T Nation

ED Medication Ineffective with TRT

Ive been low T symptomatic for years but dr unwilling to treat as TT was 240, but did prescribe Cialis for ED symptoms. Aside from being $220 per 12 pills, the Cialis has worked ~90% of the time.
Fast forward a few years and trt was started; TT is 800, E2 46.
But ever since starting TRT, Cialis no longer works (100% of time). My hope was to not need Cialis at all let alone pay for trt which doesn’t work and Cialis which doesn’t work

The TRT may be throwing off your hormones which may effect you ability.

Try levitra generic, it may work better.

Use goodrx for drugs.

@rabbit_ears - I just used good rx, as mentioned, and paid $34 for 90 5mg generic Cialis (tadalifil). Unreal how well it works.

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I get a compounded combo of 100 count with each pill containing 20mg Cialis / 10mg Viagra for $200 which includes the telephone prescription and shipping. I have them for in the future when I use drugs that make it hard to get an erection. I don’t need it at all currently but I took one just to see and DAMN does it work good for marathon sessions. It also seems to give me a good pump in the gym making my muscles look more pronounced. I know I can get it cheaper but don’t feel like actually going to the doc.

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Add citrulline to your diet. Cialis works off NO availability in the body.

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If you are having problems with erections on TRT and not as much off, you have not optimised all hormones. Some guys are sensitive to hormone swings and don’t respond well unless hormones are more stable.

You could be sensitive to estrogen and not so much to testosterone, injecting smaller doses with greater frequency can push Total T higher and estrogen lower and may be exactly what is needed.

I have found that if estrogen is low or high erections become more challenging and might even have ejaculation issues.

TRT can deplete you of other minerals and vitamins as well, all it takes is one.

@bcostigan41 you ever try l citrulline with the Cialis? I didn’t but might want to for fun.

Yes sir, I have. This was my pre-work out stack while I was intermittent fasting, since none of these broke a fast:

L-Carnitine 4g
Beta Alanine 3g
Citrulline Malate 4g
Pink Sea Salt 1/4tsp

I honestly don’t think it made a difference for me when I was taking that stuff. I could be wrong though, since I haven’t taken that stuff in a while.

Could be worth a shot though @charlie16 to see if it does anything for you. In a side note, I totally think the pharma tadalifil is better than the compounded stuff I was taking.

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I take an extra 5mg on Thursdays…

I wonder if I wasn’t taking enough.

Are Thursdays your fun day? Do you notice that extra having an effect?

Oh yeah. Throbbing when trt is right with the extra Cialis.

My Cialis dose is 20mg, even double dose does nothing.
I take at least 6g of citrulline daily with pre-workout for gym pump.
I do inject 20mg cyp daily.
Just confused and frustrated since I started TRT to alleviate ED symptoms and it has made a treatment that used to work now ineffective.
I remain optimistic that things will turn around. But so far I feel absolutely no benefits or positive effect of TRT (almost 5 months in)

What else are you taking other than testosterone?

Just saw your other thread. Try to stay in one thread. It gets confusing to follow your stuff and you get less help

Looks like you were taking an ai? Did you stop it yet?

I have had the same issue as you. I’m working my way through it but it’s slowly getting better. I’m suspecting my body is not used to estrogen in the forties compared to the teens pre trt.

I have stopped AI a couple weeks ago and switch to daily injections instead of weekly.
No HCG, only other med is dhea daily but I can’t remember the dosage at the moment (one capsule daily)

I would Stop dhea as well until you dial in. Need to give a few more weeks to see how you feel.

DHEA increases estrogen, the other issue could be that levels are low. You just changed the dosage a couple of weeks ago, 6 weeks to a stable state, then you body has to actually start using the hormones.

The common complaint from some people with thyroid problems is it feels like their injecting water. The fact you don’t feel anything, no negatives, no positives, nothing, suggests a look at thyroid hormones may be appropriate if your levels are good and you still feel nothing.

If you’re going to test thyroid levels, I would go ahead and add cortisol as well.

  • TSH
  • Free T4
  • Free T3
  • Reverse T3
  • Thyroglobulin Antibodies (TgAb)
  • Peroxidase (TPO) antibodies

systemlord’s constant terrifying fear of estrogen continues. It’s all false, just like most fears which oftentimes have no basis in reality. Doesn’t matter how many videos he’s seen with doctors who he respects confirming to not worry about estrogen. We keep providing the research and he keeps fueling the fear.

Contrary to what is being said here, don’t worry about estrogen.

TT is 800. Big deal. Most importantly, where is your free T? I’ll bet it is insufficient. I’ll bet you didn’t even measure it because you’re too concerned with total T (which is pretty much irrelevant as is estradiol).

You have provided zero info about your protocol.

Increase your dose, regardless of what it is. Cialis doesn’t give you sexual desire. Testosterone and estradiol give you sexual desire (you need both).

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You need to know total t to know that your free t is where is should be.

Your solution always seems to be ‘increase the dose’ its just not that simple. Yes that may increase free t, but it doesnt change the ratio.