Trazodone ruined my life. Potential priapism in January, uros tell me I'm okay, pills are now unreliable

[SaltRun9003]

Greetings,

I’m very thankful for this website and community and I hope you can all provide me guidance and hopefully reassurance along my journey

I’ve had ED since I was 23. I’m 31 now. I had been able to use pills extremely reliably until earlier this year. The first couple years I needed pills it took 60 – 80mg of sildenafil or 15-20 mg of Cialis. But from 2017-2021, I was able to use just 20 – 40 mg of sildenafil or 5 mg Cialis daily. I would switch between the 2 every couple months with great results. Life was good.

How my ED became more severe is a pretty tragic tale. In September 2021, I got a divorce. Not because of ED, my ex-wife didn’t even know I had ED because I was able to hide it so well and I was very methodical about timing pills correctly so I was always ready when she was ready. After the divorce, I became very depressed and suffered immense insomnia, like I was up for days at a time with literally zero sleep. I did what I was supposed to do and started therapy instead of hitting the bottle every night and asked my psychiatrist for valium to help me sleep but he refused and gave me Trazodone instead which would seemingly destroy me mentally and/ or physically.
I took Trazodone almost every night in Oct 2021 and it worked well. It definitely helped me fall asleep and helped with the depression. In Nov 2021, I got a girlfriend and was doing really well so I stopped taking it. Life was good.

However, on December 23rd, when I went to have sex with my gf, I couldn’t get it up even with 15 mg Cialis in my system. This was extremely upsetting for me since pills had ALWAYS worked for me up until this point. She left the next day to go spend the holidays with her folks and wasn’t going to be back until January 5th. I wasn’t all doom and gloom yet and just chalked me not being able to get hard to it being close to the holidays and being depressed and anxious. My ex-wife started abusing Adderall and Ambien early in 2021 and then started cheating so I divorced her. I don’t want her back, but the betrayal and losing my life partner within the span of a few months was very heartbreaking and soul crushing. She’s since apologized and begged me to take her back but I could never trust her again, but I digress.

After I couldn’t get it up on December 23rd, I started taking Trazodone on some nights because the insomnia was back. On January 4th, I took 100mg Trazodone (which I had taken many times at this point) and laid down to go to sleep. I instantly got really hard when I laid down but wasn’t alarmed. If anything, I was thrilled! I thought, “Alright, I’m not even on any PDE5 inhibitors and got night boners again! I remember these!” I didn’t jerk off because I wanted to abstain from PMO because I was going to see my gf the next day and wanted to perform and not embarrass myself again like the last time I saw her.

Anyways, I fell asleep with an erection at about 1:00 am and woke up at 5:00 am with a very hard erection. I wasn’t alarmed because night boners/ morning wood is a thing. I was also kind of delirious from the Trazodone and having just woke up out of REM sleep. I got up and took a piss but it still wouldn’t go down all the way. I sat up for a minute and tensed my muscles like I used to when I was a teenager and got random boners that wouldn’t go away. It went down to about 40% but would instantly start getting hard again if it rubbed against the sheets or if I had any sort of horny thought. I (stupidly) fell back asleep and woke up 2 hours later at 7am to my alarm with a still very hard erection. I got up, pissed, and it went away. There was no pain, no discoloration, so all seemed fine. It didn’t hit me until I was at my desk at work that, “Oh shit, that erection could have lasted all night while you were sleeping and that was 6 hours!” Panic and dread immediately seeped in and hasn’t really left since.

I looked up side effects to Trazodone and, sure as shit, priapism is a rare but possible side effect to Trazodone. Which my shrink never told me or I would have been alarmed when I got the hard erection. I would have never taken Trazodone to begin with. See, starting in early 2021, I quit smoking, drinking, eating better, and started working out 5 times a week. I lost 50 lbs and got buff again. I thought that, since I was in such good shape and hadn’t had any PMO or sex for nearly 2 weeks that my dick was finally healing and I was overcoming ED. My docs always said it was in my head and lo and behold, they were right. Or so I thought. What an idiot I was. What I wouldn’t give to have a time machine to go back to that night so I could not take Trazodone or jerk off, take a cold shower, take Sudafed, go to the ER, whatever I would have to do to make that boner not (potentially) last all night. If it didn’t do any actual physical damage, it sure did a number on me mentally.

I immediately contacted my uro’s office and explained what happened and had an appointment with him a week later. My uro said he wasn’t too worried about the potential priapism because

1) It wasn’t painful
2) It went away on its own
3) We don’t even know if it lasted all night because I was sleeping. Could very well have come and gone like nocturnal erections are supposed to.
4) It went almost all the way down at 4 hours so I got new blood in there
5) 6 hours isn’t a death sentence. He showed me an article stating 50% of men that treat their priapism within 24 hours get a full recovery and everyone in the study was at least at 18 hours in and mine was only 6 hours and I almost got it all the way down at 4 hours.
6) He inspected my dick and said it looks and feels healthy and not like a penis that’s been through priapism. He said priapism injuries make the inside of the penis feel like “dried clay” and mine was still spongy and healthy feeling.

After some research, I insisted on scheduling a doppler to assess if any damage was done. I had never heard of the procedure and it sounded like a good idea to me. The doppler was scheduled for a little over 2 months from then in mid March. I didn’t even try to have sex or get hard for the next week. I told my gf what happened and she was very sympathetic and supportive. However, after a week, I took 15 mg Cialis and it worked like a charm. Ready to go for the next 24 – 36 hours. This was the case for the next two months. Life was good. I was very relieved but decided to still do my doppler to assess if there was any damage. I thought, “I’m gonna take the test, it will come back normal, and I can finally put all this behind me.”

Well, I did the doppler and my uro told me I have venous leakage. My EDV was 12 and 17 at different intervals. I was crushed. He told me it was a minor venous leak and that pretty much all of his patients with my EDV use pills just fine so I shouldn’t worry too much. However, after that and over 2 months of pills working flawlessly again, they stopped working.

I started doing more research and discovered that false positives for venous leaks are very common. 50% of men retested come back totally normal.

https://pubmed.ncbi.nlm.nih.gov/21569215/

https://www.mmj.eg.net/article.asp?issn ... 4;aulast=M

Likewise, cavernosography performed on men previously diagnosed with venous leak via a doppler often reveal no venous leak.

https://www.researchgate.net/figure/No- ... _331574555

Essentially, if you have high anxiety, a venous leak can be mimicked during a doppler. Otherwise known as “performance anxiety”. My uro didn’t know that, but I wish he did, because I would have cancelled the test since I am very neurotic and have had a lifetime of anxiety issues. He apologized profusely and has been working closely with me since, which I appreciate. I asked him if priapism can cause VL and he said, “No.” He said if I really had a priapism and did damage that the pills wouldn’t be working at all because the tissue in the penis would be damaged and unable to receive and/or retain blood. He again reiterated that 6 hours really isn’t that bad, especially because I got it down to 40% 4 hours in. I’ve also spoken to a different uro who has echoed everything the other uro told me that I’ve mentioned so far.

So, realizing this seemed to help because the pills started working again. This is late March at this point. However, after about another month of 15 mg Cialis working flawlessly again, it started diminishing in quality then to nothing at all. I found an article showing that taking 5mg Cialis daily and 50 mg Viagra as needed worked well for men with severe ED and my uro approved so I started taking that. That worked flawlessly for the last few months up until this last weekend.

This is really stupid, but on the Friday of 4th of July weekend, my gf and I went to have sex. I went to close my bedroom window and stubbed my erect dick into my dog’s kennel. It didn’t hurt, there was no “popping” sound, my erection didn’t go away, there’s been no swelling, no discoloration, and we proceeded to have sex right after, again later that night, then again in the morning no problem. However, I started worrying that I might have had a penile fracture after I bumped into it because this whole year has been me obsessing over penis injuries and like I said and I’m sure you can all tell, I’m extremely neurotic, now more than ever. I didn’t bend it, just bumped it. I’m worried I squished it like an accordion. I didn’t see my gf all week (we both work full time and also don’t see each other every day) and then last Friday when we went to have sex, I could barely get hard and had a weak erection throughout.

I’ve been ruminating ever since and a bit suicidal. I’m not opposed to an implant, I’m just young and don’t think I’ll find a partner who accepts me like that. Also, I have insurance, but I doubt they’ll cover it and I’m not rich. It’s going to take me at least a year or more to save up for one and I’m not sure if I can make it that long. I can tell my current gf is getting tired of having to deal with this. She also insists I’m fine and that it’s all in my head so she’s getting frustrated. I don’t know about you guys, but I cry a lot ever since all this shit started. I’m not ashamed to admit it. Due to my divorce and this living hell, I’ve cried more since last September than I have for all the years combined since I was a toddler. Other than when my grandfather died when I was 19 and when my dog almost died after she injured herself (she’s recovered fully since), I don’t think I’ve cried at all from when I was 16 until last September when my divorce started and then when this nightmare started in January.

Yesterday, I had an appointment with my primary care doctor for a general physical I scheduled weeks prior when everything was running smoothly. She’s familiar with what’s been going on with me but I explained my concern about a penile fracture. She inspected my penis and assured me I didn’t hurt anything. She said I would have immediately lost my erection, dick would have swollen up, there would have been a “pop”, etc. She also reiterated what the uros said about the potential 6 hour priapism. That, even if it did last 6 hours, the fact there was no pain and that pills have been working at all for me means all this is in my head.

I guess I just want to know if my story is similar to anyone else and if there’s hope for me. I really just want reassurance from guys that have been through it. I told my uro a month ago during a follow up that I was thinking about scheduling a cavernosography but he said, “Since pills are working for you, do you really wanna know if you have a VL?” I agreed but, now that pills aren’t working again, I kind of want to get one done just to know for sure so I can take the next steps. I stopped taking all pills since last Saturday because my gf is out of town for 2 weeks and I wanted to give my body a break and a chance to reboot. I wake up with morning erections at about 80% but they go away very quickly. In about a week, I’m going to try just taking 80 mg of Viagra all by myself and see what it does for me.

Thanks for reading. Any feedback is appreciated. Again, I’m very grateful for this community. I’ve been staring into the abyss and in a real dark place, especially this last week.

I might have some follow up questions but I just wanted to start with:

Did any of you guys get a false positive for venous leak? Like, similar to those studies, did you test positive one time then negative on a follow up doppler or cavernosography?

[Benjohn]

Hey dude,

I could be in a similar position to you. Very similar story... 2019... Extreme anxiety and insomnia, prescribed Trazadone, was on it for about 3 months and slept a charm. Also during that time I had balanitis and left my foreskin back one night. Also during all of this I was entering a new relationship after being with my ex for 8 years previous. Either way, whatever has happened, since that time I've had no natural erections without pills.

I told my new gf everything and she really tried to help me through it. Sadly in mid 2020 when 100mg Sildenafil didn't work I tried taking my own life. Fortunately I survived after 4 days in hospital.

I'm very lucky that she still stuck by me. Fast forward to 2022, we've bought a house together and life is good.

3 things changed to make it all possible...

1) I went to see another Uro and was prescribed injections. This was the turning point. Needle anxiety at first but soon got used to it. I only ever had to use half a vial of Invicorp to get a 2-3 hour erection, it's scarily powerful. A lot of my performance anxiety went after that as I realised I could still get it up, even without pills. Also... It worked in 5 mins so we could be more spontaneous.

2) Discovered franktalk and saw so many positive stories about implants.

3) Started taking Sildenafil 100mg every night. I ended up waking up with an erection quite often and this really boosted my confidence. If 100mg Sildenafil worked when I slept, then there must have been a psychological element to it not working for sex. As I've become far more comfortable with my partner I've gone back to successfully using 100mg Sildenafil.

Which country are you from? Have you tried taking pills just before bed to see what happens in the morning?

[SaltRun9003]

Hey dude,

I could be in a similar position to you. Very similar story... 2019... Extreme anxiety and insomnia, prescribed Trazadone, was on it for about 3 months and slept a charm. Also during that time I had balanitis and left my foreskin back one night. Also during all of this I was entering a new relationship after being with my ex for 8 years previous. Either way, whatever has happened, since that time I've had no natural erections without pills.

I told my new gf everything and she really tried to help me through it. Sadly in mid 2020 when 100mg Sildenafil didn't work I tried taking my own life. Fortunately I survived after 4 days in hospital.

I'm very lucky that she still stuck by me. Fast forward to 2022, we've bought a house together and life is good.

3 things changed to make it all possible...

1) I went to see another Uro and was prescribed injections. This was the turning point. Needle anxiety at first but soon got used to it. I only ever had to use half a vial of Invicorp to get a 2-3 hour erection, it's scarily powerful. A lot of my performance anxiety went after that as I realised I could still get it up, even without pills. Also... It worked in 5 mins so we could be more spontaneous.

2) Discovered franktalk and saw so many positive stories about implants.

3) Started taking Sildenafil 100mg every night. I ended up waking up with an erection quite often and this really boosted my confidence. If 100mg Sildenafil worked when I slept, then there must have been a psychological element to it not working for sex. As I've become far more comfortable with my partner I've gone back to successfully using 100mg Sildenafil.

Which country are you from? Have you tried taking pills just before bed to see what happens in the morning?

I'm in the US. I actually have been waking up with like 80% morning wood in the middle of the night the last week even though I haven't taken any pills for a week. Also, I rechecked my doppler results and they were 9 and 11 at first. However, my fuckin uro told me after the first measurement, "Oh, wow, you do have a minor venous leak." He was cracking jokes beforehand telling me I'm gonna be fine since I said pills work for me. After he said that, my EDV jumped up to 17 and then 20 for the subsequent measurements. Words can not explain how absolutely horrified I was after he said that. I was having an absolute panic attack. I was already super stressed out before and my heart was pounding but after he said that I was overheating and almost fainted. I'm really hoping all of it was a false positive considering how well pills have worked for me and I still get pretty good morning wood without any pills.

And, yeah, Trazodone priapism is supposed to be super rare but it does happen. Like I said, I had no idea it can do that so I wasn't worried while I was going to bed with a super hard on. Like I said, I was stoked thinking it was a good sign. The really frustrating part is I don't know if it went down while I was sleeping, thereby restarting the clock. I did get it down from 110% to about 40% at the 4 hour mark before going to bed so I'm hoping that saved me. I'm reluctant to take pills before sleep after that experience because I'm worried about having another sleep priapism. Also, I'm getting decent morning wood already. From what I understand, if I really had a venous leak of 17/20 I shouldn't be able to get an erection period (even with pills) so I'm hopeful about the false positive status. Also the fact it jumped up so much after he told me I have one after the first measurement means anxiety was definitely playing a role. At least that's what I'm telling myself to cope, but I think I'm right.

I also never got fully erect during the procedure (because I was fucking terrified from the beginning) and, from what I'm reading, you can't really do a doppler unless the penis is fully erect. Also, after I got home, I got a hard on that was lingering so I jerked off in the shower to make it go away. All this and what I've said previously is indicative to me that I'm (hopefully) okay and it was a false positive. I'm reluctant to do another one because (frankly) I don't think my uro is educated enough to know what he's doing. I'm straight up teaching him shit by sending him articles he should already be familiar with before he sticks needles in my dick and gives me a diagnosis that lots of men kill themselves over.

Glad to hear you survived and glad to hear you're back to having reliable erections with pills. That gives me hope.