October 4, 2012

October 4, 2012
When Testosterone Replacement Doesn’t
Lead to Better Erections - Part 3


Welcome to another day in my life. Today is Thursday and I hope you are having a safe and great week so far. It is another busy week for Dab the AIDS Bear and me.

For the past two days, I have been blogging about testosterone levels and erectile dysfunction. Today I will finish up the series of these blogs:

It is extremely important to remember never to use Viagra, Cialis, or Levitra before or at the same time as you use Trimix. This is a dangerous combination that can increase the risk of priaprism. Be particularly careful with Cialis since it can stay in your blood stream for a longer time. I know someone who had priaprism since he had forgotten he had taken Cialis two days before using Trimix.

Most men who use Trimix love it, even if they have had to learn the hard way about priaprism during one instance. Most of these men did not respond well nor had too many side effects to oral agents like Viagra or Cialis.

A 10 cc bottle of Trimix can cost from $70 to $100 in compounding pharmacies. If a dose of 0.15 cc is needed per erection, this bottle can be good for 67 erections. In comparison with Cialis and Viagra ($16 a pill), this option seems economical. APSMeds.com has good prices, quality control and customer service, and can ship to your home.

You will need a prescription written as : TRIMIX (10 micrograms of alprostadil, 500 micrograms of phentolamine and 15 mg of papaverine) , 5 mls, as directed. Make sure you ask for insulin syringes (30 gauge, 1 inch needles), and alcohol swabs with your order.

Caverject— This is an injectable form of alprostadil. Injections of alprostadil have been reported to cause pain, bleeding, hematomas and scar tissue leading to Peyronie’s Disease (excessive curvature of the penis) in some patients. Caverjet is available by prescription and it is not a compounded product, so some doctors who are not comfortable prescribing compounded products feel more at ease prescribing it. However, it is not as effective as Trimix, it requires a large injection volume, and it comes preloaded in syringes with thick needles. It is also 10 times more expensive than Trimix but several insurance companies pay for it (Trimix is rarely covered by insurance). This injection into the penis that produces an erection that can last 1 to 2 hours. Follow instructions from your urologist since overdosing can also cause priaprism.

Medications that could cause decreased sex drive or erectile dysfunction: One reason that testosterone may not lead to better erections and sex drive is the use of medications that may interfere with those two benefits.

A great review of all studies of drugs that affect sexual function in men was provided by Dr. Walter K.H. Krause in his book “Drugs Compromising Male Sexual Health”. He was able to identify evidence from different studies (many uncontrolled and small) about the common classes of prescription medications that can cause erectile dysfunction. It is not known if testosterone replacement can counteract the effects of these medication classes. Among the medications are:

• Antidepressants: Selective serotonin reuptake inhibitors (SSRIs), tricyclic antidepressants, monoamine oxidase inhibitors

• Blood pressure medications (antihypertensives): Alpha andregenergic antagonists, beta-blockers, diuretics, guanethidine, methyldopa

• Narcotics and opiates

• Barbiturates and benzodiazepines

• Hormone related products: Anabolic steroids, antiandrogens used in prostate cancer, estrogens, medroxyprogesterone, 5-alpha- reductase inhibitors (Proscar, Propecia)

• Anti-acids: Histamine 2 receptor antagonists (Tagamet), proton pump inhibitors (Prilosec)

• Cholesterol –lowering agents: Bile acid sequestrants, fenofibrates (Tricor, etc), statins (Lipitor, etc)

I hope you have a beary safe and great Thursday!

Until we meet again; here's wishing you health, hope, happiness and just enough.

big bear hug,





Daddy Dab