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Curious to compare Cialis to Viagra (or generic).

I have NOT started TRT, as my symptoms are just not that bad....YET.

You can see my latest labs and stats and protocol that I'm currently doing in my footer below.

However I have noticed the following main symptoms.

1) Lower Libido.  Now this is not entirely bad as the lowered libido better matches my wife ( r at least the extreme mismatch is now lessened).  This has resulted in a lot less frustration and tension in the marriage.  However, I have recognized my drive is less. I used to be so horny I would "have to" masturbate between times my wife and I had sex to relieve sexual tension/frustration.  I now have virtually no urge to do this any more.  Not that that is a bad thing per say. But it is a sign that my drive has considerably diminished.

2) Erectile function:  Morning wood is probably 50% or less of the mornings.  And the wood is not as stiff as previous.  I have never failed to perform, however it does take considerable longer to achieve an erection.  Before my wife would say just a light wind outside and I'd be up and stiff as a board.  She has said nothing, but now it takes her use of her hand a couple minutes to gain a suitable erection. And then, even that or during sex, the stiffness is I would estimate to be about 60% of what it used to be.  Still very usable/functional. But certainly I notice the additional time it takes to get an erection, and the fact that it is "not what it used to be."  Even in the rare times I now masturbate, the erection is just not as stiff even up to maximum point of no return, it is still about 60-75% of what I would call maximum stiffness I used to once have.  Maybe this is just "normal" for a nearly 53 year old man.

3) Sensitivity:  I have noticed over the last few years, that the sensitivity and the intensity of the orgasm is certainly less than it was in the past.  Still very enjoyable/pleasurable, don't get me wrong. But definitely not like it "used to be" when I was younger.  But maybe my memory of the past is fooling me.

4) Ejaculate:  I have noticed that my ejaculate is probably about half the volume it once was.  I never had large quantity of volume even in my 20's.  I never noticed a reduction really even after I had a vasectomy. It was NOT something sudden, rather it was glacial slow incremental reduction.  and it is only now thinking back that it seems like it is a lot less in volume. I realize this really is probably no big deal in the bigger picture, and probably doesn't have anything to do with pleasure or duration/intensity of the orgasm (or does it?).  In fact my wife would probably say the lower volume is a good thing, as she has always been a little less than enthused about ejaculate anyhow. But again, it is just an observation I have made.

My questions are:

What is the difference between Viagra and Cialis? in terms of how they work and what they do and the benefits of one over the other?  Can a person use both simultaneously?

Can you become accustomed to, and thus one of both of these become less and less effective over time?

Does very low dose Cialis for example help and at what dose are you less likely to avoid your body getting accustomed to it and it become ineffective?

Can one or both of these drugs increase the sensitivity or intensity of the orgasm? Or are they both simply mechanical in nature to increase blood flow and thus stiffness, or erection quality, but do nothing to help increase sensitivity or intensity of orgasm?

Will either of these increase the volume of ejaculate, and does the volume of ejaculate have ANYTHING what so ever to do with the pleasure and intensity of the orgasm?

If I am not "failing to perform", then should I just leave well enough alone? or would adding one or the other of these drugs improve things enough to justify the cost?

Are there any other medications or supplements help to minimize the symptoms I am having besides going onto full blown TRT?
that doesn't make sense , like with a vericocele or something cutting off blood to the balls that results in lower T doesn't it ? wouldn't the inverse also be true ?
Testosterone, Hormones and General Men's Health / Re: Free estradiol
« Last post by Testos_16 on Today at 12:03:21 pm »
Thanks, that is a great spread sheet. I was surprised that the effect of SHBG changes is so small. Seems like low SHBG doesn't necessarily mean big problems through high free estradiol.
Testosterone, Hormones and General Men's Health / Re: Free estradiol
« Last post by Cataceous on Today at 11:29:27 am »
Download the free estradiol calculator referenced here. Later in the thread you'll see that the results correlated well with one guy's lab tests.

Even if the relationship between SHBG and free estradiol is fairly linear it's not one-to-one. A test case (TT=600 ng/dL, E2=30 pg/mL, SHBG=15|30 nmol/L) finds that doubling SHBG results in only a 15% rise in free estradiol.
I am VERY curious about your experience stopping the SSRI.

What was the process used?  What were the dosage(s) if more than one drug and which drug(s) were you on?  How long did it take to wean off of them?  What withdrawal symptoms did you have?

Reason I ask is my wife is dealing with depression.  She (and I) are very strongly opposed to ssri (srni). The counselor she is seeing is oK at this point, but told my wife she would discuss the opposition further with her if the counselor thought that ssri would or should be considered.

So we want to be ďarmedĒ with knowledge ahead of time. And while technically not addictive, the stories of severe withdrawals and multiple year battle to wean off of them, even some saying that heroin was easier to stop than ssriís, leads me to think that sounds like addiction to me!  A rose by any other name is still a rose.

Not to mention my wife already has extremely low libido and ssri drugs are pretty much known to kill any libido. We certainly donít need any more added stress in the marital sex department. As then I will become depressed!!!!
Testosterone, Hormones and General Men's Health / Free estradiol
« Last post by Testos_16 on Today at 09:39:59 am »
Does anyone know what is the formula for calculating free estradiol based on total estradiol and SHBG?

If two men have equal total estradiol but A has SHBG of 15 and B has SHBG of 30, does A have double free estradiol compared to B?

That's really good news. I'm sure getting off the SSRIs was not a trivial endeavor. I think it will be better if you try to focus on the future; we should remember our past mistakes but not dwell on them too much.

 Very wise words Cataceous!

Good for you Stepcurryftw, keep the momentum going.
That's really good news. I'm sure getting off the SSRIs was not a trivial endeavor. I think it will be better if you try to focus on the future; we should remember our past mistakes but not dwell on them too much.
Testosterone, Hormones and General Men's Health / Re: Low SHBG
« Last post by Testos_16 on Today at 05:23:56 am »
As an old saying goes, if you can get it hard at night, but not during the day it's all mental. The mind is a very powerful thing.

Are you in the US? I'm curious what testing you have available because you're using the wrong Estrogen test.

I am not in the US so that Estradiol test is all I got.

My understanding is that its usually younger guys who have psychologically caused ED. But ED could be due to chemical neurotransmitter imbalance as well, too low or high dopamine, etc.

Testosterone, Hormones and General Men's Health / Re: Low SHBG
« Last post by Testos_16 on Today at 05:06:32 am »
Thanks for your comments! I believe I have eliminated the usual pitfalls like high/low estradiol as I have tried many protocols and followed sites like this for years.

Latest lab free testosterone 760 (155-800) and estradiol 0.12 (<0.15).

My question is actually pretty fundamental so I try to rephrase it: If one gets consistently good morning wood can you conclude that he is hormonally balanced and that you need to look for the cause of ED elsewhere? My logic says that if you get morning erections then testosterone works as it should and your vascular function is allright as well. But does it really go like that?

I also have very low SHBG, it varies from 9 to 15, ED has been a problem however I doubt that it is related to SHBG but rather more the balance between T and E2.

If you are getting good regular normal nocturnal erections then that is generally considered a very good sign. I my self have found good/ strong libido to be the the largest factor in reversing ED once the T to E2 ratio is corrected. Increasing DHT is a very good way to improve libido and provided you dont suffer from male pattern baldness there are few negatives to increasing it.

I am still undecided what comes to role of low SHBG in ED. In the past SHBG was seen more as a volume regulator but lately I think more as a key transporter that is required to reaching correct places. It is also needed for storage during transportation as free testosterone has a short half life. SHBG also acts as a buffer to flat out fluctuations in T and E which makes TRT more challenging for low SHBG guys. 
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