The Erection Thread

[defmyst]

Hi All,

PSSD is a complex issues often times involving multiple different symptoms that may require different treatments. However, at least for me, the first and most important problem with respect to PSSD affecting guys is their ability to have and maintain an erection. The inability to have an erection or to maintain it will make it impossible for us to have proper sex and thus get into a relationship or even maintain an existing relationship.

Yes, PSSD causes low libido. Yes, we are not be able to or have a hard time getting an erection just thinking about sex (although I think most people on the forum reported they can get an erection from stimulation). Yes, we my have desensitized genitalia. Although this sucks, I am willing to live with this for the rest of my life IF I can maintain an erection and have the ability to maintain that erection and have proper sexual intercourse. As a single 30 year old guy, my BIGGEST fear is the inability to have sex with a woman which will make it impossible to get into a relationship or maintain one. I want to eventually have a family and kids and the thought of not being able to do this, because of this condition is killing me.

Therefore, in this thread, I want us to consolidate every supplement/drug we know/ or have tried that can specifically do 2 things.
1. Help us get an erection that is 100% or close to 100% similar to our pre- PSSD erection.
2. Make that erection last long enough in order to not disrupt normal sex.

[defmyst]

I don't know if anyone has done this before in the forum, but one thing I wanted to mention to you guys is that I am scheduled to get an ultrasound scan on my penis. The goal is to check for any blockage or shrinkage in the arteries that may reduce blood flow to the penis. Although I doubt this is the case, it is nevertheless something I want to check. I will write in this thread once I go through the scan and get the results.

[naiverat]

What have you tried?

These have helped me most:
- Naltrexone (~12.5 mg)
- PDE5i (viagra or cialis) - make sure to take it on an empty stomach
- Alpha 1 blockers (prazosin, doxazosin)
- Low dose of citrulline or arginine

Be careful not to end up with priapism

[defmyst]

Naiverat,

Can you please give more details with respect to how each of these helped with respect to points 1 and 2?

So far I have tried cialis (tadalafil) I am currently taking it 5mg per day. It helped me to get an erection somewhat. Before that I was not able to get properly erect. However, I cannot maintain that erection for long and I am not sure if that erection is viable sex-wise.

I have also started taking L-Citrulline (started about a week ago). I haven't noticed any improvement yet.

Also, my full erection post PSSD appears to be slightly smaller in length (i think). However, my penis definitely has smaller girth when erect. Basically it is less "fat" when erect than it was pre-PSSD. This was in fact the reason why I wrote point 1 above. Anyone else with a similar problem? Both with respect to length and girth of erection pre-PSSD relative to post-PSSD?

[naiverat]

Points one and two are really not so distinct, in my opinion. Usually bring able to get an erection and maintain it go hand-in-hand.

You can't really partition drugs on the basis of "getting" or "maintaining." All of the aforementioned drugs increase blood flow, either by increasing nitric oxide (NO) or reducing vasoconstriction (a1 antagonists help with this).

If you are unable to get an erection with PDE5is, I don't believe it's likely that any nitric oxide-boosting drug is going to fix your problem. You could look into direct injections from the doctor - those bypass the irregularities in all other systems.

It has been hypothesized that penile shrinkage (length/girth) is a product of androgen signaling issues, as these receptors are quite necessary to the structural integrity (and blood flow) within your penis.

[kpavel]

Have you read my post on sildenafil poor effectiveness? viewtopic.php?p=35047#p35047
Calorie restriction may help https://pubmed.ncbi.nlm.nih.gov/17627736/
N-acetyl-cysteine may help, I suspect.
My experience tells me DL-phenylalanine improves fullness.
Drug betahistine could be interesting to prolong erection, but that was long time ago.

[defmyst]

Points one and two are really not so distinct, in my opinion. Usually bring able to get an erection and maintain it go hand-in-hand.

You can't really partition drugs on the basis of "getting" or "maintaining." All of the aforementioned drugs increase blood flow, either by increasing nitric oxide (NO) or reducing vasoconstriction (a1 antagonists help with this).

If you are unable to get an erection with PDE5is, I don't believe it's likely that any nitric oxide-boosting drug is going to fix your problem. You could look into direct injections from the doctor - those bypass the irregularities in all other systems.

It has been hypothesized that penile shrinkage (length/girth) is a product of androgen signaling issues, as these receptors are quite necessary to the structural integrity (and blood flow) within your penis.

Do you have any other information with respect to that last point? Any treatment/supplements that can help restore androgen receptor function?

[naiverat]

Unfortunately, androgen receptor issues are quite difficult to treat. Have you had your hormones tested? If they are normal (mid - high), you may have issues with receptor receptivity.

I will be trialing high doses of testosterone with low doses of hCG in the coming months. Androgens typically autoregulate centrally, meaning the higher your hormones, the more receptors (and thus hormonal signaling) you have. Autoregulation may not function as it would in the "normal" person if the gene promoters are not working correctly to express ARs. I don't think we have enough data points to conclude how many pssd sufferers have receptor issues (if any - after all, it's all theory, though currently the strongest theory imo).

I'll be sure to create a daily log here when I begin my drug trials.

Good luck!

[Leb89]

Unfortunately, androgen receptor issues are quite difficult to treat. Have you had your hormones tested? If they are normal (mid - high), you may have issues with receptor receptivity.

I will be trialing high doses of testosterone with low doses of hCG in the coming months. Androgens typically autoregulate centrally, meaning the higher your hormones, the more receptors (and thus hormonal signaling) you have. Autoregulation may not function as it would in the "normal" person if the gene promoters are not working correctly to express ARs. I don't think we have enough data points to conclude how many pssd sufferers have receptor issues (if any - after all, it's all theory, though currently the strongest theory imo).

I'll be sure to create a daily log here when I begin my drug trials.

Good luck!

Any theory on having complete crash on cialis or tafalafil? Both meds muted my orgasm and killed my libido two times now. Since crashing down my ED got better still after stopping these two substances. But my libido, orgasm and emotions are worse than ever. Feeling stone cold all over, but can fuck. Feeling like a dead man fucking someone who is allive is so scarry!

[fbz]

Unfortunately, androgen receptor issues are quite difficult to treat. Have you had your hormones tested? If they are normal (mid - high), you may have issues with receptor receptivity.

I will be trialing high doses of testosterone with low doses of hCG in the coming months. Androgens typically autoregulate centrally, meaning the higher your hormones, the more receptors (and thus hormonal signaling) you have. Autoregulation may not function as it would in the "normal" person if the gene promoters are not working correctly to express ARs. I don't think we have enough data points to conclude how many pssd sufferers have receptor issues (if any - after all, it's all theory, though currently the strongest theory imo).

I'll be sure to create a daily log here when I begin my drug trials.

Good luck!

Any theory on having complete crash on cialis or tafalafil? Both meds muted my orgasm and killed my libido two times now. Since crashing down my ED got better still after stopping these two substances. But my libido, orgasm and emotions are worse than ever. Feeling stone cold all over, but can fuck. Feeling like a dead man fucking someone who is allive is so scarry!

It can be caused by too much NO if i'm not wrong. You should join discord channel, there are a lot of informations about crashes like this