Size loss before implant due to ED

[noot1991]

Being young and still having some response to pills, I don't want to jump immediately to an implant yet. On the other hand, I fear though that waiting with ED for too long might cause a loss in size, since I'm only very average to begin with and hence really want to avoid that!

I often read here that the key to not losing size is to maintain nocturnal erections. Currently, taking 5mg tadalafil every evening, I usually wake up with some morning wood (of varying rigidity and duration), and usually nothing when I don't take it. However, It seems that most people who lost size didn't just suffer from ED or a lack of nocturnal erections, but also had RP and/or PD, making me wonder whether ED alone can really be blamed.

Therefore, I have a few questions:

- Are there any men who experienced size losses purely due to ED (without having prostate surgery or PD)?
- In case you lost size, did you manage to recover it (either through a VED or after having an implant) or is the loss permanent?
- In your opinion, in situations such as mine, when should one consider an implant? Psychologically, I'm definitely willing to wait a few more years until I've really exhausted all other options (except for injections), while in the meantime doing VED therapy to keep everything healthy (a recommendation I got in a previous thread). Physically, however, I just fear that waiting a few more years with waning erections (I have no idea how "strong" and how frequently "morning wood" is necessary to avoid atrophy) would inevitably lead to size losses, even with VED therapy.

[newbie443]

Being young and still having some response to pills, I don't want to jump immediately to an implant yet. On the other hand, I fear though that waiting with ED for too long might cause a loss in size, since I'm only very average to begin with and hence really want to avoid that!

I often read here that the key to not losing size is to maintain nocturnal erections. Currently, taking 5mg tadalafil every evening, I usually wake up with some morning wood (of varying rigidity and duration), and usually nothing when I don't take it. However, It seems that most people who lost size didn't just suffer from ED or a lack of nocturnal erections, but also had RP and/or PD, making me wonder whether ED alone can really be blamed.

Therefore, I have a few questions:

- Are there any men who experienced size losses purely due to ED (without having prostate surgery or PD)?

Yes.

- In case you lost size, did you manage to recover it (either through a VED or after having an implant) or is the loss permanent?

Some yes. Some no.

- In your opinion, in situations such as mine, when should one consider an implant? Psychologically, I'm definitely willing to wait a few more years until I've really exhausted all other options (except for injections), while in the meantime doing VED therapy to keep everything healthy (a recommendation I got in a previous thread). Physically, however, I just fear that waiting a few more years with waning erections (I have no idea how "strong" and how frequently "morning wood" is necessary to avoid atrophy) would inevitably lead to size losses, even with VED therapy.

As you are seeing a doctor I would talk to your doctor about this. If you plan to have the surgery done by another doctor I would start the search and selection process now. And I would start or continue VED therapy. At the first sign of size loss you want to be ready to go with this. Or as most men do when nothing else works.

[Musson]

My ED started in my late 40s. It was very mild and only required micro doses of ED pills. I may have had some minor length loss over the next 15 years. Some of the perceived loss was simply weight gain and an increase in fat above my dick.

In 2020 the scourge of Peyroines hit me triggering devastating size loss. I’m convinced lack of nighttime erections contributed to getting Peyroines.

I would focus on penile health. If I could do it again I would have gone on daily cialis from the start. Regrets. Maybe something to discuss with your doctor.

[Old Guy]

Fought ED for 13 years and yes it made me lose length. Pills and injections failed after a few years of each. Since I was not knowledgeable at the time (hadn't found FT yet) I didn't know much about implants other than it would get me erections again. My implant works great but my guess is I'm about 1" shorter than before ED. If you're going to do it, don't wait too long and exhaust all other methods.

[noot1991]

Being young and still having some response to pills, I don't want to jump immediately to an implant yet. On the other hand, I fear though that waiting with ED for too long might cause a loss in size, since I'm only very average to begin with and hence really want to avoid that!

I often read here that the key to not losing size is to maintain nocturnal erections. Currently, taking 5mg tadalafil every evening, I usually wake up with some morning wood (of varying rigidity and duration), and usually nothing when I don't take it. However, It seems that most people who lost size didn't just suffer from ED or a lack of nocturnal erections, but also had RP and/or PD, making me wonder whether ED alone can really be blamed.

Therefore, I have a few questions:

- Are there any men who experienced size losses purely due to ED (without having prostate surgery or PD)?

Yes.

- In case you lost size, did you manage to recover it (either through a VED or after having an implant) or is the loss permanent?

Some yes. Some no.

- In your opinion, in situations such as mine, when should one consider an implant? Psychologically, I'm definitely willing to wait a few more years until I've really exhausted all other options (except for injections), while in the meantime doing VED therapy to keep everything healthy (a recommendation I got in a previous thread). Physically, however, I just fear that waiting a few more years with waning erections (I have no idea how "strong" and how frequently "morning wood" is necessary to avoid atrophy) would inevitably lead to size losses, even with VED therapy.

As you are seeing a doctor I would talk to your doctor about this. If you plan to have the surgery done by another doctor I would start the search and selection process now. And I would start or continue VED therapy. At the first sign of size loss you want to be ready to go with this. Or as most men do when nothing else works.

I'm seeing a doctor, but they can't really answer these questions either it seems, so the real-world data and experiences here on FT are often more useful. When I first approached my PCP about this issue, he told me that the loss of nocturnal erections is nothing to worry about - "It's not like it will die off", I was told. Luckily, the urologist he referred me to did recommend taking daily tadalafil, just to maintain those nocturnal erections (hence why I take the pill before going to bed).

Thanks to this forum, I already have a few names where I know I'd be in good hands. Currently, I'm just "monitoring" my size by measuring it at least once a week. Feels a bit weird/maniacal to do that, but I would probably take a size loss as a first indication that it is time to go through with this.

[noot1991]

My ED started in my late 40s. It was very mild and only required micro doses of ED pills. I may have had some minor length loss over the next 15 years. Some of the perceived loss was simply weight gain and an increase in fat above my dick.

In 2020 the scourge of Peyroines hit me triggering devastating size loss. I’m convinced lack of nighttime erections contributed to getting Peyroines.

I would focus on penile health. If I could do it again I would have gone on daily cialis from the start. Regrets. Maybe something to discuss with your doctor.

PD leading to size loss seems to be common. And indeed, daily Cialis might help to avoid that (apparently, not just because it causes nocturnal erections, but because it also has anti-inflammatory effects on penile tissue that may prevent Peyronie's plaque from forming). It's not all great though, because in my experience it seems that taking Cialis daily already starts to lose effectiveness, so it may be unavoidable anyway as our body builds up some kind of tolerance.

What I'm really curious about is to what extent ED alone causes a size loss. Like you said, the perceived loss may just have been due to increased weight gain, which seems to happen often as we age.

[noot1991]

Fought ED for 13 years and yes it made me lose length. Pills and injections failed after a few years of each. Since I was not knowledgeable at the time (hadn't found FT yet) I didn't know much about implants other than it would get me erections again. My implant works great but my guess is I'm about 1" shorter than before ED. If you're going to do it, don't wait too long and exhaust all other methods.

Interesting. Did you still have morning wood throughout those 13 years, or did you basically only summon erections using pills/injections "on-demand"? It could be that the injections themselves cause scar tissue and therefore reduce penis size (one of the reasons I don't want to go down the injection path).

And well, realistically speaking, as someone who already has issues with ED in his 20s (and even lost erections in his teen years during masturbation), I figure that most likely I'll need an implant at some point in my life. Ideally, because of multiple revisions etc. I'd like to postpone that as long as possible (preferably at least until my 30s), but if that would result in a worse outcome and I have to get it earlier to prevent atrophy then so be it.

[noot1991]

Btw, I first learned about the possibility of size loss (didn't know that was even possible) when I was reading an article about MtF transgenders who are on hormone replacement therapy and then investigated further. There, the reasoning was also that the lack of testosterone resulted in a lack of nocturnal erections, leading to atrophy. However, it seems that these people lose size at a much higher rate (as in, easily noticeable in a few months) compared to those with ED here on this forum. Interestingly, their size loss seems inevitable, even when they try to force daily erections (often with the help of PDE5i medication) to prevent it. So just having regular erections may not be enough to maintain size; being in good health to keep testosterone levels up probably also plays a role.

[Musson]

Interesting. Did you still have morning wood throughout those 13 years, or did you basically only summon erections using pills/injections "on-demand"? It could be that the injections themselves cause scar tissue and therefore reduce penis size (one of the reasons I don't want to go down the injection path).

And well, realistically speaking, as someone who already has issues with ED in his 20s (and even lost erections in his teen years during masturbation), I figure that most likely I'll need an implant at some point in my life. Ideally, because of multiple revisions etc. I'd like to postpone that as long as possible (preferably at least until my 30s), but if that would result in a worse outcome and I have to get it earlier to prevent atrophy then so be it.

Looking solely at ED prior to PD yes I had some degree of size loss. Probably a half inch or so from a 7 inch max when I was in my 20s. My girth however didn’t max until my early 40s at about 6.25 inches.

[newbie443]

I'm seeing a doctor, but they can't really answer these questions either it seems, so the real-world data and experiences here on FT are often more useful. When I first approached my PCP about this issue, he told me that the loss of nocturnal erections is nothing to worry about - "It's not like it will die off", I was told. Luckily, the urologist he referred me to did recommend taking daily tadalafil, just to maintain those nocturnal erections (hence why I take the pill before going to bed).

Thanks to this forum, I already have a few names where I know I'd be in good hands. Currently, I'm just "monitoring" my size by measuring it at least once a week. Feels a bit weird/maniacal to do that, but I would probably take a size loss as a first indication that it is time to go through with this.

The uro you see would be the one to make the plan with or as I said if that doctor is not the one that you trust for this now is the time to start you search for the doctor who is. If you trust a doctor enough for this surgery then you should trust the advice on when to have it and how to proceed until then. We are different as men as well as the doctors we see. So find a doctor you trust to go to that you can make a plan with for this. It is correct that your penis will not die from lack of blood flow from ED. It is just simply that the lack of erections stretching the tissue will cause shrinkage and the loss of elasticity of the tissue.

Good luck with this.