Lively seminar about men’s sexual health

[reader]

From Pattaya Mail

Pattaya is a city with its fair share of foreign males who are past the first bloom of youth. So it’s hardly surprising that a seminar on prostate problems and erectile dysfunction attracted a full house on June 7 at the resort’s most popular private hospital. The joint speakers were prosthesis surgeons and urologists Dr Niti Navanimitkul and Assistant Professor Dr Yossak Sakulchaiyakorn who managed to incorporate humor and empathy into what might appear to be dry subjects.

About half of all men start to feel the symptoms of an enlarged prostate as early as age 50, but they rise to around eighty percent for guys in their 80s. There is no doubt about the tell-tale signs: getting up more than once in the middle of the night, a weak stream, difficulty in starting and stopping amongst them. Dr Niti took the audience through the various options such including lifestyle changes (cutting down on caffeine and alcohol), medication and several surgical procedures.

But he concentrated on the latest technique in minimum invasive surgery known as water vapor therapy. The steam device is inserted and a needle deployed to inject hot steam, which immediately becomes water, into the enlarged prostate. Only moderate sedation is required and the actual procedure takes only a remarkable 10 to 15 minutes and does not require a repeat. Post operation, it is necessary for patients to use a temporary catheter for a few days whilst the swelling reduces.

A lively question and answer session followed the presentation. Water vapor therapy is a one-off procedure, but the technique is new world-wide so it’s impossible to say how long it remains effective. The hope is 10 years. The improvement is not immediate but takes place after three or four weeks once the swelling has subsided. Several audience members, who had received the treatment at the hospital, confirmed that they were delighted with the results. A total package including consultations, preparation, surgery and follow-up currently cost 210,000 baht or about US$5,500.

The session then turned to male impotence or inability to sustain an erection , or as one conference member described it, “Like playing snooker with a rope”. Erectile dysfunction can start in men as early as 40. As with the enlarged prostate, there are several options including lifestyle changes, medication, vacuum constriction devices and various surgery as described by Dr Yossak.

Open discussion followed the presentation. It was pointed out that some medications for this condition lowered blood pressure which created problems for some men. There is research currently being conducted into permanent penile implants which are not yet generally available. The session concluded with participants being handed questionnaires on their personal health issues, with the opportunity to talk privately to Dr Niti or Dr Yossack about their personal scores. The seminar was free to all.

[bkkmfj2648]

I know that this is a delicate and can be embarrassing subject - but has anyone tried any of the ED (Erectile Dysfunction) therapies?

1. TRT - Testosterone Replacement Therapy
2. Shockwave Therapy
3. ED Direct injections into the muscle part of the penis

Are there other ED treatments available?  other types of ED therapies?

I recently started with the first option = TRT - here in Pattaya at  https://www.wellthymeclinic.com/

after I saw the below 2 Youtube videos put out by Buzzin Pattaya.

I am only 1 month into my new TRT treatments and there have been some positive results.  

The down side is that you need to go to the clinic twice a week to get the testosterone injections into your ass cheeks.

Is it a "pain in the ass" - hahaha  - a slight pain like a prolongated mosquito bite that lasts for a couple of seconds.  

Once a month you get your blood/urine work done so that they can monitor all of your levels - so it is a holistic health strategy.

Doctor from the clinic told me to join a gym as that will also help and I immediately joined the Jomtien Fitness gym and now I have a personal trainer.

I want to make the best out of this embarrassing situation and to get back into the swing of things and I want the POWER of our AMAZING Vinapu - my hero.

Knowing this group - I am prepared for the ridicule - but if any of you are serious and know of other options and which one was the most successful for you I would be truly appreciated to know about it - and perhaps other members may also benefit.

Thanks 😘 

 

[reader]

No experience with any treatments but here’s my anecdotal experience.

For me, emotions I experience with individual guys plays a role in how physically aroused I become. I feed off their emotions. 

I can be with a really hot guy but if he’s not emitting the visual and audio signals, I tend not.to respond physically . But if I’m with your typical guy next door who is displaying emotional involvement, I do get aroused. 

I know there are physical conditions responsible for  ED, but I sense that emotions are a less appreciated component that can trigger physical arousal.

[omega]

Excercise is probably the cheapest and most effective thing a guy could do to improve his "performance".

It solves a number of issues:

Improves circulation, so blood can get to the important places

Improves stamina and stregnth so you go longer and harder.

Improves mental health, making you feel better about your own body

And also makes you more attractive to the boys... which could help on the bargaining front

 

Of course if you're already a mature adonis, and you're still having some issues getting it up, have a chat with your doctor; it could be symptoms of something else. A friend of mine in his 30's went to his Doctor about ED, found out he had a nasty case of untreated hypertension. 

 

[floridarob]

Use it or lose it....my Dr told me when I was young, he gave me permission to masturbate a minimum of 2 times a day, to keep a healthy prostate and the plumbing working. 

I told him I didn't need his permission, I was way ahead of schedule, he laughed.

People either get busy with life or lose interest in sex, or for whatever reason and don't think about sex.  It's part of my daily routine, with or without someone....

[Olddaddy]

I'm on TRT 

I had to cut it down as it can cause enlarged breast tissue I'm on 250ml a month 

It does NOT do anything for my erection ( lucky I'm a bottom)

It's a myth that TRT does anything for erectionds,but it increases your nipples to hard and sensitive  

Be careful with TRT I'm getting heart ❤️ pain now after a year on it 

By the end of my 4 week cycle I'm getting very tired I need another injection just like a junkie hanging out 

My GP in Australia refused and still refuses to prescribe it to me 

My erection is still not any better ,it's a myth by these TRT companies 

 

[unicorn]

There are basically four treatments for ED. The most common, working for most men are the PDE5 inhibitors (avanafil, sildenafil, tadalafil, and vardenafil). If those don't work, or have undesirable side-effects, there are injections which go directly into the penis, little pellets one can put up the urethra (not too popular), or vacuum/rubber band devices, such as Erec-Aid. The last three usually work if the first doesn't. TRT is not really a treatment for ED. It should be used only for testosterone deficiency, and then only with informed consent, since it has both risks and benefits. Any other treatments for ED aren't supported by factual evidence.

[bkkmfj2648]

Thanks everybody for your feedback and opinions.

Regarding PDE5 inhibitors, I have been on these for many years already and they are starting to have diminishing returns.  I also hate the side effects; diarrhea, bloated bowels, and sometimes head pain.  I also hate that it makes sex less spontaneous.  Also, when mixed with alcohol the side effects are worse.

I decided on the TRT treatment because of the success that the local Youtube star, Buzzin Pattaya, has had with it and consequently I have been in contact with other TRT beneficiaries and although it does not work for everyone - I want to give it a fair shot - like for 3 to 4 months.

This week I passed my 1 month mark and the new blood results just came back and my testosterone level prior to starting these TRT treatments was a poor 285, which is under the minimum for proper sexual and libido activity.  As of my post 1 month blood results, the testosterone has jumped up to 525, however it is still well below the optimal target of 1,000 - where the range should be from 900 to 1200 for optimal sexual arousal, libido, and performance.

Many of you wrote that going to the gym is very helpful and my TRT doctor said the same and I immediately enrolled in a local Jomtien gym with a personal trainer to get me going after 10 long years of non-gym activity.

On 6/11/2024 at 8:19 PM, Olddaddy said:

I had to cut it down as it can cause enlarged breast tissue

Olddaddy - in the TRT program that I am in - they give you an estrogen blocker with each testosterone injection to avoid enlarged breast tissue.  My dosage is 175 mg 2 times a week and yours was 250 mg - 42% more than my dosage.

My erections are improving - but I am still not yet satisfied - as their advertising stated - have the libido and erection of a 22 year old.  At this stage where I am at 525 I am feeling like I have the libido of a 52 year old (I will be 63 soon) and the erection of a 55 year old - albeit an improvement, but still a long way to go.  But I still have 2 to 3 more months to go before I can critique the outcome.

Another positive is that my blood pressure has moved into a normal range as I suffer from hypertension - I believe this is a direct benefit of the intense gym workouts.

None of you have commented on the Shockwave Therapy. 

Anybody have anything to share?

https://heclinics.com/shockwave-therapy-for-erectile-dysfunction-in-bangkok/

 

[Olddaddy]

That was a paid  advertising for that YouTube channel 

I'm going to be honest with you ....I believe the TRT injections will eventually cause a heart attack or stroke 

I cut mine down to 250 a month .

I would love to get off it but I'm hooked like a druggie and that's why doctor in Australia won't give it to me .I have to get it from Thailand 

I give advice to guys not to go on it ,once your on it your trt levels won't recover 

It doesn't do anything for my erection the only thing is does is give me energy for the gym.

 

 

[floridarob]

My testosterone was 173.....but it didn't stop this whore, mind over matter, lol   

They gave me Androgel to apply to my body, I used it for a little but but stopped because it was messy and sticky, not in the good way.

My last test  was 291, inside a normal range. I was more worried about the long term affect of low T, brittle bones for example. My erections and horniness never diminished,

I've never been a multiple Programma/session guy even when young. one or two a day is enough, I know people in Brasil and Thailand that are doing 3, 4, 5 guys a day....I wonder what their Testosterone levels and bank accounts are , lol

[Olddaddy]

3 hours ago, floridarob said:

My testosterone was 173.....but it didn't stop this whore, mind over matter, lol   

They gave me Androgel to apply to my body, I used it for a little but but stopped because it was messy and sticky, not in the good way.

My last test  was 291, inside a normal range. I was more worried about the long term affect of low T, brittle bones for example. My erections and horniness never diminished,

I've never been a multiple Programma/session guy even when young. one or two a day is enough, I know people in Brasil and Thailand that are doing 3, 4, 5 guys a day....I wonder what their Testosterone levels and bank accounts are , lol

My testereone levels are high with one injection per month.

I don't get horny that much.

The reason most get horny on TRT is because they take 5mg of Cialis per day to prevent prostate cancer .

Injecting this *oil" into my bum every month can't be doing my heart ❤️ any good 

[bkkmfj2648]

Time for an update.

I have completed 5 months of TRT (Testosterone Replacement Therapy) and the results are:

• predictable erection resolution?  partially.  I still have a dependency on PDE5 inhibitors (cialis, sideagra, viagra, etc.),
• more muscle mass as a result of returning to the gym and TRT,
• assertiveness - a noticeable increase due to my elevated testosterone levels - in excess of 1,300.

Doctor asked me if I was happy and I told him:

• returning to the gym after 10 years has lowered my blood pressure and I am happy that I could stop with the related blood pressure medications,
• I am not happy with the unpredictability of my erections - as this was the expectation from TRT - where I had hoped to shed the dependency on the PDE5 inhibitors

So, doctor prescribed to me peptide PT-141 (Bremelanotide), which you self inject at home into your belly abdomen area.  The PT-141 was SUPER effective - when I needed an erection it was there and very erect - however, the main drawback is that erections were coming and going spontaneously throughout the day and night - interrupting sleep. So, after a couple of weeks on PT-141 - I stopped as I did not like the side effects - as the PDE5 inhibitors rarely give me spontaneous erections like the PT-141 does.

Now we are on the next phase of ED (Erectile Dysfunction) treatment, which is ED Shockwave Treatment.  Unfortunately, my TRT's clinic does not offer this service so I had to find one and I found the Yada Clinic here in Pattaya and today, 04-Oct-2024, I had my first shockwave treatment.  Included in their elevated price, is:

• 15 minute treatment with the BTL shockwave machine pressed onto various areas of your penis by the female technician (It has been WAY too many years since a woman has had her fingers on my penis - no arousal as I was VERY tense about what was about to happen to my penis {note they don't have male technicians}).  The wand applicator is pressed onto your penis and electrical shockwaves penetrate your penis - the technician adjusts the shockwave value to a level that you can tolerate - I made it to 48%.  She told me that the average is around 50%.  I will try to go to 50% next week.  Is it painful?  kind of - but it is tolerable - as it is not constant but comes in short bursts with intervals between the sets of bursts.

BTL Shockwave applicator

after I got up off of the ED shockwave table

• After completing the 15 minute shockwave treatment you move to the next machine = MSsculpt and sit on a chair for 30 minutes where the purpose of this machine is to provide you with pelvic muscle strengthening by electrically stimulating the ischiocavernosus muscle --> read more here at: https://hermanwallace.com/blog/pelvic-muscle-rehabilitation-and-mens-sexual-health
• This was not painful and actually rather enjoyable - as the machine cycles through various electrical stimulations at different speeds that are stimulating your pelvic muscle region.

you sit on this contraption for 30 minutes

My goal for this ED shockwave therapy is to eliminate the dependency on PDE5 inhibitors and also eventually TRT.  The Yada doctor tells me that once you complete 13 treatments (6 weeks at 2 times per week) you should be good to go with an erect penis for 6 months to 1 year - which would be great for me instead of doing TRT injections 2 times a week for the rest of my life.

After all was said and done today - I felt like Frankenstein - like in one of the comical scenes from Young Frankenstein with Gene Wilder

My ex does not like that I am doing all of this as he says that I will kill and short circuit my dick and that I should just accept to give up sex.  I replied to him that I did not move to the other side of the planet to one of the sex capitals of the world to give up sex.  He did not like this comment because Pattaya is now going through this recent societal phase of Pattaya is no longer "sin city" = hahahaha.....

I share all of this information with you forum members - as I don't mind to be a guinea pig and to embarrass myself with what I am sure will be some belittling comments  - but my real hope is for those forum members who suffer from ED - to not give up and to know that there are many possible solutions so that you do not need to give up on the joys of sex.

Related information for those who want to know more:

Video on how the Yada Clinic uses the BTL machine on your penis.

Below link to the Yada Clinic information about the Focus Shockwave therapy that they employ:

https://www.doctoryadaclinic.com/focus-shockwave-for-erectile-dysfunction/

Update recently published by Buzzin Pattaya on his Youtube channel regarding his success with TRT.  In the video is my doctor that I am very happy with - even though my body did not obtain the desired to be able to drop the dependency on the need for PDE5 inhibitors.

I will update this thread after I have completed the 13 shockwave and pelvic strengthening sessions - in about 6 to 7 weeks.

 

 

[unicorn]

16 hours ago, bkkmfj2648 said:

...

• assertiveness - a noticeable increase due to my elevated testosterone levels - in excess of 1,300...

Well, I hope that this testosterone level you're mentioning is at least a total testosterone level (not the best level to follow), and not a free testosterone level (the level one should be following to monitor response to treatment). Even if it's your total testosterone level which is over 1300, that's significantly above physiological (normal) levels. This is potentially hazardous and could lead to complications, especially polycythemia, an increase in hemoglobin which leads to increased blood viscosity ("thickness"), which increases the risk of blood clots (including strokes or heart attacks). I hope they're following your hemoglobin. 

Bremelanotide has shown efficacy in improving sexual desire in premenopausal women. It is not a treatment for ED, and certainly not approved for use in men:

https://medlineplus.gov/druginfo/meds/a619054.html#:~:text=Bremelanotide injection should not be,or to improve sexual performance.

"...Bremelanotide injection is used to treat women with hypoactive sexual desire disorder (HSDD; a low sexual desire that causes distress or interpersonal difficulty) who have not experienced menopause (change of life; the end of monthly menstrual periods); who have not had problems with low sexual desire in the past; and whose low sexual desire is not due to a medical or mental health problem, a relationship problem, or medication or other drug use. Bremelanotide injection should not be used for the treatment of HSDD in women who have gone through menopause, in men, or to improve sexual performance...".

https://www.mayoclinic.org/drugs-supplements/bremelanotide-subcutaneous-route/side-effects/drg-20466805?p=1

"...Women who have gone through menopause and men should not use bremelanotide. Do not use this medicine to improve sexual performance...".

Shockwave treatment for ED is still considered experimental. I would definitely not consider videos put out by a clinic which makes money from selling such treatment as "evidence" of this treatment's efficacy. There are plenty of approved and extremely effective treatments for ED. If free testosterone levels are low, then returning the levels to physiological levels can be helpful. Exceeding those levels is dangerous. Why mess with unapproved (by the FDA) treatments, when there are approved treatments which work for virtually all men?

 

[bkkmfj2648]

11 minutes ago, unicorn said:

There are plenty of approved and extremely effective treatments for ED. If free testosterone levels are low, then returning the levels to physiological levels can be helpful. Exceeding those levels is dangerous. Why mess with unapproved (by the FDA) treatments, when there are approved treatments which work for virtually all men?

Dear @unicorn, many thanks for sharing with me/us your concerns on my ED journey.  If I am honest with myself, it is more than 10 years that I have been struggling with ED and I have tried many different treatments over the years.

My doctor orders blood work every month and all of my levels are healthy and ok - and I have had 4 months of results so far.

If you know of any other ED treatments please share them here with all of us - because in 6 more weeks when I will conclude the ED shockwave therapy - if it is not successful - I will be looking for other alternative solutions.

With my current TRT doctor - we have discussed what alternatives that remain if the ED shockwave therapy is not a success and I do not like any of these "end of the road" solutions, which are:

• PIT - Penile Injection Therapy - similar to what I was doing with the PT-141 peptide injection into the stomach abdomen - but instead the injection (self injected) is made directly into the penis where the prescribed medications can be:  Rimix, Bimix, or Papaverine,

• Penile Prosthesis - which requires invasive penile surgery where they insert a prosthesis into your penis.

These "end of the road" solutions do not appeal to me, so I think that I would just return to full-time use of the PDE5 inhibitors and live with the fact that sex can no longer be spontaneous and that I need to accept the side-effects of said inhibitors for the remainder of my life.

[unicorn]

9 hours ago, bkkmfj2648 said:

Dear @unicorn, many thanks for sharing with me/us your concerns on my ED journey.  If I am honest with myself, it is more than 10 years that I have been struggling with ED and I have tried many different treatments over the years.

My doctor orders blood work every month and all of my levels are healthy and ok - and I have had 4 months of results so far.

If you know of any other ED treatments please share them here with all of us - because in 6 more weeks when I will conclude the ED shockwave therapy - if it is not successful - I will be looking for other alternative solutions.

With my current TRT doctor - we have discussed what alternatives that remain if the ED shockwave therapy is not a success and I do not like any of these "end of the road" solutions, which are:

• PIT - Penile Injection Therapy - similar to what I was doing with the PT-141 peptide injection into the stomach abdomen - but instead the injection (self injected) is made directly into the penis where the prescribed medications can be:  Rimix, Bimix, or Papaverine,

• Penile Prosthesis - which requires invasive penile surgery where they insert a prosthesis into your penis.

These "end of the road" solutions do not appeal to me, so I think that I would just return to full-time use of the PDE5 inhibitors and live with the fact that sex can no longer be spontaneous and that I need to accept the side-effects of said inhibitors for the remainder of my life.

As I mentioned in a prior post further up the string, the approved methods, aside from the medications, are the penile injections, the urethral suppository (MUSE), and the vacuum/constriction devices (such as ErecAid). Obviously, penile prostheses will also work 100% of the time, and there are various of them (some provide a fixed erection, and others can be controlled using a pump). Penile injections are over 95% effective. I've never come across someone for whom it didn't work.