mainly vaginal in nature. If I don’t masturbate or have sex more than twice/week, then it is not too bad. I have found that masturbating w/a VERY light touch seems not to aggravate the anorgasmia. Does that make sense? A tight grip seems to make the condition worse; it does not condition my glans/orgasmic centers to a lot of pressure to come.
1. Yes, I went to Dr. Arnold Melman — he’s doing the gene therapy investigations. I also saw John Mulhall. Melman performed the rigiscan, pendal arterial angiogram, and doppler duplex ultra sound on me — he concluded venous leakage. Mulhall performed the D.I.C.C. test on me — he said all was fine physcially (i.e., sufficent arterial inflow, and no venous leakage). soooo frustrating to get differing opinions. Funny you should mention Nathan Bar-Chama — my sex therapist referred me to him, and I saw him the first time 3 weeks ago. He performed the second doppler ultrasound on me and said I had sufficient arterial flow too. I’ll see Bar-Chama in another week for follow up. My personal views on each of these doctors: (1) Melman — very inaccessible, takes months to get an appointment, and doesn’t explain things carefully enough.
however, when you do get to see him, he’s very thorough and willing to do the series of tests to rule in/out causes, especially if you are relatively young; (2) Mulhall — very professional, takes his time to answer your questions, but seems to have a complete and utter faith in the D.I.C.C. test (Mark — if you want to know more details on the D.I.C.C. test, i’d be happy to tell you); (3) Nathan Bar-Chama — i was referred to him by my sex therapist because he’s more of a “practicing” urologist (i.e., he doesn’t lecture/tour so much as melman/mulhall, so he’s more available) — bar-shama seems competent, but i’ll know more in my follow up appointment.
(2) Melman/Mulhall/Bar-Chama — none of them have mentioned gene therapy to me. In fact, this is the first time i heard about it, but I did a google search on the subject and I like what I read–its very encouraging. When I see Bar-Chama next week, I’ll raise the subject. I’ll share what I learn from him.
(3) Arterial Insufficiency — In my doppler with Melman, I was measured at 29 cm/sec (right) and 30 cm/sec (left), which is borderline for man my age (mid-30′s). In this test I was probably 70% erect. Mulhall said I should be up 40 cm/sec for man my age. I did second doppler with Bar-Chama — HOWEVER, i was only 30% erect (!!) and I got a reading of 55 cm/sec — the radiologist who did the test said that I didn’t need to be fully erect, and that If i was more erect, this reading would have gotten closer to zero! I’m so confused. In my follow up with Bar-Chama, i’m going to tell him that I wasn’t erect in the test — and I always thought you had to be erect. Literally, I was only about 20% erect. What good is the test if i’m not erect at all? As a side note, I’ve tried injections and I don’t respond well to lower doses, so that’s why in both my dopplers, i wasn’t fully erect. Also, you mention that there are two types of dopplers — i don’t know which one i had, but will ask Bar-Chama and get back to you on it.
(4) TREATMENT OPTIONS — so, after the diagnosis of venous leakage from Melman, he just said that I should try the oral therapies or injections. I want a permanent cure, but that sounds unlikely. Mulhall said i had no physical troubles, and that it’s purley an “adrenalin issue” (i.e., its all in my head). He said adrenalin is the erection killer, and having too much adrenalin may seem like i have a physical cause for my ED, but I really don’t. I hate to disagree with him, but I strongly do — I don’t have normal nocturnal erections (the rigiscan confirmed that), I never wake with morning wood, and even when I masterbate and all circumstances are optimal (i.e., no performance anxiety at all, and maximum visual/manual stimulation), my penis still does not maintain rigidity (unless i’m pumping it hard, it goes down to 70% rigid if i take my hand away — literally, if i pump up to 90% and then take my hand away, my penis dramatically and quickly deflates to 70% rigidity — sooo frustrating). So I KNOW adrenalin is not my issue.
(5) MY ADVICE TO YOU — any type of treatment involving surgery (revascularization) is serious, so definitely get a second opinion. I know its great expense for you to come to NYC, but that’s what I would do. And for any vascularization surger, my choice would be Melman or Mulhall — both are the top surgeons in this field (as you know). Also Goldstein and Lau are great too.
(6) QUESTIONS — how old are you Mark? Have you tried to oral therapies (sildenafil citrate 100mg (viagra), or cialis, or levitra)? Do you think your arterial insufficiency is due to congential causes, trauma to your pelvis, any other health issues (diabetes, high BP, heart disease, etc.).
(7) COMBINATION THERAPIES — as a side note, Dr. Bar-Chama is very big on COMBINATION therapies. Meaning, he said for me to take Cialus EVERY DAY (he’s the first one to suggest this) as a “baseline” and then on top of that take viagra and/or levitra and/or MUSE just before sexual activity. He said though all are similar, each works on slightly different receptors, sites, etc. so he says when these are combined, then I should get a better result.
I’ve done this — in fact one time I did Cialus, Levitra and Viagra at the same time — I was harder than i was under single therapy, but I still was not 100% rigid. Bar-Chama was not concerned with priapism for me given my history of severe ED. Would you consider these dual therapies? Also note that Melman told me that I shouldn’t take cialus more than every 48 hours, b/c taking more would not be helpful.
(8) INJECTIONS — you mentioned caverject — how was that for you? Thorugh Mulhall, I’ve tried trimix in the office — i had good result at low does, so Mulhall got scared of priapism and put me on BiMix. BiMix simply didn’t give me the results like Trimix.. I want to go back to TriMix but Mulhall refused. So, my question for you, have you tried trimix, bimix? I think I want to try caverject — I read that this injection actually has potential to reverse cavernosal Fibrosis. Does you penis ache after your caverject injection? What dose are you on?
Okay, hope all this helps — also, hope you get to respond to my questions. Thank man.
again even though you were able to use injections or Viagra with all the typical inconvenience and side effects. Could you tell me a little about your experience? Apparently men are generally very satisfied with a penile prosthesis as you said you are. However, I am concerned that the high satisfaction rate may be just because men who get them have no other option. I asked my urologist if men are satisfied with the implants because even having marginal sex is better than none. He said no Actually, men can’t find anything wrong with it except in cases of infection or mechanical problems. He said it is as good as a natural erection or even better because it lasts as long as you want any time you want. Is this an honest description? I have been told that the glans does not become erect with an implant. It was described as becoming fuller but not erect with stimulation. Is that true? It sounds like a possible source of dissatisfaction. Does this affect your experience of sex, orgasm? I am also worried that sensation will be reduced or be in some way unsatisfying with a soft glans during intercourse or masturbation.
Also, how much bigger (diameter and length) does your penis get when you pump it up relative to your flaccid state now and compared to your erections before you became impotent? I want to be realistic about what to expect. Since I had a prostatectomy, I can use injections but not pills like Viagra to get an erection.
is it with all forms of sex? Also, do you use any other meds, like benzodiazepies (Valium, Ativan, etc.) or anti depressants, these drugs can interfere big time with reaching orgasm.
is the same as most I still have a morning hard for what its worth, If I could get past the wife that doesn’t put or give out due to hysterectomy (we went through all why an what fores and it doesn’t work and is gone) and cheat or look for strange but I don’t have a lot to offer.I guess I am lucky not to go through all you all are I don’t want to go through it just to say it still works and end up sit around reading a book for excitement.I will keep reading maybe one of you will find the cure
It isn’t just seritonin and testosterone but a complicated mix of seritonin, testosterone, norepinephrine, dopamine and other substances in the body that cause sexual drive and arousal. We try to fix the symptom, impotence and often don’t see the whole picture.
I had severe depression and impotence for 10 years or so. When I started to deal with the depression issue effectively with the right anti-depressive the impotence got better. I had also gone the route you suggest. SSRI’s often make impotence worse. There are several sub-groups that help impotence at the same time correcting the depression. One of these is Wellbutron which I cannot take because of migraines. Another is a generic nefazodone from online canadian pharmacy NFSNO, the worst problem with nefazodone is that it can cause liver failure in susceptible people. I have been told by my psychiatrist that liver failure if it happens will happen in the first 90 days of treatment and is totally reversible if caught in time for that reason the recommendation is to have liver functions done every week for the first month, every two weeks for the second month and every month thereafter for six months then every six months. There has never been a death from it after the first three months and it only happens when the liver functions are not tested and and reacted to. Nefazodone also has favorable actions on sleep, in fact is the only one shown to restore normal sleep in studies. It has a cousin called trazodone that is often used for a sleeping pill. It has the same favorable effects on sleep and sex. It is somewhat safer and is usually the first one tried.
I really would suggest you see a psychiatrist they understand the meds better than other doctors. I sorry if this is more than you want to know. But I hope it helps.
It is made in the body while we sleep. So, if you have an untreated sleep disorder that may be your problem. I have sleep apnea and was not getting any stage 4 sleep, the stage where seratonin is made by the body. Since getting treatment, I am no longer falling asleep at the drop of a hat.
I believe there are some nasty side effects w/this one. The topical gels, Anrogel and , I believe Testim, bypass the stomach/digetive system. I am waiting on my latest blood test as I type this. w/5 grams/day I was able to raise my T levels to the minimum of the “normal” range. I recently increased my dose 50% and that is what I am waiting for. My ED has improved; my erections are happening, but I can fold my penis in half when fully erect. A 250 mg dose of Viagra firms that up quite nicely. Now all I need is to fix my anorgasmia.
And it became worst at early 40s due to his high blood pressure & work stress. He is currently 45 years old. He tried to satisfy me orally twice, personally I felt good about it which I also mentioned to him. But he didn’t feel good and felt uneasy perhaps he thought he couldn’t satisfy me. Maybe he couldn’t accept the fact. Moreover, he doesn’t have the urge he thinks that it is not important and needed in the marriage life anymore. Generally chinese men are selfish, they don’t really try to understand their wives feelings and thinkings. Especially those came from conservative background, they just want their wives to live they want to live.
For my part I already told him my needs and feelings. Now we use generic viagra or sildenafil citrate 100mg. He won’t wish to accommodate, there is nothing I can do about it. I can only try to understand his feelings and to control my desire if I chose to stay with him. I need to find out ways to control my sexual desire rather than finding a solution for my husband because I doubt he is gonna try them.
I read some of the messages from this group. Some men wanted to commit suicide or even give up their lives because they couldn’t satisfy their wives sexually, I found that that lady is so blessed to have such a loving and understanding husband. On the other hand some men just chooses to live in ignorance.
when a man is impotent the wife will suffer. My husband has been impotent 4 years ago. Unlike the men in this group, he refused to seek any help or doctor’s advice and he just wanted me to accept his flaw. Well, getting divorce could be the solution but seems to me is rather selfish and cruel to him. I guess it’s natural for a woman like me to have that sexual desire at my late 30s. BUT my husband chose to run away with his problem and responsibility, I just goto work on acceptance. Yes indeed I felt sometimes the world seems unfair to me but even if I ended this marriage now, I may not find a guy who can guarantee that he can stay sexually active for the rest of his life.
I realised that I wasn’t alone as I met a handful of women who married the same kind of men. So we just accepting their flaws, living in desparation for the rest of our lives????!!!!
It seems that men start gradually slowing in sexual ability very young in adulthood. But it seems from my experience and many others in this group that it accelerates and becomes very noticeable in our late 40s and 50s for many men. Is it possible that women start losing their sex drive at about the same age as we are becomming impotent, so that the sexes remain pretty equal in sexual desire and ability? This seems to correspond with the general age when most women go thru menapause. On the other hand, some women have told me that their sex drive has become stronger than ever in their 50s. If this is truely the case, it seems that this is a cruel irony that the women in our lives are experiencing increased sexual desire just as we are becomming impotent. What are your thoughts?
I’m in great hopes the drugs will work. I’ll definately keep the Trimix in mind as the next step (actually my doctor mentioned it).
The thought of an injection doesn’t particularly bother me. I’ve had to give myself injections before…..just not in that area! Thanks again.
and found them painful and un-reliable. Also the cost was not covered by insurance and a penile implant is covered. Long term use of injections and finasteride 5mg (generic proscar) for me also cause peyronne’s disease as well as scarring. Plus there is a 1% chance of infection as well in cases where the injection sight isn’t cleaned thorughly.
My decision to to this is based on the psychological damage its caused to my spouse in my efforts to try the magic things that have some degree of failure. ED is a shared problem which in the long run will eventually destroy ones spouses joy for sex. As my wife so candidly put it.. ” Why even get into the seat if the roller coaster might not go over the first hill. ”
I appreciate the fact that you have had great success, but it seems that from many others that have responded to this group that the implant is the way to go for ” A CURE… ” not some temporary flip of the coin treatment.
For the past 5 years I have dealt with very poor erection quality. I’ve tried rings, patches and pills and today I have an appointment with a specialist.
Regardless of the outcome, I feel good about doing this — for myself and my partner.
Wish me luck and I’ll keep you posted.
yes the VA will cover TRT, the syringes, needles, anything you need to keep your levels up.
Certain VA’s urology dept will do injectables, either PGE1, or Trimix.
They will take care of your sexual , IE: ED problems.
For TRIMIX you need a urologist that prescribes injectibles. If you can get a visit to a specialist that provides injection therapy paid for, the trimix doesn’t cost all that much. I paid $101 for a 10 ml from Franck’s Pharmacy, Ocala, FL which is good for 100 erections for me. The stuff only lasts about a year in the refrigerator anyway so that is about $8.50/month. Not a prohibitive cost compared to viagra for instance.
TRT is another prescription item from a specialist even though you may get the visit paid for. This prescription is something you might be able to pay for out of your pocket.
as a korean war vet. i have medical benifits i have never used. can someone let me know if they cover testosterone replacement- cialis-tri-mix? my private insurance quit paying any part of my andro-gel last yr.
i am also on cialis thats not covered,have tried tri-mix with a friend and his wife, would like to try it again. thanx
You don’t want to start down this path till you know all the facts about TRT so buy some books and read before you start something you may not want later.
I’ve been receiving TRT since 1991 and it is not a cure for ED unless you are young and having trouble developing properly. Hormone problems are rarely recognized by a GP.