Peak Testosterone Forum

General Category => Testosterone, Hormones and General Men's Health => Topic started by: master3 on June 04, 2012, 04:49:39 am

Title: 40 Years Old & Sudden ED Problems - Input greatly appreciated
Post by: master3 on June 04, 2012, 04:49:39 am
This is my first post.  I must say I really appreciate this site.  I’ve learned a lot, and this knowledge has helped during recent doctor’s visits.  Any feedback that could be offered regarding my issues would be greatly appreciated.

Here is my deal.  I am 40 years old and a couple of months ago, I very suddenly began having problems achieving and maintaining an erection.  I literally went from never having a hint of a problem to having significant issues.   Previously, simply enjoying a few fantasies or exchanging ‘sexting’ messages with my wife would result in an erection. 

The first issue was halfway through sex with my wife, just getting ready for intercourse.  I simply lost the erection and couldn’t get it back.  A week later, and I couldn’t even get anything going.  Lifeless is the term I would use.

I went to the urologist and he prescribed daily Cialis, 5mg.  It worked fantastic, both getting and keeping an erection.  Ten days later and I developed ringing in the ears.  I didn’t realize that one of the side effects could be hearing loss and tinnitus.  Needless to say, I discontinued using Cialis.  I was prescribed prednisone to improve the symptoms, and that seems to have helped and I’ve noticed the tinnitus has reduced.  Without baseline data, the ENT doctor isn’t sure but he did think I have minimal hearing loss at very high frequencies, but not enough to notice. 

Within two days of stopping Cialis, the erection problems returned.  Last week’s follow up with the urologist to review my blood work resulted in the following data:

Testosterone: 465 ng/dL  (normal – 348-1197)
TSH:   2.48 uIU/mL  (normal – 0.45-4.5)
Gonadotropin FSH: 2.3 uIU/mL  (normal – 1.5-12.4)
Gonadotropin LH: 3.6 uIU/mL  (normal – 1.7-8.6)
Sex Horm Bind Glob: 33.1 nmol/L  (normal – 16.5-55.9)
Prolactin:   4.4 ng/mL  (normal – 4.0-15.2)
Estradiol:   25.1 pg/mL  (normal – 7.6-42.6)

Based on what I’ve read, Testosterone seems a little low, but nothing to be alarmed about(?).  I’ve poked around the site and haven’t seen anything significant on the other data, yet.

Here’s the punch line.  I am a competitive cyclist.  I have been racing for about 6 years.  Seven months ago, I had a professional bike fit which changed my position and at the same time I changed my seat.  I believe the seat may be at least a part of the ED problem.  I realized that I had dismissed occasional penis numbness during rides.  The remedy was usually standing up, adjusting positions, etc. and the numbness would go away.  Immediately after the ED problems began, I purchased a new seat that is very friendly to the downstairs plumbing.  The difference in the pressure in the perineal area is huge.  I can’t understand how I thought the previous seat was comfortable.  Absolutely no numbness since I’ve changed seats about 6 weeks ago.

At the follow-up appointment with the urologist last week, he provided three samples of Muse, a urethral suppository.  Sounds fun.  I’m not all that excited about another RX, plus its crazy expensive at $45 per dose.  Ouch. 

As a dedicated cyclist, I am careful with my diet.  In fact, I weigh about the same as I did when I was running track in high school.  Don’t get me wrong, I allow myself a treat now and then and have about 2-3 alcoholic drinks a week, beer or red wine typically.

I wouldn’t call the symptoms lifeless at this point, but there are times when it seems as though it is.  In the last week or so, I have been able to ‘self-perform’ and times when I haven’t been able to.  Sex with my fantastic wife hasn’t been an option for the past week or so, but will be soon.  I’m anxious, so we’ll see how that goes.  I am having morning erections, but they aren’t particularly hard.

I do have a vericocele, but the urologist didn’t seem too concerned about it, probably because the testosterone levels weren’t too bad and I don’t have any discomfort or pain.

A few thoughts I have floating around in my cranium;

1)   If Cialis worked so well, and I was able to keep an erection for an extended period, it seems as though venous leakage is not the likely problem.  ???
2)   Is there any value on an ultrasound?  The procedure seems at a minimum, odd.  Thanks starry for the post a couple of weeks ago.  However, I am concerned that cycling may have caused damage, and it may be good to know results that an ultrasound can provide.
3)   Regarding increasing blood flow, supplements and diet seem like the best option, just not sure where to focus my attention.
4)   I’ll probably order the Neogenis test strips to check Nitric Oxide levels. 
5)   My libido is not as strong as it was, say, six months ago, but wouldn’t say it’s a dramatic decrease.

I’d like to treat this issue without an RX, but with all the great information on the site, I’m not sure where to start.  I’d like to come up with a plan and present it to my urologist this week.

So there’s my story.  Sorry for the long post.  As I mentioned at the beginning of the post, any feedback would be greatly appreciated.

Title: Re: 40 Years Old & Sudden ED Problems - Input greatly appreciated
Post by: feelgood on June 04, 2012, 02:00:42 pm
hi master, yeah, i feel your pain....

i do a lot of mountain biking, and i switched over to the ISM Peak Adamo split nose saddle, which is actually really good - though arterial damage from biking doesn't seem to be my problem, given his comments on my really strong arterial health.

I think perhaps the ultrasound thing from the urologist office might be good for you for piece of's really pretty odd and uncomfortable, but maybe having knowledge of that going into it, it will help (or not at all :). But it really does let them know about overall health in there i believe.

I mean, they said venous leakage, but i'm still not clear how they can really tell. I need to ask if it actually shows up on that ultrasound. If not, and they are basing the diagnosis on me losing my erections when the guy kept coming in to put cold jell on my unit? well, i'm really not surprised that was the case. Maybe the drug they inject you with is really powerful for most guys and they stay hard even if they are kinda freaked out...i don't know.

And if i do have venous leakage - well, he prescribed the cialis, viagra, etc to me too, so that must be something they "do/offer" for venous leakage. I think a solid dose of those drugs might combat the venous leak and over ride it. I really don't know.

I still think some of my issues are a bit psychological as well, but that's another story. And - the low T for most likely a really long time (i'm 43) - i'm hoping my raised T will eventually "normalize" my plumbing as well.

I trust Peak and others will have more helpful comments...Good luck and keep us posted. It helps knowing what other guys do/face, etc.

Title: Re: 40 Years Old & Sudden ED Problems - Input greatly appreciated
Post by: PeakT on June 04, 2012, 03:38:11 pm
Sorry to hear about the struggles.  Considering that you are a competitive cyclist, only 40 and very little body fat, I kind of doubt that it is nitric oxide related.  Then, why, you may ask, would Cialis help?  Well, my theory has always been that in some men it pushes them supraphysiological (especially with the dosage in a 10 or 20 mg tablet).

In other words, with normal aging, you probably need maybe 2 mg of Cialis to boost your NO to youthful levels and then instead you took what was a huge dose for you (10 or 20 mg) and this pushed things too far and then tinnitus occurred.  To me it seems obvious that they dosed Cialis for the typical middle-aged or senior male with serious endothelial issues and that almost for sure does not fit you.

Now I can't prove what I'm saying and one could argue that blood pressure should fall dangerously if that were the case.  But I do know this:  some men do great only taking 3-5 mg of Cialis and 10-20 mg is way, way too much and causes them nasty side effects.

Furthermore, think about this:  your original bike seat may have aggravated the nerve and thus you needed to go supraphysiological to achieve an erection even though your nitric oxide levels were just fine.  Again, that's just a theory but it seems reasonable to me. 

In any event, here is the key thing:  your description sounds like a classic case of bike seat injury.  Read this medicinenet summary which seems to match your situation very well.

Of course, keep in mind that I'm not a doctor, so any testing you think might be appropriate, ask him or her about it and go with what they say.  I'm just pointing out that many things in the above article match what you posted.

And, if that is the case, then you should be able to make a nice recovery by the way.  For example, if you look at the end of page two, it states:

"Of course, just because you bike doesn't mean that you will experience perineal symptoms; in fact, many cyclists ride for years and never experience any of them. But if you do, and they continue after you make adjustments in your bike or riding style, then see your doctor because they probably won't get better on their own if you continue to bike. In most cases, perineal symptoms are not permanent and can be treated successfully."

One more important questions for someone like yourself:  you sure you're not overtraining?  The suddenness of your description could fit in there.  And overtraining can affect everything in the bedroom of course...

Title: Re: 40 Years Old & Sudden ED Problems - Input greatly appreciated
Post by: LowerT51 on June 04, 2012, 03:39:38 pm
Starry - Been there done that.  The ultrasound is measuring blood flow and not the firmness of the erection.  I was in a semi state but the doc stopped the test early on as he could quickly tell that blood flow was not an issue.  BTW - I was as nervous as could be but you need to keep in mind that the docs see and do this stuff all of the time and the goal is to either eliminate causes or to treat the issues.  It's a big deal to the guy laying there with a stiffy waiting for the doc to enter the examining room, but not to the doc doing the test!!
Title: Re: 40 Years Old & Sudden ED Problems - Input greatly appreciated
Post by: master3 on June 05, 2012, 03:56:46 am
Thanks for the input guys.

Starry – I’ve settled on the Specialized Body Geometry Ronin.  It certainly has done the trick.  Would highly recommend it to others.  I couldn’t quite make the leap to the ISM saddle – just too odd looking.

Peak – I was actually only given the 5mg daily dose of Cialis.  It worked so well that the 2.5mg would likely have been enough.  Your theories sound pretty good, certainly worth mentioning to the urologist.  It’s difficult to admit because cycling is important to me, but as I mentioned in my earlier post, the previous seat had to be a least a part of the problem.  Regarding overtraining…luckily I am pretty sure that’s not it.  I allowed myself to get overtrained a few years ago.  It really sucked.  Ruined a whole season.  Since then, I’ve been pretty careful about scheduling time off.  When I doubt, stay home and play catch with my son.

Starry and LowerT51 – I appreciate the descriptions of the ultrasound.  I left a message with the urologist’s assistant to review the procedure, check coverage, etc., with the intent of getting the procedure scheduled.  We’ll see how it goes.  I mentioned to my wife that the procedure starts with a needle…even she winced.

Regarding my generic question on where to start for supplements and diet…Is there any particular place I should focus my attention?  I’ve been reviewing the site and the books, but I’d love to hear any recommendations/suggestions etc.  My first thoughts are to start with Ginseng,  Horny Goat Weed and Fish Oil and see what happens.

Thanks again.
Title: Re: 40 Years Old & Sudden ED Problems - Input greatly appreciated
Post by: PeakT on June 05, 2012, 04:50:49 am
My first thoughts are to start with Ginseng,  Horny Goat Weed and Fish Oil and see what happens.

Ginseng is good and pretty safe and has a rich study history and centures of use to boot.  (Of course, always talk to your doctor first.)  I take it every day myself.  As you may have read on my site, it's important to get a good manufacturer that screens for lead. 

Ginseng can be stimulating for some.  And there are other things to be aware of.  Here is a great summary page by the way:

Horny Goat Weed really helps some guys, the Icaarin extract some and the tea still others.  It's a weak PDE5 Inhibitor so something else is going on there.  It is not as well understood or studied but looks very promising especially for shorter term use.

Imo fish oil is a "no brainer" if you're not eating fish at least once per week and especially for you imo.

You can get it those essential fatty acids from other sources, but you should get them from somewhere...
Title: Re: 40 Years Old & Sudden ED Problems - Input greatly appreciated
Post by: feelgood on June 05, 2012, 01:49:51 pm
yeah, i had to get over the "weird" factor of the ISM i think it's kinda cool, but maybe that's just a mental defense mechanism :)

Yes, so the needle is rather small, but it's freaky for sure. Just look stings your unit for sure, but it's not like "yell out loud" painful (though it's not too far away from that :). But again, that wasn't the worst part for was the "oh shit i need to get hard somehow" feeling...wondering why the "drug" wasn't working enough for me, wondering if he'd even be able to get a reading, etc...

again, i only say all this because it was all sort of a shock to me. Maybe *knowing* the procedure and what you *could* feel will help you? i hope i don't freak you out for it...I really think it's worth you doing, for peace of mind.

i've tried the 5mg Cialis and i honestly felt like it did nothing for me. Viagara seems to work better for me. But i hate the need to "time for sex." It doesn't really work with my wife so much...she's more a spontaneous gal.  Maybe i need the 10mg Cialis. Can you take the 10mg daily? I hate just relying on these things, as it just seems to be masking what the problem might be, but...that's all my urologist gave me. So....

Anyway - good luck - keep us posted.