Topic
Cause of ED / Low desire
I’m 61/M with ED and low desire. My symptoms include loss of desire, inability to attain and maintain an erection without PDE5’s, decreased sensation in genitalia, delayed ejaculation.
I’ve had several low back surgeries including 2-level lumbar fusion 2 years ago (L4-L5-S1). Other than that, my health is excellent. Labs, EKG, Phys. Exam all normal, no smoking/caffeine/alcohol/drugs, regular exercise, decent diet. No obesity, diabetes, heart problems or other major organ disease. Other than ‘age’, I have none of the risk factors for ED. I’ve been to my family doctor, 2 urologists and an endocrinologist. My testosterone is low-normal but doctors are reluctant to classify my condition as hypogonadism. Nevertheless, I have tried testosterone, first the injections, then the cream, with no success in improving libido. My other sex hormones seem to be well within the normal ranges. My assumption has been that nerve damage somehow occurred during one of my back surgeries, and that has affected my sexual functioning. However, the onset of my symptoms has been gradual, seemingly not related to any particular surgery.
QUESTION: Does anyone really know if ‘age’ by itself is truly a risk factor? i.e., is there a gene for sexual dysfunction whereby the DNA is programmed to shut down sexual response at a certain age?
Treatment-wise, I’ve tried the PDE5 inhibitors. They seem to work with mixed results. I’ve tried Cialis 5 mg for daily use with good erectile response, however, my erections don’t last long enough for satisfactory intercourse. When I tried adding Viagra, there was no additional response. I seem to get a better result using Viagra 50mg by itself, as needed, than using Cialis daily or Cialis plus Viagra. Higher doses of Cialis (one-time use) have resulted in uncomfortable side effects. None of these help with desire, and my girlfriend is getting very frustrated that I never seem to be interested in her, and when I do take a Viagra for sex, it never seems to end satisfactorily.
I’m scheduled to see Dr. Goldstein for nerve and vascular testing. Will update from there.