New Member, Hard Choices

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hopeful_future
Posts: 190
Joined: Thu Oct 31, 2019 7:58 pm

New Member, Hard Choices

Postby hopeful_future » Fri Nov 01, 2019 11:16 am

Alright, alright, I will do my best to avoid too many puns going forward...No promises though.

I've been reading this forum on and off for a while now, and I think it's time for me to join so I can talk things through with others who have been through similar circumstances. For an intro, I'm a 39 year old bi man, happily married to my wonderful husband, generally successful in life, living in California. In general, I'm in great shape, eat right, exercise and lift regularly. However, I've had lifelong moderate-to-severe ED...That is, there has never been a time in my life where my penis worked like those of my peers. As a bi (and leaning more toward gay) guy, I have had the opportunity to see, feel, and play with a lot of dicks in my life, so I realized pretty early on that something was wrong.

In my early 20s, when I started being sexually active, I was devastated when I could not have sex normally. I managed to scrape together enough money for one of those fly-by-night grey market call-in pharmacies, and got viagra. It was a bit of an improvement, but still not enough for penetration. I'd say on a scale from 1-10, where 7 is about the erection needed for penetrative sex, I would go from my usual 2-5 to 5-7. Even though I'd reach an erection capable of penetration, however, it would stay in that state for no more than 30 seconds to a minute. Over the years since, I've tried the following:

  • Cialis, Levitra, Viagra (gets me closer to erection, have had successful penetrative sex a handful of times in 2 decades)
  • A year of psychological therapy with a licensed sex therapist (AASECT, good folks, helped me "cope", but no erectile improvement)
  • Trimix (does very little for me except ache terribly, produces slight erection, maybe a 5/10)
  • A year of TRT since I was "lowish". (really horny, feel great, no help to erections)
  • Abstaining from porn/masturbation for 90 days (just made lack of ability more frustrating)
  • Muse, the worst thing ever (I have a small urethra, just placing the tablet had me in horrible pain, no effect)
  • All sorts of kink play, porn, positions, whatever I could find, just in case I was just barking up the wrong tree or confused about my sexuality (if I found that thing, I wouldn't be here)

So here I am, and I'm looking at the course that WILL fix my ED, which would be an implant, and trying to understand and think through the choice. On one hand, I have a good sex life. While I'm mentally a switch (both giving and recieving penetration is enjoyable to me), physically, I have had to play the role of bottom 90% of the time. I have amazing orgasms from this, and a very understanding husband. I enjoy the headspace too. But I want to top as well. I crave it mentally. I want to do for my husband what he does for me. The 5% time I can actually manage that, it is a lot of effort. Between that effort, the high chance of failure, and the horrific headaches I get from the amount of PDE5 inhibs I need to get there...I barely even try any more.

So it's a tricky situation for me. I have masturbation, being the receptive partner in gay sex, a loving husband, strong orgasms, and a good life in general. Surgery involves pain, risk, expense, and no guarantees. At my fairly young age, it is almost certain I will need surgical intervention in the future to repair or replace the device. Once it is implanted, there is no turning back.

I am thoroughly on the fence. I hope I can use the experience and thoughts of the people here to help me get through this. I also hope my experiences can help others who are similar to me, men who have never had a fully functional penis. At the very least, I've found a few people like that on this board and just knowing I'm not alone is so much solace.

Thanks in advance for your assistance and compassion!
39yo, ED since sexually active, moderate to severe. Bisexual. Pills helped a little, trimix and muse failed. Implanted 8/25/20 by Dr. Karpman, 22cm+1RTE Titan Touch.

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Happy Toy
Posts: 765
Joined: Fri May 11, 2018 9:30 am

Re: New Member, Hard Choices

Postby Happy Toy » Fri Nov 01, 2019 11:39 am

hopeful_future wrote:Alright, alright, I will do my best to avoid too many puns going forward...No promises though.

I've been reading this forum on and off for a while now, and I think it's time for me to join so I can talk things through with others who have been through similar circumstances. For an intro, I'm a 39 year old bi man, happily married to my wonderful husband, generally successful in life, living in California. In general, I'm in great shape, eat right, exercise and lift regularly. However, I've had lifelong moderate-to-severe ED...That is, there has never been a time in my life where my penis worked like those of my peers. As a bi (and leaning more toward gay) guy, I have had the opportunity to see, feel, and play with a lot of dicks in my life, so I realized pretty early on that something was wrong.

In my early 20s, when I started being sexually active, I was devastated when I could not have sex normally. I managed to scrape together enough money for one of those fly-by-night grey market call-in pharmacies, and got viagra. It was a bit of an improvement, but still not enough for penetration. I'd say on a scale from 1-10, where 7 is about the erection needed for penetrative sex, I would go from my usual 2-5 to 5-7. Even though I'd reach an erection capable of penetration, however, it would stay in that state for no more than 30 seconds to a minute. Over the years since, I've tried the following:

  • Cialis, Levitra, Viagra (gets me closer to erection, have had successful penetrative sex a handful of times in 2 decades)
  • A year of psychological therapy with a licensed sex therapist (AASECT, good folks, helped me "cope", but no erectile improvement)
  • Trimix (does very little for me except ache terribly, produces slight erection, maybe a 5/10)
  • A year of TRT since I was "lowish". (really horny, feel great, no help to erections)
  • Abstaining from porn/masturbation for 90 days (just made lack of ability more frustrating)
  • Muse, the worst thing ever (I have a small urethra, just placing the tablet had me in horrible pain, no effect)
  • All sorts of kink play, porn, positions, whatever I could find, just in case I was just barking up the wrong tree or confused about my sexuality (if I found that thing, I wouldn't be here)

So here I am, and I'm looking at the course that WILL fix my ED, which would be an implant, and trying to understand and think through the choice. On one hand, I have a good sex life. While I'm mentally a switch (both giving and recieving penetration is enjoyable to me), physically, I have had to play the role of bottom 90% of the time. I have amazing orgasms from this, and a very understanding husband. I enjoy the headspace too. But I want to top as well. I crave it mentally. I want to do for my husband what he does for me. The 5% time I can actually manage that, it is a lot of effort. Between that effort, the high chance of failure, and the horrific headaches I get from the amount of PDE5 inhibs I need to get there...I barely even try any more.

So it's a tricky situation for me. I have masturbation, being the receptive partner in gay sex, a loving husband, strong orgasms, and a good life in general. Surgery involves pain, risk, expense, and no guarantees. At my fairly young age, it is almost certain I will need surgical intervention in the future to repair or replace the device. Once it is implanted, there is no turning back.

I am thoroughly on the fence. I hope I can use the experience and thoughts of the people here to help me get through this. I also hope my experiences can help others who are similar to me, men who have never had a fully functional penis. At the very least, I've found a few people like that on this board and just knowing I'm not alone is so much solace.

Thanks in advance for your assistance and compassion!


I sent you a PM.
Implanted 6/26/2018, Coloplast Titan 20cm, no RTE'S, infra pubic, Dr. Rhee, Kaiser :o 8-) 76yrs., married 53 yrs. ED for over 20 yrs.

Lost Sheep
Posts: 3748
Joined: Mon Jul 04, 2016 11:16 pm

Re: New Member, Hard Choices

Postby Lost Sheep » Fri Nov 01, 2019 1:55 pm

hopeful_future wrote:So here I am, and I'm looking at the course that WILL fix my ED, which would be an implant

It is a misconception that an implant fixes E.D. In point of fact, it compromises/damages/destroys/removes tissue from the corpus cavernosum. Those tissues are what provide erections. This guarantees complete (organic) impotence. Implant is a treatment, not a cure. But a very powerful and capable treatment.

What the implant DOES do is replace whatever natural erectile function you had before surgery with a hydraulic/mechanical erection.

You will be totally dependent (with the marginal exception of what engorgement spongiosum tissue can give - which is fullness without rigidity) on the implant for erections for the rest of your life. The surgery is not reversible.

However, those erections are great! Long-lasting. Rigidity unknown (to me) since post-puberty. And, while not spontaneous (self-erecting), those erections are available on demand (no waiting period as with medications)> And no apparatus to carry around as with constriction rings and V.E.D.s).


With that disclaimer, it appears you have exhausted all the less-invasive solutions (except injections?) and, since you DO want to have the joy of penetrating and being inside your partner more intimately than with your hand or tongue, you are a good candidate for implant.

In my journey, once I made that decision, I began researching the devices assiduously and researching surgeons even more thoroughly. I found a surgeon who accepted me as a member of my medical team and never had a moment's doubt after that.

Good luck and good loving to you.
Last edited by Lost Sheep on Fri Nov 01, 2019 3:45 pm, edited 3 times in total.
Lost Sheep
AMS LGX 18+3 Nov 6, 2017 Dr Shaw.
READ OLD THREADS to ask better questions and better understand answers.
Make yourself part of your medical team.
Document your current penile size: photos and written records.
Pre-op V.E.D. therapy helps.

GoodWood
Posts: 194
Joined: Sun Jun 16, 2019 1:07 pm

Re: New Member, Hard Choices

Postby GoodWood » Fri Nov 01, 2019 3:02 pm

Welcome to FT. I hope you find the help you need here. I have found it really beneficial.

My current situation is similar to yours with the exception of the reaction to trimix. I get good firm erections with trimix that allow me to have penetrative sex consistently. If it did not I would be getting an implant. My required dose of trimix necessary for a firm erection has been increasing over time. If it gets to the point that trimix no longer works consistently then I will get an implant.

It seems like being firm enough to top (in penetrating sex) is important to you. Is that the case?

It seems like you have tried a great many of the available erection aids. There are still a few more to explore though. Does combining a cock ring with meds (oral or injections) help you? A cock ring makes me a lot firmer and that could help. Have you tried a VED (vacuum pump) and constriction device? Burning or ache from trimix is a side effect I’ve heard mentioned before. I’ve also heard some people say that larger doses of bimix gave them a good erection without the burning. For them the prostaglandins in trimix were the culprit.

Has the underlying cause of your ED been tracked down? Is it an inflow problem? (Not enough blood flow into the penis), an outflow problem? (Venous leak), or something else?

You have more options to explore. What does your husband think about all of this? Hopefully he is supportive and communicating with out about all of this as well.

Best of luck.
51yo. Progressively worsening ED over 6 years. No HTN, DM, or related health issues. 20-40mg of Sildenafil or TriMix (30mg, 4mg, 40mcg) 45 units. Doses have been increasing so staying open to the idea of an implant. Pumping daily to maintain size.

hopeful_future
Posts: 190
Joined: Thu Oct 31, 2019 7:58 pm

Re: New Member, Hard Choices

Postby hopeful_future » Fri Nov 01, 2019 5:01 pm

Lost Sheep wrote:With that disclaimer, it appears you have exhausted all the less-invasive solutions (except injections?) and, since you DO want to have the joy of penetrating and being inside your partner more intimately than with your hand or tongue, you are a good candidate for implant.

In my journey, once I made that decision, I began researching the devices assiduously and researching surgeons even more thoroughly. I found a surgeon who accepted me as a member of my medical team and never had a moment's doubt after that.

Good luck and good loving to you.


I did attempt injections (Alprostadil and Trimix) with little success, unfortunately. Unless you're talking about stem cell or platelet injections, which...Well, I'd love to think they might help, but nothing about my understanding of the potential mechanisms of my lack of rigidity says that they would be any help. Same with EPAT. Probably my first steps towards implant will be to insist on diagnostics and diagnosis on why I can't achieve and maintain erection. So far, every doctor I have spoken to has been pretty dismissive. Maybe due to my age, I'm not sure. It is extremely frustrating.

I really like how you describe your doctor as a member of your medical team. I'm very dedicated to the idea of taking responsibility in my own medical treatment. It has already taken a lot of work to get to attempt the solutions I've tried, and I am sure it will be an uphill battle getting cleared for an implant as well.

Thank you for your kind words, shared experience, and description of how the implant has worked for you. I look forward to being a part of this community.
39yo, ED since sexually active, moderate to severe. Bisexual. Pills helped a little, trimix and muse failed. Implanted 8/25/20 by Dr. Karpman, 22cm+1RTE Titan Touch.

hopeful_future
Posts: 190
Joined: Thu Oct 31, 2019 7:58 pm

Re: New Member, Hard Choices

Postby hopeful_future » Fri Nov 01, 2019 5:17 pm

GoodWood wrote:It seems like being firm enough to top (in penetrating sex) is important to you. Is that the case?


This is one of the difficult questions I'm trying to answer. It is something that I want, certainly. But do I need it? Is that additional thing worth having mechanical parts that may fail or require upkeep, or have complications down the road? I can be okay with being the receptive partner 95% of the time...I've managed for 25 years after all (since I've been sexually active). But the desire and frustration and resentment over not being able to do this thing I have a drive for has been weighing on me.

GoodWood wrote:It seems like you have tried a great many of the available erection aids. There are still a few more to explore though. Does combining a cock ring with meds (oral or injections) help you? A cock ring makes me a lot firmer and that could help. Have you tried a VED (vacuum pump) and constriction device? Burning or ache from trimix is a side effect I’ve heard mentioned before. I’ve also heard some people say that larger doses of bimix gave them a good erection without the burning. For them the prostaglandins in trimix were the culprit.


I have considered bimix, and might see if my men's clinic will hook me up with some. Aside from that, I've tried medications combined with cock ring, without any real success. Blood makes its way out unless I have things very uncomfortably tight, to the point where it is painful.

GoodWood wrote:Has the underlying cause of your ED been tracked down? Is it an inflow problem? (Not enough blood flow into the penis), an outflow problem? (Venous leak), or something else?


This is the thing I most want to know. Every doctor I've spoken to has basically just shrugged and told me to try a different medication, or when I told them which I had tried, basically said there was nothing else they could recommend to me. Never any type of attempted diagnosis beyond "it doesn't work". How did you find a doc that was willing to do some deeper testing?

My guess is that it's an issue with outflow, because I can definitely get an erection, but it is incredibly fleeting, often seems position-dependent, etc. I'm a very healthy individual cardiovascularly, no problems with cholesterol or blood pressure, seems unlikely I've got arterial blockage of any sort.

GoodWood wrote:You have more options to explore. What does your husband think about all of this? Hopefully he is supportive and communicating with out about all of this as well.


Regarding ED in general, he has been very supportive and compassionate. But also, to the extent that I don't think he sees a problem with the way things are now. I haven't started talking about an implant yet. I think he will be against it. I also think he may be hurt by the idea that I haven't been satisfied, even though the sex I have with him is the best I've had in my life. It means saying "That's not good enough" to some extent, and that's a little scary to me.

But if I do start walking down that path, it will only be after I talk it through with him thoroughly. This isn't a decision that only affects me, and I won't unilaterally make the choice.

Thank you for the welcome, for the advice, and for your very helpful questions! Looking forward to more discussions with this wonderful community.
39yo, ED since sexually active, moderate to severe. Bisexual. Pills helped a little, trimix and muse failed. Implanted 8/25/20 by Dr. Karpman, 22cm+1RTE Titan Touch.

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NeedleD
Posts: 275
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Location: Midwest

Re: New Member, Hard Choices

Postby NeedleD » Fri Nov 01, 2019 9:51 pm

In my humble opinion you need to get to a Uro who will Doppler test you. You say your may have excessive outflow, you may also have low insufficient inflow as in my case. Only a penile Doppler will tell, then you can decide from there which route (in my case Implant suggested) you need to go. Good Luck!
Use Super Quadmix due to severe Venous leak.Have a GREAT DAY!

Txagq8
Posts: 152
Joined: Tue Oct 01, 2019 4:41 pm
Location: Texas Hill Country

Re: New Member, Hard Choices

Postby Txagq8 » Fri Nov 01, 2019 11:33 pm

Dear Hopeful

I kind of feel like we are in the same boat, although I guess our ships are sailing under different flags. I'm married to a woman. Sex has sucked (and not in a good way) for a long time.

My biggest problem is I can achieve a good erection, suitable for penetration, with the assist of trimix, viagra, and a leather cock strap/ring. Once that's been accomplished, it doesn't last long. Regardless of position once I start to thrust the veins open up and I go form 90% erection quality to maybe 50%.

You can saw away with a 50% limp dick and you're probably not going to climax. I've gone as long as 1.5 hours and all I did was scrape her raw (I'm fairly thick, girth of 6") and the abrasion set up the mother of all yeast infections.

I am convinced I want to go implant. I'm debating how to broach topic with wife. She is post menopausal and sex is ranked somewhere between cleaning out her car and sanitizing the refrigerator.

Hasn't always been that way. But that's how it is now. I halfway think if I had semi normal function and orgasmed in a timely manner she would regain some lost interest. But I'm male, and I learned years ago not to even try to think of what wife might think.

The big veins on my pecker look neat, but they aren't my friends. They drain away arterial blood at too fast a rate to maintain.

The fact that I still get erections scares me when I contemplate an implant, even though their longevity is too poor to do me any good.

I'm inclined to simply tell her the urologist says he can fix this congenital defect with new modern techniques, and see how she reacts.
Age 63. Retired Army. Married to Louisiana woman 33 yrs so I ain’t scared of nothing! VL diagnosed in early 30s. Injections, Pills, both helped some but never really fixed issue. Implanted 31Dec2019 in Austin Tx. AMS 700 LGX 18 cm with 5 cm RTE.

jump.ship
Posts: 79
Joined: Fri Apr 26, 2019 2:03 am

Re: New Member, Hard Choices

Postby jump.ship » Sat Nov 02, 2019 12:22 pm

Hey hopeful_future,

I am so very happy to hear your story because the sex bit exactly mirrors mine!

When I hear of people on here in their early 20s getting implants I don't understand how the hell I have put up with ED for so long, but I think its because I had the option of gay sex. I am also bi(ish) and I had some girlfriends in my early 20s, but the sex was seriously rubbish. Sex with men, however, is different from straight sex in two ways:

1. Penetration is not at all compulsory
2. If penetration is in the mix, then you can pretend to dislike being the top

If I take a bunch of pills I can muster a semi erection, or even a good erection, but they are ALWAYS temporary. This is enough to avoid total embarrassment: the person will just think I'm not that into them. This approach, therefore, means that so long as I only meet people once, I have avoided them knowing I have a real problem while having some form of a sex life (early on I did have some relationships with men but its not worth it with ED and the pills are awful to take everyday).

Because it is so unbelievably easy to meet people for no strings sex, I have been doing this for years now. If I was exclusively straight and needed to penetrate for all sex then I would have ended up where I am now (getting the implant) a LOT sooner.

It seems we have both done the same thing: worked around the ED so we can have some form of a sex life - and even enjoy some if it! But this work around eventually wears off.

I, like you, have tried all the options, including years in therapy, which simply helped me mentally deal with the ED but with zero impact on the actual erection.

The decision for the implant for me was easy because I would really like to meet some of these people more than once! Or be a top - or even have sex with a female again; I actually don't even know concretely what my sexuality is because I can't go out and experiment.

You are already in a relationship (that appears monogamous) so the benefit is less clear. But if these issues are staring now, they will probably continue to grow until the benefit becomes crystal clear.
ED from day one. Pills semi work. Implant in the works. 36 years. Uk based.

hopeful_future
Posts: 190
Joined: Thu Oct 31, 2019 7:58 pm

Re: New Member, Hard Choices

Postby hopeful_future » Sat Nov 02, 2019 10:26 pm

jump.ship wrote:Hey hopeful_future,

I am so very happy to hear your story because the sex bit exactly mirrors mine!

When I hear of people on here in their early 20s getting implants I don't understand how the hell I have put up with ED for so long, but I think its because I had the option of gay sex. I am also bi(ish) and I had some girlfriends in my early 20s, but the sex was seriously rubbish. Sex with men, however, is different from straight sex in two ways:

1. Penetration is not at all compulsory
2. If penetration is in the mix, then you can pretend to dislike being the top

If I take a bunch of pills I can muster a semi erection, or even a good erection, but they are ALWAYS temporary. This is enough to avoid total embarrassment: the person will just think I'm not that into them. This approach, therefore, means that so long as I only meet people once, I have avoided them knowing I have a real problem while having some form of a sex life (early on I did have some relationships with men but its not worth it with ED and the pills are awful to take everyday).

Because it is so unbelievably easy to meet people for no strings sex, I have been doing this for years now. If I was exclusively straight and needed to penetrate for all sex then I would have ended up where I am now (getting the implant) a LOT sooner.

It seems we have both done the same thing: worked around the ED so we can have some form of a sex life - and even enjoy some if it! But this work around eventually wears off.

I, like you, have tried all the options, including years in therapy, which simply helped me mentally deal with the ED but with zero impact on the actual erection.

The decision for the implant for me was easy because I would really like to meet some of these people more than once! Or be a top - or even have sex with a female again; I actually don't even know concretely what my sexuality is because I can't go out and experiment.

You are already in a relationship (that appears monogamous) so the benefit is less clear. But if these issues are staring now, they will probably continue to grow until the benefit becomes crystal clear.


Wow. This all strikes so close to home. Everything, right down to that questioning of your own sexual preferences. I'm going to send you a PM, I want to discuss more. It's such a relief to find someone going through the same symptoms in such similar circumstances, but also heartbreaking because I know what you've gone through.

I think I ended up being lucky because I got very comfortable early on just saying "I might not get hard or cum when we have sex. It doesn't mean I don't like you, it's just the way my dick works." But I definitely leaned very hard towards identifying as a bottom because of it. Just so much easier to explain. In any case, the people who had a problem with it, I wouldn't have really wanted to get to know better anyway.

There are people out there, especially queer people, who are not going to judge you on how your penis works (or doesn't). But when there's a part of you that really wants to be the penetrating partner, and you can't...The frustration and resentment do build up, and it's a feeling that is impossible to describe to people who don't have that problem.

Anyway, thank you SO MUCH for replying to this. I'll send a message your way.
39yo, ED since sexually active, moderate to severe. Bisexual. Pills helped a little, trimix and muse failed. Implanted 8/25/20 by Dr. Karpman, 22cm+1RTE Titan Touch.


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