alpha blockers for psychogenic ed?

[Flavio]

In older men, sympathetic activity increases in the penis as we age, combine this with a reduction of smooth muscle in the penis due to oxidative stress, lowered T levels, ischemia and hypoxia [...]

Brilliant info as always, Simbarn.

Maybe this is a silly question but here it goes: is there any way to improve/protect smooth muscle in the penis? Maybe taking antioxidants?

[passerarf]

FYI, I'm on Terazosin (an alpha blocker) right now per this study: http://tau.amegroups.com/article/view/9503/10291

Hoping that it works for me - I'm about a week in. The doc has started me on one pill and will move to 2 pills after 2 weeks and keep increasing until we (hopefully) see an effect.

His plan is to use this approach to correct an imbalance that he believes I have between the nerve response that triggers an erection and the nerve response that inhibits an erection.

Separately, I also have phentolamine in hand now and tried it once, but that was on the same day that I started the Terazosin. I definitely saw an improvement, but can't tell if it was due to one or the other or both. I'm going to try it again soon.

[Simbarn]

In older men, sympathetic activity increases in the penis as we age, combine this with a reduction of smooth muscle in the penis due to oxidative stress, lowered T levels, ischemia and hypoxia [...]

Brilliant info as always, Simbarn.

Maybe this is a silly question but here it goes: is there any way to improve/protect smooth muscle in the penis? Maybe taking antioxidants?

I have missed this reply. Sorry.

To help with the prevention of oxidative damage which appears to increase with age, antioxidants have indeed been suggested as a possible therapy.
Chronic dosing (daily) of a PDE5 inhibitor has also been shown in studies to mitigate the cascade of events created by oxidative damage that cause changes in the structure of the trabeculae and also smooth muscle loss. It has also been shown that they help repair some of the damage over time.

Ensuring that nocturnal erections are maintained also plays a big part in preventing hypoxia which accelerates smooth muscle deterioration. This is tied in with adequate androgen levels, testosterone and DHT. Both of these hormones contribute to penile tissue health.

[Simbarn]

FYI, I'm on Terazosin (an alpha blocker) right now per this study: http://tau.amegroups.com/article/view/9503/10291

Hoping that it works for me - I'm about a week in. The doc has started me on one pill and will move to 2 pills after 2 weeks and keep increasing until we (hopefully) see an effect.

His plan is to use this approach to correct an imbalance that he believes I have between the nerve response that triggers an erection and the nerve response that inhibits an erection.

Separately, I also have phentolamine in hand now and tried it once, but that was on the same day that I started the Terazosin. I definitely saw an improvement, but can't tell if it was due to one or the other or both. I'm going to try it again soon.

Excellent Passerarf. I am extremely interested to hear how this works for you. As we have been discussing sympathetic hyperactivity so much recently and the possibility of an autonomic imbalance in your case, as in excessive adrenergic activity. It will be very interesting to see what affect it has for you.
I read a study only recently about how Alfuzosin over a period of time appeared to bring the autonomic system into balance whether it was sympathetic or parasympathetic hyperactivity occurring. I would not get discouraged in the short term as the effects may build over time.

I think selective a1 blockers may work cumulatively compared to the on demand use of phentolamine mesylate. Phentolamine mesylate has an A2 blocker combined with A1, which could make the side effects worse.
Also interested to hear what side effects you feel from either medication.

[passerarf]

I will keep you posted! I don't have any noticeable side effects yet. I've moved to 2 pills per night as of last night. We'll see.

[passerarf]

Just an update - I'm now up to 5mg of terazosin per night. It definitely seems to have a minor effect (higher frequency and quality of morning erections), but even with the usual above max dose of viagra that I take to attempt to have sex, I still have the same problems that I had been having before.

I've also noticed that my scrotum hands looser than it had before.

Dr. Tsu has told me to take the 5mg dosage for 2 months and then follow-up with him - I'm coming up on that 2 months and will see what's up.

[Flavio]

Just an update - I'm now up to 5mg of terazosin per night. It definitely seems to have a minor effect (higher frequency and quality of morning erections), but even with the usual above max dose of viagra that I take to attempt to have sex, I still have the same problems that I had been having before.

I've also noticed that my scrotum hands looser than it had before.

Dr. Tsu has told me to take the 5mg dosage for 2 months and then follow-up with him - I'm coming up on that 2 months and will see what's up.

Alpha blockers definitely work but from my personal experience, reactions vary a lot.

I tried several alpha blockers and oral phentolamine (brand name Vasomax) was the only one that worked for me. I know, however, several guys that tried it and couldn't tolerate the side effects.

Speaking of which, I just got an order of 10 phentolamine boxes from my Chinese forwarder. It's going to be a fun summer!

[Flavio]

[...] Separately, I also have phentolamine in hand now and tried it once, but that was on the same day that I started the Terazosin. I definitely saw an improvement, but can't tell if it was due to one or the other or both. I'm going to try it again soon.

I combine phentolamine + avanafil and results are spectacular (e.g. I am able to ejaculate several times and maintain an erection) because both drugs work sinergistically. Side effects may, however, be severe (e.g. hypotension, tachycardia) and I don't even like to recommend this regimen. It works for me but it's definitely not for everyone.

I'd love to know the opinion of your doctor on this regimen and also on other alpha blockers for the treatment of ED.

I think Simbarn is absolutely right when he mentions sympathetic hyperactivity. I have no doubt this is a major cause of sexual dysfunction in men and should be looked into. I'm not a neurologist but it's undisputed that the nervous system plays a major role in sexual function.

The good news is you can control sympathetic activity and improve your sex life, whether by the use of alpha blockers or maybe even the right anxiolytics.

[mr.skin]

I am using doxazosin for that reason but it seems to affect my mood negatively.

Funny enough - sleep deprivation improves my ed significantly

[passerarf]

Update: unfortunately I've gone ahead and discontinued the 5mg/daily terazosin after months of being on it, without enough of an improvement to warrant continuation.

I continue to be confused about the cause of my ED - it seems to be down to venous leak vs. some sort of sympathetic inhibition (or a mix of the two).

Need to figure out next steps.