Sidegra, Kamagra, Viagra and Cialis

[Tagged]

1 hour ago, faraday said:

Stop the Testosterone & any ED drugs.

Have a full hormone blood panel & also a CBC.

Which Testosterone are you taking, dose & frequency?

Stop testosteoron after many years, is not recomended if not necessery because of life treathning causes that infere with testosteoron. 

 

But take a full blood check up and do a proper screening is necessery. Doing all that viagra, cialis and copy medicine sounds like a slow suicide if you ask me

[bkk6060]

How ignorant of some to bad mouth sex.

There are so many positive effects on the body from sex/ejaculation.

Lowers chances of P cancer, better sleep, better general moods, increases immune system, several other positives some studies show it may increase your life span.

It is one of the reasons I am here enjoy it everyday.

 

[faraday]

6 minutes ago, polpott said:

For me, they always disappear during sex. Tedious ferreting around for them afterwards, particularly if you lost it inside the back door.

Perhaps you need a smaller condom....?

????

[polpott]

Just now, bkk6060 said:

Lowers chances of P cancer

Increases it considerably.

[Berkshire]

1 minute ago, bkk6060 said:

How ignorant of some to bad mouth sex.

There are so many positive effects on the body from sex/ejaculation.

Lowers chances of P cancer, better sleep, better general moods, increases immune system, several other positives some studies show it may increase your life span.

It is one of the reasons I am here enjoy it everyday.

 

This explains why I'm in the best shape of my life at 60+.....555!

[polpott]

2 minutes ago, faraday said:

Perhaps you need a smaller condom....?

????

Never found one big enough in Thailand, which was the root cause of the problem. I've had them ping across the room and stick to the wall.

[WaveHunter]

52 minutes ago, Mister Fixit said:

I have told people already in my OP  - test. enanthate 3-weekly and whatever the dose on the ampoule is - 250 mgs.  

Why would I stop the testosterone?  My body doesn't make it because my pituitary gland has atrophied since my TRT.  Do you mean stop in the short term until I have a full hormone test?

I had a CBC 10 days ago.  All fine, but slightly elevated uric acid. 

I am having my  testosterone check on Thursday.  I am unsure what to ask for though - total free testosterone or something else?

 

 

IMHO, your first step should be to find a good MD well versed in TRT.  I know that here in Thailand you can get very inexpensive blood testing on your own, and you can buy injectable Test without a prescription but interpreting your blood panels on your own or self-medicating with Test is a very unwise proposition.

TRT is not just about administering testosterone injections.  You also need to be aware of changed estrogen levels as a result of TRT.  You also need to be aware of changes in CBC panels (hematocrit specifically) that can result from TRT, and can be very dangerous if not properly addressed. 

Only a qualified MD can properly interpret your baseline panels and then properly titrate your TRT dosage and decide whether changes in estrogen levels need to be addressed, and also monitor hematocrit). 

The MD will interpret your baseline panels, set a starting dosage of Test, and then retest you after several months to adjust dosage and decide if anti-aromatase inhibitors need to be used to control estrogen.  A few months later, he'll retest your panels to fine-tune things and then you should be good-to-go long term with self-testing your blood panels and sending them in to your MD for analysis twice a year.  At least that's how my MD handled things.

Bottom line:  FInd a good MD!

The MD you should seek need not be a specialist (i.e.: endocrinologist or urologist); a general practitioner that is well versed in TRT is all you need, and it's very easy to vet one to be sure he/she is right for you. 

Do NOT go to a TRT clinic.  Most of them are run by scammers, and if they even have a MD on staff, their prime motive is get as much money as they can from you.  Instead, simply to to your local hospital and ask for a consult with a GP well versed in TRT.  I had a great GP when I lived in Chiang Mai but when I moved to Pattaya I had trouble finding one so I went to the hospital and found a GP that was just fine.  It was easy to do ????

 

[Mister Fixit]

1 hour ago, Orton Rd said:

 At my age i'd rather have a good dump, and it's not as messy either.

Depends on how many chilies are in the food - things can certainly get messy then.

[Boomer6969]

2 hours ago, Mister Fixit said:

The other option is to see a urologist and see what else might be going on down below.  Perhaps I need to increase the testosterone dosage or frequency.

The only option, if you ask me. My blue pills are provided by urologist. And the problem you describe is consistent with the normal drop of Libido we all experience as we age. So the answer is more in Testosterone and motivational speech. 

[Mister Fixit]

53 minutes ago, Tagged said:

Stop testosteoron after many years, is not recomended if not necessery because of life treathning causes that infere with testosteoron. 

 

But take a full blood check up and do a proper screening is necessery. Doing all that viagra, cialis and copy medicine sounds like a slow suicide if you ask me

Absolutely wrong information. 

You obviously haven't properly read my post.   I don't have a pituitary gland any longer so I depend on exogenous testosterone by injection.  

Are you aware of what it does?  You know it isn't just a sex hormone right?  That it also helps regulate bone and muscle mass, helps with memory, helps burn fat, helps with skin etc and many others things?  

And if is a slow suicide, I seem to be doing OK after 17 years of it

[Mister Fixit]

53 minutes ago, WaveHunter said:

IMHO, your first step should be to find a good MD well versed in TRT.  I know that here in Thailand you can get very inexpensive blood testing on your own, and you can buy injectable Test without a prescription but interpreting your blood panels on your own or self-medicating with Test is a very unwise proposition.

TRT is not just about administering testosterone injections.  You also need to be aware of changed estrogen levels as a result of TRT.  You also need to be aware of changes in CBC panels (hematocrit specifically) that can result from TRT, and can be very dangerous if not properly addressed. 

Only a qualified MD can properly interpret your baseline panels and then properly titrate your TRT dosage and decide whether changes in estrogen levels need to be addressed, and also monitor hematocrit). 

The MD will interpret your baseline panels, set a starting dosage of Test, and then retest you after several months to adjust dosage and decide if anti-aromatase inhibitors need to be used to control estrogen.  A few months later, he'll retest your panels to fine-tune things and then you should be good-to-go long term with self-testing your blood panels and sending them in to your MD for analysis twice a year.  At least that's how my MD handled things.

Bottom line:  FInd a good MD!

The MD you should seek need not be a specialist (i.e.: endocrinologist or urologist); a general practitioner that is well versed in TRT is all you need, and it's very easy to vet one to be sure he/she is right for you. 

Do NOT go to a TRT clinic.  Most of them are run by scammers, and if they even have a MD on staff, their prime motive is get as much money as they can from you.  Instead, simply to to your local hospital and ask for a consult with a GP well versed in TRT.  I had a great GP when I lived in Chiang Mai but when I moved to Pattaya I had trouble finding one so I went to the hospital and found a GP that was just fine.  It was easy to do ????

 

@WaveHunter

Nice reply and I will respond more fully later when I have studied it a bit more.

Interesting that you mention haematocrit.  In my blood test 10 days ago, both that and haemoglobin were very slightly down

Hb was 13.4 g/dl with a range of 14-18 and Hct (which I assume is haematocrit) was 38% with a range of 42-54%. so probably just nudging into slight anaemia.

However, both the doc and I think that is because I have been on a strict keto diet for almost 4 years and have lost about 50 kgs or 110 lbs and kept it off.  My BMI is 23.75 and has been around that for a few years now.  It was 34.5 when I started in May 2017.

She just suggested I take an iron supplement for a while. and as I am booked to see her in August, we'll check again.

 

[KannikaP]

1 hour ago, polpott said:

living in pattaya, as I do, my problem is keeping it down, not keeping it up. Agree with scuba though, condoms are a passion killer, I gave them up years ago.

Are you in a monogamous relationship or freelance?

[Tagged]

10 minutes ago, Mister Fixit said:

Absolutely wrong information. 

You obviously haven't properly read my post.   I don't have a pituitary gland any longer so I depend on exogenous testosterone by injection.  

Are you aware of what it does?  You know it isn't just a sex hormone right?  That it also helps regulate bone and muscle mass, helps with memory, helps burn fat, helps with skin etc and many others things?  

And if is a slow suicide, I seem to be doing OK after 17 years of it

Seems you missed my point on trt, but however, and stimulants I will resist to comment any further. You are the one who knows. Just want to say good luck, hope it works out for you

[KannikaP]

3 minutes ago, Mister Fixit said:

Nice reply and I will respond more fully later when I have studied it a bit more.

Interesting that you mention haematocrit.  In my blood test 10 days ago, both that and haemoglobin were very slightly down

Hb was 13.4 g/dl with a range of 14-18 and Hct (which I assume is haematocrit) was 38% with a range of 42-54%. so probably just nudging into slight anaemia.

However, both the doc and I think that is because I have been on a strict keto diet for almost 4 years and have lost about 50 kgs or 110 lbs and kept it off.  My BMI is 23.75 and has been around that for a few years now.  It was 34.5 when I started in May 2017.

She just suggested I take an iron supplement for a while. and as I am booked to see her in August, we'll check again.

 

Was Mr Hampton working OK before the Keto diet?

[Mister Fixit]

10 minutes ago, KannikaP said:

Was Mr Hampton working OK before the Keto diet?

Things were sometimes a bit hit and miss before then but as I started it almost 4 years ago I am therefore 4 years older and so I suspect it's more age-related rather than diet-related.

And if it was a choice between being 100 pounds lighter with all its benefits, and having sex twice a day, I'd go for the weight loss.

[polpott]

1 hour ago, KannikaP said:

Are you in a monogamous relationship or freelance?

Both.

[KannikaP]

12 minutes ago, polpott said:

Both.

So in which circumstance do you not use a Johnny?

[WaveHunter]

3 hours ago, Mister Fixit said:

@WaveHunter

Nice reply and I will respond more fully later when I have studied it a bit more.

Interesting that you mention haematocrit.  In my blood test 10 days ago, both that and haemoglobin were very slightly down

Hb was 13.4 g/dl with a range of 14-18 and Hct (which I assume is haematocrit) was 38% with a range of 42-54%. so probably just nudging into slight anaemia.

However, both the doc and I think that is because I have been on a strict keto diet for almost 4 years and have lost about 50 kgs or 110 lbs and kept it off.  My BMI is 23.75 and has been around that for a few years now.  It was 34.5 when I started in May 2017.

She just suggested I take an iron supplement for a while. and as I am booked to see her in August, we'll check again.

 

Good for you on your success with Keto.  I'm also very much into a keto lifestyle and find it amazing in how good I feel as a result. ????

Regarding hematocrit, it is high levels that are the primary concern from use of injectable Testosterone and that can be dangerous since it effectively means your blood is a lot thicker and thus more prone to clotting and possibly having a coronary event. 

The fix is real easy; just donate some blood and hematocrit will quickly return to normal ranges , but knowing when it becomes too high is key to avoiding it becoming dangerously high. 

It's not that likely to occur on TRT dosages, and is more apt to occur with people taking extremely high doses like bodybuilders for instance,  but better to be safe than sorry and test for it regularly.

The same thing is true of Estrogen levels.  Injectable testosterone can raise Estradiol (E2) levels far too high and you'll feel it primarily as bloating.  At the same time, countering that with too much aromatase inhibitors can lower E2 far too low, and that can be very unhealthy (yes, for a man). 

For me at least it has always been a delicate balancing act because the levels can really jump around from one blood test to another for no apparent reason, and you can really feel it when it's not right.  For me (and many other TRT users) an Estradiol range in your blood panel of 20-30 pg/mL is ideal.

This is an example of where a good TRT doctor is important because most published estradiol reference ranges are far higher (up to 50pg/mL), but on TRT such a level can make you (at least me) feel like horrible!  A MD without a good understanding of TRT would shy away from a level of below 30 pg/mL since it is outside of the standard reference range.  A good TRT MD will understand this.

[Lacessit]

4 hours ago, bkk6060 said:

How ignorant of some to bad mouth sex.

There are so many positive effects on the body from sex/ejaculation.

Lowers chances of P cancer, better sleep, better general moods, increases immune system, several other positives some studies show it may increase your life span.

It is one of the reasons I am here enjoy it everyday.

 

Every day? I'm jealous, once or twice a week is my usual.

Could not agree more, good healthy exercise.

"Golf and sex are about the only things you can enjoy without being good at it". ( Jimmy Demaret)

[rcuthbert]

6 hours ago, Mister Fixit said:

I have told people already in my OP  - test. enanthate 3-weekly and whatever the dose on the ampoule is - 250 mgs.  

Why would I stop the testosterone?  My body doesn't make it because my pituitary gland has atrophied since my TRT.  Do you mean stop in the short term until I have a full hormone test?

I had a CBC 10 days ago.  All fine, but slightly elevated uric acid. 

I am having my  testosterone check on Thursday.  I am unsure what to ask for though - total free testosterone or something else?

 

 

TRT has at least 2 pitfalls. It shuts down your HPTA (hypothalamic-pituitary-gonadal axis*) - which stops (In layman's terms) the testes production of sperm and testosterone - so your nuts shrink.
The aromatase enzyme# converts the excess testosterone to estrogen. Excess  estrogen is both a libido, and a boner, killer. Also, if your estrogen drops (from taking too much anti-aromatase) too low - it's limp weenie city.

For me - I would to do TRT unless I was under a doctor's - with knowledge of hormone management - supervision.

 

*  https://en.wikipedia.org/wiki/Hypothalamic–pituitary–gonadal_axis

 

#  https://en.wikipedia.org/wiki/Aromatase

[onebir]

6 hours ago, Sticky Rice Balls said:

Ive tinkered with this one ...good for a quickie but not long time ????

TBA: https://www.fda.gov/drugs/medication-health-fraud/public-notification-grakcu-capsule-contains-hidden-drug-ingredients

(Same warning from Aus FDA; IDK if the verion(s) sold in Thailand also have this problem.)

Looks like this is what they're supposed to contain:

- Cordyceps sinensis
- Goryanka grandiflora (aka epimedium/'horny goat weed')
- Dodder (aka Cuscuta)
- Wild Yam
- Schisandra chinensis
- Ziziphus jujube
- Lycium chinensis

(ie pretty standard TCM herbs.)

[onebir]

11 minutes ago, rcuthbert said:

TRT has at least 2 pitfalls. It shuts down your HPTA (hypothalamic-pituitary-gonadal axis*) - which stops (In layman's terms) the testes production of sperm and testosterone - so your nuts shrink.

The OP had a pituitary adenoma, could his HPTA return to normal functioning?

[onebir]

7 hours ago, Mister Fixit said:

At first I used half a 100 mg tablet of real Viagra, then changed to Kamagra as it was cheaper.  Over time, I had to increase to a full 100mg tablet.  Then I tried the Thai GPO version, Sidegra, but that really was not as good at all so I reverted to Kamagra.

1) How often do you use these drugs; have you tried using them less often &/taking a break from them?

'Chronic' use of many drugs causes downregulation of the relevant receptors, weakening their effectiveness. Often the only fix is to stop using them/use them less for a while; this can allow the receptors to recover. (Occasionally there's another drug that prevents receptor downregulation, but that's a bit of a needle in a haystack.)

2) Have you (or your doc) reviewed their metabolic pathway of silfafenil?

IIRC it involves increasing NO2 synthesis, and that needs some inputs (amino acids?). Perhaps your intake/reserves of these inputs are low.

 

[rcuthbert]

1 hour ago, onebir said:

The OP had a pituitary adenoma, could his HPTA return to normal functioning?

That is beyond my knowledge - hence the recommendation to see doctor. At the same time, estrogen will definitely be a factor of limp weenie.

[Mister Fixit]

@WaveHunter @onebir @rcuthbert

Sorry, got caught up in something else but you guys seem to know most of what's going on in this thread.

I have had a former Thai student who works for Pfizer tell me that either Bangkok Christian Hospital  or St Louis are worth trying for a decent urologist and checkup.

I need to be in Silom tomorrow anyway so thought I would see what's what at both.

Does anyone know anything about them in this regard?  Do they have ED and testosterone deficiency specialists at either and are they any good?  And which is the cheapest - I'm on a budget?  Bangkok Christian?

Or are there any other places which are better?  I go to the Army hospital, Phramongkutklao, for my knee arthritis and they are good for that - worth trying them?

Also, I am due a testosterone shot on Friday and before the shot I was going to get the clinic to take a blood test to check my testosterone levels but I can't remember if it should test for free or total testosterone or both.  Anyone know?  I think the first ever test I had about 2004 was for free testosterone.

 

Could do with a quick answer!  ???? 

 

[rcuthbert]

32 minutes ago, Mister Fixit said:

@WaveHunter @onebir @rcuthbert

Sorry, got caught up in something else but you guys seem to know most of what's going on in this thread.

I have had a former Thai student who works for Pfizer tell me that either Bangkok Christian Hospital  or St Louis are worth trying for a decent urologist and checkup.

I need to be in Silom tomorrow anyway so thought I would see what's what at both.

Does anyone know anything about them in this regard?  Do they have ED and testosterone deficiency specialists at either and are they any good?  And which is the cheapest - I'm on a budget?  Bangkok Christian?

Or are there any other places which are better?  I go to the Army hospital, Phramongkutklao, for my knee arthritis and they are good for that - worth trying them?

Also, I am due a testosterone shot on Friday and before the shot I was going to get the clinic to take a blood test to check my testosterone levels but I can't remember if it should test for free or total testosterone or both.  Anyone know?  I think the first ever test I had about 2004 was for free testosterone.

 

Could do with a quick answer!  ???? 

 

Get your estrogen checked.

I would get free and total testosterone checked.

Sometimes, the independent labs have good prices; however, I'm in Patts, so I can not offer any practical suggestions.

[Mister Fixit]

1 minute ago, rcuthbert said:

Get your estrogen checked.

I would get free and total testosterone checked.

Sometimes, the independent labs have good prices; however, I'm in Patts, so I can not offer any practical suggestions.

Yes, I think I will just ask the nice lady doctor at my local clinic on Friday before she does the shot to take blood for all three tests.  Thanks for the advice on the oestrogen (and test for oestradiol too?).

It's 700 baht for a testosterone blood test but I don't know which type, free or total or if it's double the price for both.

Then, if there are any anomalies, I will look for a decent endocrinologist and maybe urologist.  This is an endocrine problem which causes a limp dick, not a physical one AFAICS.

I will write up the history when I get a minute and you will see what's been happening.  Waaay too many wrong conclusions and assumptions have been made by most commenters so far.

 

[Mister Fixit]

4 hours ago, onebir said:

1) How often do you use these drugs; have you tried using them less often &/taking a break from them?

'Chronic' use of many drugs causes downregulation of the relevant receptors, weakening their effectiveness. Often the only fix is to stop using them/use them less for a while; this can allow the receptors to recover. (Occasionally there's another drug that prevents receptor downregulation, but that's a bit of a needle in a haystack.)

2) Have you (or your doc) reviewed their metabolic pathway of silfafenil?

IIRC it involves increasing NO2 synthesis, and that needs some inputs (amino acids?). Perhaps your intake/reserves of these inputs are low.

 

1)  I suppose I use between 4 and 6 tablets a month, more likely nearer the 4.  It's a bit awkward at the moment because we have my wife's dim 23 year old niece staying which is off-putting anyway but that's not the issue.
That's not excessive use so no need to reduce intake and if I took a break I would not be able to have sex.  Hence, there is no 'chronic use'  to be concerned about in my view.

2) No.

And I thought it was nitrous oxide which was involved in vaso-dilation in an erection, not nitrous dioxide.  I am no biochemist though so I could well be wrong but I think not.

[Mister Fixit]

3 hours ago, rcuthbert said:

That is beyond my knowledge - hence the recommendation to see doctor. At the same time, estrogen will definitely be a factor of limp weenie.

But it isn't limp when I take Viagra. 

However over the last maybe 6 months things will fade away after some time and need to be revived by oral or manual means before continuing.   It usually only happens once, but sometimes twice but eventually things come to fruition.  

On a few occasions I have just said forget it and gone to sleep.

So, the Kamagra isn't acting as effectively as it was, but it always works, even if only for a while.

It's working out why that is happening which is the key.

 

 

[scubascuba3]

13 minutes ago, Mister Fixit said:

But it isn't limp when I take Viagra. 

However over the last maybe 6 months things will fade away after some time and need to be revived by oral or manual means before continuing.   It usually only happens once, but sometimes twice but eventually things come to fruition.  

On a few occasions I have just said forget it and gone to sleep.

So, the Kamagra isn't acting as effectively as it was, but it always works, even if only for a while.

It's working out why that is happening which is the key.

 

 

Sounds like you aren't turned on enough