T Nation

ED at 28 Years Old

Okay, I’ve pondered posting about this for weeks, but honestly this place seems as good as any to ask, considering I know a lot of people on here have struggled due to PED use and whatnot.

So I’ve always had performance anxiety, even when I was a teenager, it would take weeks before i was comfortable enough (and drunk enough) to have sex with a new partner. After that, smooth sailing. But that first time or two was always a pain.

Also abused the fuck out of dextromethorphan as a teenager and think that had some serious long term effects.

However, in my last long term relationship (8 years) I could catch a nip slip 8 years in and be ready to knock down walls. I figured I had gotten past it.

Well on to new things, I had a couple of partners this year with mixed results, ended up getting a script for some slidenafil, thinking maybe it was just more performance anxiety and it would give me a bump to get over that hill. Well. That shit certainly works, havent had so much sex in my entire life, but it definitely isnt performance anxiety anymore. I’ve been with the new lady for about 3 months now, and I dont always need it, but arguably more often than not, I do. The sex drive is there, I’m ready to fucking go, and it just doesnt happen.

Shes super cool about it, and I put in the work every night no matter what. Like I said, turned on, so we’ll have fun, just sometimes cant actually get it up.

Any advice? I’m pretty damn healthy. 6’3, 220lbs. Active at my job and in the gym, about as happy and upbeat as I’ve ever been.

Ive read about cialis, is the generic affordable with insurance, and uncommon underlying issues worth checking out?

This is super uncomfortable for me, but like I said, this board seemed like the best public forum to ask on

I know how frustrating it could be. And then you get it up and it goes noodle.

You want to switch to cialis even viagra working?
I personally take daily 5mg cialis cause I have sex more than 2x a week and want be to ready all the time. You can take an extra 5 if for example you have more action on the weekend.

Anyway, it can be psychological and you may not be able to pin point the reason.

I would do a cardio check up with a dr if you have not recently.

Also, maybe more info on medications you take esp new, and supplements, also are you on testosterone?

Maybe get labs to seeing where you are at.

Cbc
Lipids
Prolactin
Total and free t
Thyroid panel
Etc

1 Like

Yeah, definitely a bit frustrating. The Viagra works, but this girls sex drive is wild. I’d like to be able to go at the drop of a hat, not have to coordinate you know? Honeymoon phase and all that, its daily right now. Definitely some psychological I’m sure.

No testosterone, and no supplements currently. The most I take is some MRE meal replacement.

I guess it’s worth noting too, the last relationship ended with dramatic weight loss and loads of living situation stress, and like everyone else, 2020 has been a stressful year in general, so that could have some carrying effect.

But for sure, were in the slow season at my job and I do have insurance, so I’ll go get those checked out in the coming weeks. Havent been to a doctor for more than an ER visit in over 10 years lol, overdue anyways.

So for now you can try daily Cialis. And you can use GoodRx they’re very cheap I could get 90 pills for like $25. it’s okay to use that temporarily while you figure this out. Just take it and have a blast. And also if you take it on a regular basis you basically would get no side affects

I’m 43 but I actually plan on taking that for the rest of my life on cialis. I’ve read longevity studies on it and good things on it in general. Lowers your blood pressure a little bit etc.

Once in a while I may even take like 25 mg of Viagra just for fun even though I’m taking the daily Cialis. But it’s usually better to take extra Cialis since you’re already on that for that extra boost instead of the Viagra but you can try it out.

If you start thinking man I’m young to be taking this and you keep trying to stop it to see if it’s your d is working, It will not work as well and be frustrating.

maybe after a few months of taking it on a regular basis , then stop taking it and seesee if everything is restored.

1 Like

Yeah, definitely seems like a the drug of choice from what I’ve been reading. also some cursory research, the retail and markdowns are insane on the generic. I’ll probably sign up tonight and give it a go.

I’m not terribly concerned about taking it long term, doesnt really bother me. But it’s definitely something I want to get control over, and see if there are any underlying causes that this is just a symptom of.

I have been reading T-Nation for several years and just created my login today so I can help somebody to avoid going down the same road with bad advice. I strongly suggest to anybody with early life symptoms, you must find and seek out care from an Endocrinologist and get your proper blood work done. At age 43 I went on T-replacement after seeing a Urologist and having testosterone levels of a 90 yr. old man, total T level was 91 !! The downhill slide to E.D. hell was beyond even T-replacement, only 2 years later I finally find it’s due to Prolactin being 250 times the high range for a male, normal is 3.7 - 17.9 ng/mL, mine was 683 ng. That led the Endocrinologist to immediately schedule my MRI and find a Prolactinoma, which is a small benign tumor (lession) growing on/near your Pituitary gland. Unfortunately mine was large, 2.5 cm. and wrapping around my carotid artery, which supplies blood to your brain. Without consulting a surgeon it appeared to be an inoperable condition. Regardless, there is a medicinal approach to reverse that condition. Since finding this in Aug. I have been on medication (cabergoline) to shrink the Prolactinoma and my Prolactin is now down substantially, it’s only twice the normal level, and Testosterone is 297 which is just below the low range… not great but FAR above and beyond where I was headed. I had to stop TRT to get accurate blood work and begin this Prolactinoma treatment protocol. I feel outstanding and my normal hormone levels are becoming evident in my libido. Sex was damn near not even of interest anymore prior to all this being properly addressed and squashing my Prolactin levels, as it robs your body of the ability to produce Testosterone naturally. Soooooo anybody reading this, please see the right doctor, not your family practitioner or a Urologist. Find an Endocronologist that is doing a FULL hormone panel and finding the root cause of a high/low hormone issue. You are far too young to be living with an unknown and masking it with E.D. meds to get over the “hump”. I lived that for 8 years, until I found a doctor that wanted to address the issue properly. Learn from my mistake, it is far easier to explain all this at a doctor visit than to your wife or girlfriend why your not performing up to par routinely like you know you can or used to. The worst advice I ever received was a Nurse Practioner at my family practice told me at age 40 there is no way you have low Testosterone, so here is your bag of trial packs of Ciallis. I thought that was my life, take meds. to get the plumbing in tune (I hate taking it for the side affects on me). Then next worst advice was jumping on Urologist proposal for the TRT replacement plan without proper hormone panels being done. Which seemed awesome for awhile. Then allowing my newer family practitioner to take over the treatment plan. Three under-educated physicians / med-professionals led me astray from addressing a life-altering condition that could have really had severe consequences on my life. Today I am hoping to educate others that are also shying away from addressing their real underlying cause of low-T or “hypogonadism” as it becomes classified when your basic blood work show low T levels.
PLEASE GET THE PROPER BLOOD WORK DONE and find a doctor that doesn’t prescribe a box of Bandaids for a real life altering issue you’re living (in hell) with.
Do your own homework on actual medical websites, do not take advice to just take a pill for your libido or inject replacement hormones if you haven’t exhausted all tests to find your underlying issue.
There many reasons that can be present for hormone level condition problem, but don’t let a major underlying health condition go unfound because of taking bad advice ! I did for too long due to seeing the wrong doctors and reading about how TRT is a good thing when levels are down.

3 Likes

I really appreciate you taking the time dude, seriously. I’m aware it’s not normal, and I definitely plan on taking your advice and following up through the proper channels. Especially considering aside from some stress fatigue from this year that I’m about as healthy as I can get. I feel like a million bucks, I’m a healthier weight than I’ve ever been, I feel strong, and generally life is on a huge upswing for me, so I’m definitely concerned there is something else up.

I’m looking for an affordable bandaid in the meantime, because I seem to avoid all the bad side effects from slidenafil short of stuffy nose and very light flushing, and there doesnt seem to be any long term side effects that are well documented.

However I definitely will be seeking the proper channels to see what I can find out. I may have more questions as work frees up and I can find the time. I havent been to a doctor in a decade and I’m pretty inexperienced in where to even begin. I really appreciate it again.

Cialis daily. At 5mg a day you shouldn’t get headaches or flushing and you’ll be ready to go any time. If that isn’t quite doing it then 10mg can be done, but it takes time to not get headaches. I have zero ED issues but still like to take Cialis just because it’s pretty much harmless (unless you have existing low BP) and it works great.

1 Like

I get the worst migraine headaches on 10mg Cialis daily, to the point where things are looking dire. I am on 5mg Cialis daily and I feel better in every way when taking it, however it doesn’t make or break erections.

It’s been said people with metabolic disorders especially diabetes should be on it regardless if there is ED.

1 Like

Sorry to hear about this happening to you with your particular urologist. However, your advice is misguided, especially when it is applied to the typical TRT patient. I think it would be better to seek out care from a TRT or HRT practice.

First off, prolactinomas or pituitary microadenomas are not all that rare, or particularly common either. They are more common in women. However, off the top of my head, I don’t recall the exact odds, but if it is 1/1,000,000, it really does not matter to you if you are the one, does it? In my practice, I’ve seen at least five, but not more than ten. The odds are greater than if we sampled the general population because I see guys with signs and/or symptoms which could be the result of some type of hormonal insufficiency, therefore be at increased risk of microadenoma.

The typical TRT practitioner will begin by ruling out conditions such as yours, probably in the initial workup. Most of those here on tnation, and those presenting for TRT, are “normal” with “within the range” testosterone levels and will not get any help from an endocrinologist. I know some of them, they have no interest in treating low testosterone. I should say in range testosterone. They are interested in treating prolactinomas.

However, I also know some endos who are very interested in treating TRT patients, and actually have BHRT practices. Some urologists as well, the bulk of their practice is TRT. That is the urologist you want.

I think your advice to find the “root cause” is sound, regardless of the age of the patient, but yeah, 28y/o with ED points to a health issue beyond low normal or mid range testosterone levels. Often, the cause of lower levels is not found, and we can only speculate.

For anyone reading this, again, I believe the best advice is to find someone who specializes in TRT or BHRT. By that I mean one who only does that, not diabetes, not renal disease, bladder or prostate disease, etc.

2 Likes

Great advice. Even though the endocrinologist may not know trt they can investigate other issues that are in their ball bark.

Before you get to a good confident position, you may see more than 1dr.

I went to 2 endos and 2 urologist before I got resolution. But I feel good that they each investigated possible causes. A TRT clinic I believe should not be anyone’s first choice.

Each specialty has their own view on how they look on something. And that’s useful for a patient. They usually run their own set of labs and order different diagnostic tests.

2 Likes

I’d get the blood work.

But seeing as your libido is great, i’d be more apt to treat with just some daily cialis and citrilline.

TRT can affect your libido, sometimes wipe it out.

Step one should be daily cialis and see if that gets things fixed. Sometimes i just think some people produce too much of the PDE5 enzyme. OR, nerves somehow affect the release of the enzyme.

1 Like

Yeah, this year has definitely been the most taxing of my life, as far as stress goes. I’m not super worried about the longevity of this to be honest, I think I’m just stressed way more than I’m accustomed too, and its rearing up in a way I specifically would rather it not.

So far Slidenafil has worked like 95% of the time, and usually multiple times per day. And the libido is definitely 100% there, with or without it. Which leads me to think there is probably something underlying that I need to get looked at, even if it may just be related to stress in general. I would just like to not have to worry about the day to day in between, and I’m sexually active enough to justify daily cialis, because the slidenafil is expensive as hell in comparison.

Are you in the USA? Did you check GoodRx they’re both very cheap you just need a prescription

1 Like

Thanks for your quality insight and respectfully I’m sharing my “patient opinion” due to my experience. I absolutely don’t want to lead anyone astray from getting proper care for himself. I did not seek out a TRT clinic for my issues, I sought out a reputable Urology physician to diagnose my male E.D. condition and advise me on an appropriate treatment plan for my health condition. I was not sure if my vasectomy had physiologically caused my E.D. or if it was something else I was oblivious to.

I unfortunately found the lazy physician that based on numbers in basic labs offered to write the script for recurrent visits and a good chunk of revenue when the patient returns every 3 weeks for an injection. I chose self-administered TRT and had routine lab work done for the same basics. Saving a great deal of money doing self-administration, it was satisfied to continue for almost 3 years. I felt good but low T was clearly a side-affect of my prolactin being insanely high.

Not catching that before writing prescriptions for TRT is inexcusable in my opinion, I’m a patient that expects a medical professional to be thorough with life altering conditions. I asked for more thorough labs from my primary care practitioner several times before I finally got in to the Endocrinologist I am thoroughly impressed with. I have spent countless hours reading and researching trying to make sense of my continuing issue when my testosterone levels were in the 900+ range on only 200ml of cypionate per 3 weeks.

Although I played with splitting the dosing up to avoid the roller coaster ride, and even against advice did sub-Q injections to avoid any estrogen spike inflammatory response condition. I feel like each an every guy that is battling E.D. or low T is potentially fighting his own unique battle, and each of us may cope with it better or worse than others. Hormones are life changing when they are off the charts in any direction, so all I can say to anyone seeking advice or providing advice, is please be aware that a lazy physician not being thorough is potentially dismissing a life altering condition or life ending condition.

As for that stats on prolactin producing adenomas, through my reading I understand it’s 1/10K males. I’m just one example of an underlying issue being overlooked and with appropriate care I am returning to a point where I feel TRT may not even need to be a component of my life once the prolactin is within normal range. However, I am not opposed to continuing TRT, it’s my absolute “patient opinion” recommendation if you’re a male and just do not have the natural production occurring due to an irreversible condition. If my T level doesn’t naturally reach a moderate level I will definitely be back on board. I’m glad to know my Endocrinologist is agreeable with that plan, thus far in my journey I found that not all Endocrinologists agree with TRT.

1 Like

Can you create some paragraphs. Or just have an empty line after about 6 lines. It’s hard to read now

1 Like

Of course, nothing wrong with that. We are all a product of our unique experiences. I did the same thing you did, coming from my own experiences and biases.

Yes, absolutely agree. Everyone gets prolactin checked in my practice.

Yes, and it can be frustrating for some. Those are guys on the internet with crazy stories like yours. Thankfully, it worked out for you.

Yes, about 1/10,000, but look at it this way: Take 10,000 men at random, how many of them may be experiencing low testosterone symptoms? I honestly do not know and more and more guys are using TRT, but lets say one out of ten are experiencing symptoms, which makes it even more inexcusable to not check this out in a hormone practice. Prolactinomas are discovered for other reasons than searching for a cause for low T, headaches, visual disturbance, etc., but still, I think my point that the incidence is increased in a TRT practice is valid.

Don’t count on that. Some of the guys I see need ongoing treatment, like cabergoline, some do not (except for the test), one had surgery. However, my sample is biased as if they are in my office, they are having low T symptoms and if they are patients, they are responding to testosterone. A guy with a prolactinoma without low T symptoms in not showing up to see me.

1 Like

Thanks again for taking the time to share your educated perspectives and valuable experience! I understand I’ll be on the cabergoline for a couple years. If I do resume TRT, at least I’ll be reaping the benefits once the prolactin levels are within healthy range. I only wish I knew how long that the adenoma has been present and causing affliction. The primary MRI caught it at 2.5cm.

Are you saying you were only getting 1 injection every 3 weeks?

Circling back around with some (unimpressive) updates.

Got on Cialis. Doesnt do jack shit for me. Even at 20mg I can get like half hard but I’m just pushing rope. With a nice side effect of blueballs like I’ve never felt before.

Interesting side note though. I had 1 20mg Sildenafil left, and took it one night as a test, thought I was going to rip a hole through my shorts. 1/3 my recommended dose was incredibly efficient.

So I think I’m just a non responder to Cialis.

Also leads me to believe, for better or worse, this has just become way more psychological. Between the blueballs and the super low dose of Viagra working so well.

Also had a small bit of depression and a freak out and officially opened up to my gf about all of it. Shes fucking awesome and took all of it really well. So were scheduling a visit to a urologist and an endocrinologist shortly. Well see what happens :man_shrugging:

Edit*** I dont think this would have bothered me so much if it weren’t for the fact my libido is through the roof, that’s as frustrating as the worry for her satisfaction. Yeesh.