CIALIS: ineffective over 40 y.o.?

[Flavio]

And another thing: Avodart doesn't stop me from having erections but there are definitely side effects, ejaculation volume is minimal.

[Mazzio]

Try this:
- Don't eat anything after 6 PM
- Drink a little if thirsty
- Take a pill (Viagra, sildenafil, whatever) at 5 AM.
- Wait one hour.
- Have sex.

In my case sildenafil worked for about 10 years. No brand of pills have worked well after that. But this "early in the morning" exercise makes the pill almost as powerful as it was when I started to use them.

[Charlie2019]

Try this:
- Don't eat anything after 6 PM
- Drink a little if thirsty
- Take a pill (Viagra, sildenafil, whatever) at 5 AM.
- Wait one hour.
- Have sex.

In my case sildenafil worked for about 10 years. No brand of pills have worked well after that. But this "early in the morning" exercise makes the pill almost as powerful as it was when I started to use them.

I use to take 5mg Cialis every morning and then viagra or Cialis 30 minutes before sex.

[Canuck67]

For me I have been taking Viagra & Cialis for about 20 years and I would say Cialis is actually working as good or better at the 10-15 mg 1-2 hrs before sex.

If I take it late at night its actually better in the morning.
The side effects are worst with Viagra or higher dose Cialis Over 10 mg.

[Simbarn]

That's the million dollar question: how important really is DHT?

I suppose it may also play a positive role in our body (e.g. sexual function, muscle growth.

I have no idea what the long term effects may be, though.

Flavio, I didn’t want to offend you by what I said or am about to say with regard to Finasteride. It is a personal choice if one is prepared to take the risk of taking a drug that may have bad consequences.

The most important thing is that one is aware of these possible consequences from the beginning.

You said “That's the million dollar question: how important really is DHT?”

I don’t believe it’s a question at all.

All the hormones in our bodies are important. DHT is actually more potent than testosterone and many of the effects testosterone has are exerted through DHT, as testosterone is converted into DHT for that reason.
It would be very naive in my opinion to consider DHT as not important or unnecessary. It is part of our “male” make up.

It is not a fact that because some men lose their hair that they have an excess of this hormone in their bodies. It is because they have a particular gene that is programmed into some of the hair follicles in their scalp, that will respond to DHT in a certain manner at a predetermined time of life.
This response appears to be the shutdown of the blood supply to those hair follicles and they gradually die. These men do not have an excess of DHT and the DHT they have is doing important things in the body.
Each hormone is vital in the body; if we don’t have enough testosterone there are consequences, if we do not have enough estrogen there are consequences, if we do not have enough cortisol there are very serious consequences, I could go on, epinephrine, adrenalin….
Why would DHT be any different?
In most tissues of the body the effects of testosterone are mainly mediated by DHT, not testosterone itself; the brain, central nervous system, skin, hair and genitals but not muscle. Muscle is mostly affected by testosterone. If you completely took the enzyme away that converts T into DHT in the aforementioned areas of the body, there would be substantial changes in physiology. It binds to the androgen receptor 3-5 times more strongly than testosterone does. The body converts our vital hormone testosterone into DHT for essential reasons.
DHT also controls estrogen in the male body. If levels of DHT decrease, estrogen can become a problem. This can definitely contribute to erectile difficulties, libido issues and possible brain function changes in the male.
Finasteride can reduce DHT by up to 70% in the body, Duasteride probably even more. Given how important this hormone is in regard to its relationship with testosterone, it is quite clear In my mind that this drug will cause significant changes in the male body.
So when we understand what DHT does in the body, it becomes clear that in effect, Finasteride has an effeminising effect in the male. Males are extremely sensitive to estrogen, any alterations in the levels of estrogen in the male will have significant effect. The same happens with females and testosterone.

One of my close friends has been using Finasteride for many years. He has been complaining of tiredness and loss of sexual potency for quite some time. He tried HRT (His T levels were very low normal), using testosterone Enanthate IM. Surprisingly he felt very little when using the preparation. This is very odd as most men who are new to using this form of injectable testosterone feel immediate effects strongly as the receptors for DHT and T are very fresh in all areas of the body, especially if endogenous T is low. I then remembered he was still using Finasteride. My hypothesis of his subjective response to the treatment, was that as DHT is responsible for many of the effects of T in the body, Finasteride most likely thwarted the positive effect of T as DHT levels failed to rise! There would also most likely be an excess of T being converted into estrogen, further compounding his apparent negative impression of T replacement. What is frightening is that this could be a permanent issue if the Finasteride was discontinued.

It seems obvious to me that Finasteride is having a detrimental effect on your body as your seminal vesicles are being shut down due to low ejaculate levels and possibly also the muscles responsible for ejaculation are being affected, as mentioned above the male genitals are affected greatly by DHT. You cannot assume that Finasteride is not contributing to your ED. Avodart as you say is not causing complete erectile failure in your case, but over time changes in the health of the endothelium and smooth muscle will most likely be occurring as DHT helps maintain penile health. The large doses of erectile drugs you are taking may be masking what is happening. 20 years of use of this drug during most if not all of your active sexual life, will complicate diagnosis. Your issues may have been psychogenic in the beginning, but more than likely have a significant physiological component now.
I suggest you read all the statements by these medical professionals as to how they think on the issue if you have not already done so:

https://www.pfsfoundation.org/what-doct ... re-saying/

Given what Finasteride can do to some men in a short time and with no known way to correct the damage it does, this drug IMO should be taken off the market for cosmetic use.
Merck have tried in the past to cover up the side effects this drug can cause. They are one of the biggest drug companies in the world and have enormous power when it comes to influencing what people understand, even doctors! They have been quite successful when it comes to demonising the hormone DHT and making people think that the hormone is not really needed and causes problems, or as you described the “bad testosterone”. As you can now see this is absolutely not true. DHT is the essential counter part of testosterone.
Think about these points for a moment; If you did not have sufficient DHT in your body as a child during puberty you would not have developed your genital organs correctly, nor your prostate or your seminal vesicles. You would have been sexually malformed. Even more critical is DHT in the womb for sexual differentiation of the male genitalia. Just given these two points it would be simple-minded of us to consider DHT as unimportant past puberty. We still have much to learn about all the hormones in our bodies, don’t forget this critical fact.

Hormone homeostasis is very important in our bodies. Putting a drug like Finasteride into the body is akin to hitting this intricate balance of hormones with a mallet. Our bodies are extremely competent at correcting these imbalances after millions of years of evolution, but sometimes the body just can’t manage such an insult, hence why some men taking it are permanently damaged.

It should be quite evident that DHT plays an important role in cognitive function. Some people taking Finasteride have developed serious depression and suicide has followed. Once again we are reminded that many actions of testosterone are performed by DHT.
I recently read this; “a recent study demonstrated changes in the levels of certain steroids in cerebrospinal fluid of men taking Finasteride for hair loss. These steroids have been shown to influence brain function, and their presence may help explain the profound psychological changes such as depression and suicidality that have been associated with Finasteride use.”

I have also read, that the loss of this hormone may contribute to prostate cancer. Completely the opposite to what has been thought previously. Excessive estrogen in the male body is thought to be a contributing factor to prostate cancer. DHT helps control estrogen. As we age testosterone declines and therefore DHT, but estrogen rises! Estrogen rises due to an increase in the aromatase enzyme in various tissues in the body and most likely from a drop in DHT.
It has also been shown the older men given only DHT as a form of hormone replacement (not testosterone) feel many of the positive effects of T replacement and improvement in erectile function. This would suggest the importance of the hormone in an endogenous setting. What was interesting is that these men showed no signs of prostate enlargement or issues with LUTS during these studies.

There would be no chance of a testosterone lowering medication being approved or made for a cosmetic application. As this is akin to chemical castration (They actually did this to gay men last century, the great Alan Turing being one of the victims of this). How its vital counterpart DHT was recently considered superfluous, even detrimental and following that, a drug approved to remove it from the body for something as cosmetic as hair loss, is in my opinion unbelievable.

You are aware that there is a class action law suit against Merck in regard to the all sexual side effects that Propecia has caused to young men?

I hope that men considering using the drug in the future reading this may think twice before doing so.