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Old 01-19-2009, 05:57 PM   #1
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Male sexual problems. Way too young!

Hey everybody, I am new to this board but I would like some advice on some disappointing sexual problems that I've been experiencing for at least the past year.

Health Background:
21 year old male
6'5" 220lbs
Non smoker
Social drinker and occasional pot
Consistent exercise consisting of resistance training and cardio. In good shape overall, but I do seem to have high blood pressure at times (140/90) which is being treated with an ARB drug (just started a few weeks ago).
Severe e-coli hospitalization at age 13
Taken two courses of accutane for severe acne, the last one ending spring 2007.
I have experienced depression at times but have never sought treatment.

To cut to the chase, I have experienced varying degrees of impotence for at least a year, although I have reason to suspect that this has been going on for much longer. The problem came into plain view after I began dating my first girlfriend about a year ago, and I could not get an erection. We blamed it on nerves and booze and things seemed to get better afterwards, but I still could not get more than 75% of a quality erection and it took lots of work to get it up to that point.

Now after a few months and a little digging on the internet about erections, I made a strange discovery: I don't get morning erections like I did when I was younger. In fact, it had been so long that I forgot what they were! If I get them now, they're so weak that I don't even really notice. I remember when I was a young teen I had to wait for them to go away in the morning so that I could pee.

Fast forward another few months. I find myself in the urologist office with a levitra sample. It worked extremely well! but I'm 21 and that seems like a superficial treatment for something that must run much deeper. I wish that he had probed deeper into the nature of my problem rather than throwing expensive pills at me that I can't afford anyways. And at this point I began to realize that even during masturbation I was running into problems keeping it up and could remember losing erections as far back as 2 years ago.

So, last week I went to my family practice doctor to sort out what's going on. He gave me a lab order including total testosterone, which came back normal with a total testosterone level of 590ng/dL. (ref range 300-800 or so I believe).

I haven't told him this yet, but my problems have sent me into a spiral of deep depression and confusion regarding what's going on with my body. I can take the drugs, but I'm far too young and (supposedly) healthy for that. Sexually, I feel like an elderly man trapped in a 21 year old body. My libido feels like it's waning to the point that I can get off 2-3 times a week and be able to get maybe 80 percent erect with a lot of work (intense direct stimulation that you would never get from normal sex), but it seems as if any sexual activity beyond that will completely zap my libido and erectile capabilities. I suspect an abnormal hormonal problem, however my testosterone results are confusing.

What I need to know is.. (because I know people on these boards know more about this than a lot of doctors)

What medically should I do next? I have a follow up appointment next week. should I request to see an endo?

If my free testosterone ends up being normal as well, could any other hormones be killing my erections?...nighttime erections too?

Does anyone (males) here with sexual dysfunction have experience with Bupropion? I here it can help with sexual dysfunction....and depression...and people with both (like me at this point)...so maybe I could knock two birds with one stone.

Thanks in advance and sorry for the looooong post!

 
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Old 01-20-2009, 12:28 PM   #2
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Re: Male sexual problems. Way too young!

If you don't get morning erections, it is physical, not psychological. There is likely some damage to the blood vessels supplying the penis. It is easy to do...bicycle riding can cause this. It can be corrected, surgically. This would be the first place I would have tested.
The second is hormonal balance. I would see an endocrinologist for that.
Remember, you are the consumer of health care, and you are paying for it. If they want to give you levitra, and you want to get at the cause, call them on it. You would if it was a store, or a restaurant. This situation is no different. Best of luck with it.

 
Old 01-21-2009, 12:29 AM   #3
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Re: Male sexual problems. Way too young!

You're not the only one. I'm still trying to figure out the similarities and differences between our cases, but check out some of the posts I've made. donyaboi is another. The mental confusion, depression, and lack of sex drive are associated with low testosterone, thyroid malfunction, as well as other things. I've also read stuff on here about lingering e-coli infections causing problems.

I just made contact with a urologist for the first time and hopefully will make an appointment soon, but I tend to think it's an endocrinology issue.

Keep me (and the rest of us) posted. I'm surprised how many people have been having this problem.

 
Old 01-21-2009, 12:32 AM   #4
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Re: Male sexual problems. Way too young!

By the way, I'm on bupropion for depression (like you, it was a confusing spiral downward for me). It's helped with the confusion, and I highly highly recommend it. After the first few weeks there's a definite improvement mentally and emotionally, but there has been no effect on the sex drive for me.

 
Old 01-21-2009, 02:16 PM   #5
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Re: Male sexual problems. Way too young!

Hello and thank you for those who have posted.

I have a lengthy post that may shed some light on ED for a few of you out there. The first part is a philosophical rant, the second: a scientific discussion.

Part one
My educational background is biochemistry and biology, and recently I have been searching all legitimate scientific outlets for information regarding the pathology and treatment of this condition. Let me preface the following by stating a basic biochemical principle: all physiological and psychological realities of a given organism (including us humans) are governed by a complex mosaic of chemical interactions. The fact that we are here alive, and reading these messages means that 99.9% of the endless processes in our bodies are functioning correctly, so letís be thankful for that! Now, considering that we are a highly organized conglomeration of chemicals, in those of us with ED some specific aspects of this homeostasis have been disrupted. Why? And in exactly which ways? The possibilities are endless. Nature can be quite cruel, and frankly some of us got the short straw when it came to the genetics of sexual reproduction. And this will shake most of us with ED, especially young men, to our absolute core. Young men especially have a fundamental drive, a libido so to say, that results in unparalleled energy, creativity, physical well-being, and productivity. I am a firm believer that this energy is driven by sexual forces. Even with the bastardization of sex with birth control, our primal reason for existence is still reproduction. With this in mind, once a young man realizes that his ability to reproduce is limited, his conscious and subconscious mind makes the grim conclusion that the fundamental reason for existence appears difficult to achieve, and the body is further driven away from equilibrium. I donít think that I would be making an outlandish statement in proposing that that many older men who have had fulfilled their sexual desires in this life for decades are less bothered by ED. It is rather unfortunate, but it hasnít ruined their life because that intense psychological libido stage is over and they have decades of satisfaction over which to reminisce. But my final point is that ED is especially serious in young men. There needs to be a better and more accessible treatment protocol for young men with this issue. After reading these boards (which represents a tiny subset of men with this problem), I am realizing that there must be thousands and thousands of young men who need help.

Part two
But there is much hope for us young sufferers. Science and innovation is a beautiful thing. However, the fact of the matter is that impotence has received very little medical attention until recently. Case in point: Viagra, the wonder drug and godsend of impotence treatments, was never intended to treat ED. It was a heart and blood pressure drug that happened to give life to dormant penises. Last night I stumbled upon two very interesting and important scientific studies regarding sildenafil (Viagra) that I will discuss later.

As we all know by now, Nitric oxide (NO) is the chief chemical responsible for erections. It is the end product of a complex series of neural and enzymatic pathways. The disruption of any of these pathways for any reason would absolutely result in erectile dysfunction. I am perplexed by the cases of ED in healthy young men that seem to have no discernable origin, and I have suspicion that they are related to a disease pathology related to the synthesis/ and or mobilization of NO. I believe that a consistent lack of the vasodilator NO in the bloodstream, especially at night, has serious effects on male reproductive abilities, and is probably responsible for high blood pressure too, as the two tend to occur simultaneously. Nighttime erections are clearly linked to normal erectile functioning. I am under the impression that lengthy erections at night deliver essential nutrients to the blood vessels in the penis that maintain penile tissue and the cardiovascular system in optimal health. This is why patients with sleep apnea who lack REM sleep, and hence nitric oxide vasodilation, tend to have high blood pressure and sexual dysfunction. So we have now established the possible importance of NO in our ED problems

Now for the sildenafil studies. If youíve been skimming, please pay attention right now. Sildenafil works by maintaining elevated levels of nitric oxide in the blood stream. Iím not going to explain exactly how, but the concept is PDE5 enzyme inhibition, and it works beautifully. The first study I came across discovered that Sildenafil injections, and hence higher NO concentrations, in mammals causes significant increases in oxytocin levels, a chemical that is known to increase male-female bonding such as cuddling, AND is crucial in sexual arousal; in rat studies, injections of oxytocin results in spontaneous erections. Researchers are now reevaluating their initial statements about how Viagra does not increase sexual desire. It now appears that the chemical can work on sexual pathways that we do not even understand. The main point that I extract from this study is that the role of NO in sexual functioning is most likely underestimated and probably has many effects on sexual and overall cardiovascular health.

The second sildenafil study that really caught my interest consisted of a manipulation of the dosing of Viagra. Normally, it is consumed on an ďas neededĒ basis. A very smart researcher decided to compare the results of patients using Viagra ďas neededĒ to patients taking a full 50mg dose every night before bedtime. The study duration was 6 months. What were the results? In some patients who took a full dose before bed every night, and therefore had consistent nighttime erections, the result was a REVERSAL of their ED. Thatís right, a REVERSAL. The extensive periods of nighttime NO vasodilation somehow rejuvenated their erectile tissue and possibly worked on those unknown pathways.

So hereís my plan. Once I can secure a 6 month supply of levitra, I am going to take it every night before bed and see if I can jumpstart my erectile tissue again. Furthermore, I personally would like to band together a statistically significant group of men under 30 years of age who have ED of unexplainable origin to test my theory on NO disease pathology. If we get good results, we might have stumbled on a better way of treating ED. I know there are plenty of guys just like me, but I just need them to come out of the woodwork so we can try this.

Thanks for the read. Contact me with questions or post on this thread as I have become quite knowledgeable on the subject of ED in the past few days.

 
Old 01-23-2009, 03:30 PM   #6
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Re: Male sexual problems. Way too young!

My bound testosterone level was right in the middle of the range [certainly not bad at 62], not far from yours. But the free T level was below the normal cutoff point so I've just started Androgel T therapy. Some of the things you've mentioned were [are] bothering me too and I've used antidepressants for years. And like you I tend to analyze things to death since I have a Ph. D. in Biology and teach. Sometimes a little knowledge is a dangerous thing and we look for things to go wrong or explain what has. I find the more I know the less I know. I used to have all the answers, now most things are in the gray zone. Get the best medical advice you can and follow it and give it time. And don't concentrate on the problems too much. That can make things worse or at least seem worse. Best of luck. You certainly do a great job of expressing yourself and communicating in writing.

 
Old 02-03-2009, 11:39 PM   #7
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Re: Male sexual problems. Way too young!

I thought that I wasn't having morning erections, but now I think that I may actually be having them. The problem is that the moment I come into consciousness it instantly vanishes.

In the last couple of days I noticed that I actually did have them as I was waking up. But in the time it took to hit the alarm it was gone.

I was given some Cialis samples by my urologist. Even if it only gives me a couple of No-Reason-Boners that's a great improvement and maybe the psychological satisfaction of knowing that it is possible for me to get a nice hard erection will help me if it's some sort of circular mental barrier.

I'll keep you posted as to how that goes. Let us know how things are going for you.

Last edited by guy7802; 02-03-2009 at 11:39 PM.

 
Old 08-09-2009, 08:37 PM   #8
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Re: Male sexual problems. Way too young!

I now have more information surrounding my situation. TRT experts please give me your 2 cents. New blood work:

Total testosterone: 345 (241-827)
Free testosterone: 14.3 (9.3-26.5)
Estradiol: 35 (0-53)

These numbers are in range but weak as hell. My doctor prescribed testim gel 2.5g/daily. Yes, I know that dosage is worthless. Any comments? I'm hoping that finding a new doctor and beefing up my testosterone to around 800-1000 will do the trick. Anybody suffering from similar problems....go get your blood work done. At least get testosterone, free test, and estradiol (e2 ultra sensitive) checked.

 
Old 08-10-2009, 07:51 PM   #9
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Re: Male sexual problems. Way too young!

I disagree in that not having morning erections indicates only a physical problem. Psychological issues can certainly reduce them, at least indirectly. It is also possible that worry and anxiety about getting an erection can lead to ED issues; and when you are worried about getting an errection, you make it harder to get one, which leads to more anxiety and woory, which makes it even harder to get an erection the next time, etc. So, I don't know that you can totally rule out psychological issues.

You have an interesting theory regarding take Cialis or Viagra daily, but one still wouldn't know for certain if the expectation of getting better is what is actually making you better. The only way to know would be a blind study that you would undertake on yourself, but I suppose someone of your resourcefullness could figure out a way.

 
Old 08-10-2009, 08:23 PM   #10
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Re: Male sexual problems. Way too young!

Ha this will be a quick reply especially considering that I haven't been on these boards for months. I definitely admit that it is now a physical AND psychological problem. I can't help but be mentally affected by this. It comes down to something called CONFIDENCE. I have a ton of sexual anxiety now. In this regard, I agree with your post. But the lack of morning wood and waning libido indicate to me that something physical is definitely messed up. I can vividly remember when I was younger (and had some normal sexual anxiety), just a hug from a girl gave me a stiff erection. A HUG! Now I have to break a sweat to get one that lasts for anything more than 20 seconds.

Do you think with high testosterone levels, morning wood, nighttime and occasional spontaneous erections, and a high libido (ie: physical normalcy for a 21 year old) that I would even be on this board? Nope. But here I am with a physcial and psychological problem.

 
Old 08-10-2009, 08:41 PM   #11
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Re: Male sexual problems. Way too young!

I have experienced profound sexual disfunction for a period of about 4 mos. Maintaining or even getting an erection was extremely difficult, I would feel i had drive - and i would start to get about 25% and then the steam would just seem to go out. It was very troubling for me - because it was almost as all my life it had been the same - and one day - gone..

I have a twin brother - he wasnt having any problems - and my father much much older in his 60's wasnt having any problems and never did. of course i do have health problems but - i had had those for 15 years without sexual problems.


Consequently it dawned on me one day as i went to the refrigerator one morning for breakfast and saw the carton of soy milk i had been drinking for about the same period of sexual disfunction. I started drinking this as my sister and her trainer advised for my health problems.. - never the less, I decided to stop drinking it and within days - i had my full usual vigor restored and 7 years later in my mid 40s now ,dont have any problems again. Me and my wife (25) have sex 10 times per week. I probably dont get quite hard as i used to maybe 85% - sometimes full - but heck i am doing it everyday.

Its hard to believe one dietary change can have such a profound effect. anyhow i learn now soy mimicks female hormones. -----

take a good look at your diet..its night and day for me...with this condition.

 
Old 08-10-2009, 08:46 PM   #12
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Re: Male sexual problems. Way too young!

Quote:
Originally Posted by DeadSynapse View Post
I now have more information surrounding my situation. TRT experts please give me your 2 cents. New blood work:

Total testosterone: 345 (241-827)
Free testosterone: 14.3 (9.3-26.5)
Estradiol: 35 (0-53)

These numbers are in range but weak as hell. My doctor prescribed testim gel 2.5g/daily. Yes, I know that dosage is worthless. Any comments? I'm hoping that finding a new doctor and beefing up my testosterone to around 800-1000 will do the trick. Anybody suffering from similar problems....go get your blood work done. At least get testosterone, free test, and estradiol (e2 ultra sensitive) checked.
seems weak - especially regarding your age.. it should be the highest at your age.. you should be fully there at the top of the range - see my previous post - let me know if anything in your diet can be causing this.

 
Old 08-10-2009, 10:13 PM   #13
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Re: Male sexual problems. Way too young!

Aha now you are onto something. I have cut soy out as much as possible for that very reason. Now if you look at my e2 number, it is 35. In range, however the optimum e2 level for men is somewhere in the low 20s. E2, just like the estrogen mimicks found in soy products, binds to testosterone receptors and renders them useless to testosterone's effects. That was your problem. Also, my testosterone:estrogen ratio is about 10:1. From what I have gathered from firsthand accounts of people doing testosterone replacement, real potent sexual function for many doesn't occur until their ratio hits 30:1.

In terms of my diet, I eat pretty clean these days. My diet consists of chicken, vegetables, fruit, some beef, dairy products (mainly cheese), eggs, beans, rice, whey protein. Nothing super processed. Drink lots of water. I supplement 4,000 iu vitamin D every day and a high potency fish oil (fish oil works! - lowered my blood pressure at least 10 points).

I have wondered if it's environmental. I live in a decent sized city and I work in a chemistry lab that is full of toxic toxic materials. I went on a camping trip this summer and did a ton of walking (but I am pretty active in town as well) and got a lot of sun, and I did notice that my libido and function definitely improved. Go figure. Maybe I need to move, but that's not an option right now.

 
Old 08-10-2009, 11:59 PM   #14
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Re: Male sexual problems. Way too young!

wow working in chem lab, - it could be environmental for you.. I have switched things like even drinking water(filtered or bottled only-thinking of even filtering shower water) to eliminate as a potential health issue. I have also found flouride toothpaste affects my health.

 
Old 08-11-2009, 03:57 PM   #15
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Re: Male sexual problems. Way too young!

Basically, your body is a walking chemistry experiment. Anything you put into it will affect you. The question is how will the body deal with it? Some things can whack you out. Depends on who you are. This is why when I retest my hormones and if they come back low again, I will be skeptical about injecting testosterone because that can change some aspects of your body chemistry for life, especially if you have a doctor who does not know what they're doing (like mine!).

 
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