is becoming more prevalent, probably due to cost and availability. In the U.S. if not covered by insurance, Edex and Caverject are very expensive. A Mono-mix compounded like the Tri-mix is available but not as readily available as the compounded Tri-mix's that are more easily available. In fewer instances some doctors start their patients on Bi-mix.

The duration of the injection erections vary based upon mix, dose and the underlying cause of the ED. They can last from a few minutes to several hours, ideally not more than 3 hours.

Ideally the injection erections will equal or surpass the best 18 YOA erection, but maybe not. If they aren't much better than a PDE5 erection, then you don't need to use injections.

In most cases, if not using a proprietary preparation like Edex or Caverject, they are very cost effective, as in cheap. If not, you need to find a cheaper supplier. The exception would be if they aren't working well and you're having to use a very high dose of a very strong mix.

Side effects very a lot. For a minority of guys the side effects of ache and pain are intolerable. The alprostadil (PGE1), one of the ingredients of Tri-mix and the only active of most versions of Mono-mix and the only ingredient of Edex and Caverject, is the ingredient most likely to cause ache. It's also the ingredient probably the least likely to cause fibrosis or scaring. Many users that initially experience alprostadil ache find it diminishes or disappears completely with continued use, but that's not the case with all users. Fibrosis and scaring is a risk for all users but can be minimized with proper injection techniques, including following ideal intervals along with trying to use the more benign mixes.

Good luck.

[Markc2008]

I have pssd as well. I’m 38. I have had issues ever since stopping ssri two years ago. I started with orals and they worked for a while but quit working since I have libido issues from the antidepressant. I’m now doing injections and still adjusting but it is the next step. They seem to work well when you get them dialed in.