Trimix causing inability to orgasm

I was a little worried about that also. I was prescribed 10 units and I had zero problem. Erection went away about an hour later. I also read that it’s a “rare” situation. Just stick to the prescribed dose. If that’s not enough to get an erection I was told by my doc to increase by 5 units at a time

I have always understood that you should NOT use trimix and Viagra or any other oral meds like Sildenafil at the same time!

Priapism can occur with any overdose of a vasodilator. Be careful. Better to under dose and work your up than experience the pain from priapism. Look it up. There are you tube videos from ERs draining the blood from an engorged penis Not a pretty sight!

I am a 79yo male who was in excellent health until hit by a diagnosis of metastatic prostate cancer at 78. I was put on ADT (Androgen Deprivation Therapy), which dropped my T level from 540 to < 7. That means I have zero sexual function, and Trimix is the only way to have any sex life. For me, zero T means that the maximum dose of sildenafil or tadalafil has no effect.

In general, what I can say about Trimix is that it is a tricky, difficult, and unforgiving medication to use. Depending on your insurance, a trip to the ER to treat a priapism with injected phenylephrine could be expensive. (Only MDs are allowed to use phenylephrine; the patient cannot have it.) I have tried 2 different strengths of Trimix: the standard 30-1-10 formula offered by most compounders, and the (weaker) 18-0.6-7 formula offered by a couple local compounders. I was hoping the weaker formula would be more forgiving, but it has not been.

Starting at 20 units (0.2 ml) of either formula is a starting point that will work for most men. That is unlikely to result in priapism. However the tricky part is, what amount to increase by. Some docs recommend 5 units, however, 2 units is safer in terms of avoiding priapism. As an example: with the weaker formula, I experience a semi-erection at 24 units; a pretty good erection at 26 units; and a borderline priapism at 28 units. At 28 units, the erection lasted over 4 hours and I was able to get rid of it by taking regular (not time release) sudafed, 120mg. I actually started out for the ER after taking sudafed, but the erection subsided on the way to the ER. (Whew!) I have had phenylephrine treatments at two different ERs, and one of the docs who treated me did not have proper technique; I ended up with large areas of under-skin hemorrhage. So avoiding ERs is the best way to go.

I learned the mechanics of the injection process by looking at multiple videos and descriptions. The first sexual-health PA I saw, did not get all the details right. It is especially important to apply pressure on the injection site for 5 minutes (to avoid appearance of a small blood blister), and massage the penis after the 5 minutes is up, to distribute the medication throughout the spongy tissue areas. I find injection at 10 or 2 is easier than injection at 9 or 3.

My experience has been that a Trimix erection is not really like the real thing. If I overdose the appropriate amount of Trimix, the erection can tingle, with an unpleasant burning sensation, for a long time. An icebag can help reduce unpleasant sensations. That overdose can also cause pain during sexual stimulation, which makes it more difficult to reach orgasm.

@ezed2
I get the antidote,
0.2 Phenylephrine (10mg/ml)
0.2 ml Lidocaine
with every refill. I currently have six syringes of it. I've only had one 4 hour erection. I took two doses of Sudafed and two antidote injections and then it resolved.
Take care,
Jake

I am to start trimix in a week or so. 78 year old . What should I be certain to understand and ask my PA trainer at my education session? Thanks in advance! The talk of a >> 4 hours erection is enough to get my major attention.

Ask your urologist if Cabergoline is worth a try. It’s a dopamine mimetic (agonist) and has been shown to help some people achieve orgasm. For some it takes many weeks or months to see the benefit; so, you have to be patient.

I am about your age. I have been trying to get a good result from Trimix since last September. Perhaps my biochemistry is weird, but the problem I have run into is this. If I raise the dose to the point where the erection is good enough for intercourse, then I get an erection which takes a very long time to go down. Have had to go to ERs twice because of this. These very hard erections are also not comfortable, there can be a tingling/burning sensation, and there is sensitivity at the base which makes it uncomfortable to squeeze, or move around, the erection. I am about to go in to see the doc who wrote my last prescription, to see if there is some formula (Bimix?) which does not have this problem. If I drop the dose to the point where the erection does not last a long time, then I have a sort of floppy semi-erection. I have been using a weak version of Trimix, the 18mg/0.6mg/7mcg per ml formula. A dose of 26 units (0.26ml) drives me into the "forever erection". 🙁

Thank you very much. I will bring this up with my dr I hope to avoid the forever erection! I plan to try the vacuum erection device also.

Update. I started doing Kegel exercises and taking a B complex vitamin and Im back o normal,maybe even better.