Is it erectile dysfunction (ED)?

There are many tests that can be done .. is it a matter of becoming erect or do you become erect then not able to hold an erection? If so that is called venous leakage meaning the blood goes in to make an erection but leaks back out. There is little or nothing that can be done to the blood vessels most times it does not help. I went through all the tests ..tried the penile shots which did not work and last June ended up doing an implant.

Dear Arctic22.....would you be willing to discuss all the testing and work-up that you went thru in seeking a solution to challenges you may have had? Thanks! jhawk1975

@laughlin1947 - The ED diagnosis and treatment is a very frustrating issue! I encountered three basic doctor attitudes: (1) My PCP was at sea with ED. Pills were the only answer...(2) Urologists that stated ED was part of their practice - only to discover the ED part of their practice is a side light and they had little more to offer than my PCP. (3) A true urologist/ED specialist. That diagnostic process was entirely different leading to a solution that's happily been successful for nine years.

Ask around. Research urologists with a true ED specialty. )I'm not sure what to think of the specialty ED clinics that have popped up.)

In the screening process - I might think through questions relating to how the doctor goes about the diagnosis, testing, etc. The diagnosis can be tricky as often there are other conditions present, Rx drugs, Lifestyle concerns, and even psychological issues...

Well, I've been to 3 urologists by now, and still no progress. The first 2 were highly regarded with great credentials, and they didn't even examine me. After 5 minutes in the office, I was done with each appointment and told to go get an implant. The 3rd urologist is a woman who specializes in implants. I've been taking topical Androgel 1.62 (one gel pulse per shoulder per day) for 2 months now, and although it has raised my total testosterone to a high level near the top of the range, I feel no increase in libido, no matter how small of a touch of it. I am now seeing an endocrinologist because I still think the is still something hormonal that is off with me, like lack of free testosterone or high estrogen levels in my body (I do have a high out of range level of estradiol). My free testosterone levels are well below the lower end of the range, have been that way for a very long time. I've read where that may or not be a factor with libido. So, maybe there will be trials with antiestrogen meds, although I'd like supplements testosterone, either tablets or injections to see if they could increase my zero libido. I met with a physician assistant (PA-C) endocrinologist who spent a lot of useful time with me. He siad I shold consider getting the book written by Dr. Aaron Spitz, titled "The Penis Book". So, I have at least one blood test for hormones to come, then I will see the doctor above the PA-C and see what else could be tried.

Well, I've been to 3 urologists by now, and still no progress. The first 2 were highly regarded with great credentials, and they didn't even examine me. After 5 minutes in the office, I was done with each appointment and told to go get an implant. The 3rd urologist is a woman who specializes in implants. I've been taking topical Androgel 1.62 (one gel pulse per shoulder per day) for 2 months now, and although it has raised my total testosterone to a high level near the top of the range, I feel no increase in libido, no matter how small of a touch of it. I am now seeing an endocrinologist because I still think the is still something hormonal that is off with me, like lack of free testosterone or high estrogen levels in my body (I do have a high out of range level of estradiol). My free testosterone levels are well below the lower end of the range, have been that way for a very long time. I've read where that may or not be a factor with libido. So, maybe there will be trials with antiestrogen meds, although I'd like supplements testosterone, either tablets or injections to see if they could increase my zero libido. I met with a physician assistant (PA-C) endocrinologist who spent a lot of useful time with me. He siad I shold consider getting the book written by Dr. Aaron Spitz, titled "The Penis Book". So, I have at least one blood test for hormones to come, then I will see the doctor above the PA-C and see what else could be tried.

I take Tamsulosin for BPH and it has decreased and almost stopped me being able to ejaculate and really volume .. maybe a drop or two and if I have a flare up and have to double the dose then can't even climax at all ..

@laughlin1947 - As I said earlier, tracking down the root cause (might be causes) of ED can be frustrating and time consuming. It took me multiple internists and urologists to get to a urologist who specializes in ED and was associated with a top-notch facility - Mayo in my case.

Like many in our age cohort (I'm early 70's) testosterone production has slowly petered (pun intended) out. I was uncomfortable with HRT due to possible dire side effects. Instead, I reacted to my T levels being consistently 200 or even less, by starting a periodic regimen of inserted (inserted in my hip) bio-identical hormone pellets that time-release over a six month period or so. When my T levels are normal - I feel better, have more energy, and my libido is happily active.

Do you have a strategy to keep working towards an answer that works for you? Don't give up!

Thank you for your response!!!! It is encouraging to know that "eventually" there is a possibility of a more likely path for me to regaining sexual satisfaction, meaning for instance, as you say, "a periodic regimen of inserted (inserted in the hip) bio-identical hormone pellets that time-release over a six month period" could be helpful. Seems to me that if at the age of mid-70's, there is ED and loss of libido at a steady rate of decline, and a person has had doctors rule out the likely culprits such as blood flow restrictions, psychological reasons, etc., then science should be able to restore the hormone levels of when we were in our 30's or 40's. I just need a local doctor to champion the cause.
My strategy is to keep pursuing an endocrinologist who will take an interest in my case. I think I have found one. But first I need to have a test for a plethora of hormone levels. I may splurge and buy the $35 book by Dr. Aaron Spitz, "The Penis Book". I haven't ruled out trying hypnosis further down the road. When you said HRT with respect to dire side effects, did you mean something related to cancer? Would you know the drug name for the bio-identical hormone pellet implants you received?