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Need advice please!

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    Thumbs down Need advice please!


    I've read several threads and see a lot of knowledgeable individuals in this field. I'm hoping someone can point me in the right direction. Here's my situation:
    I have suffered from low libido and inability to maintain an erection going on three years now. It's getting to the point where it's damn near impossible to even get an erection anymore.
    I know the first thing everyone will say (and for good reason) is to consult my physician, but I recently switched jobs and my benefits won't kick in until the beginning of January, so this is not financially feasible at the moment. Plus, my doctor doesn't know her ass from a hole in the ground when it comes to TRT and the like. While I know I should seek out an Endocrenologist and maybe even a new PCP, I don't have that option at the moment and am getting pretty frustratred and depressed over the whole thing. Anyway, here's what I'm working with:

    I'm 32 years old, 5'10", 225 lbs. I haven't had my bodyfat tested but know my ideal weight is between 180 - 190 lbs. I haven't been working out or doing cardio on a regular basis for quite a while and my diet leaves a lot to be desired. I do get 8 hours of sleep per night regularly though.

    List of medications:
    1oomg Wellbutrin 3x daily
    35 mg Phendimetrazine 3x daily
    40mg Lisinopril/ 50 mg Hydrochlorothiazide 1x in the morning
    Xanax 1mg as needed (up to 4x daily sometimes)
    Soma 350mg as needed (up to 3x daily)
    50mg Zinc 1x in the morning
    Omega 3,6,9 Blend 2x Daily
    Vitamin D3 5,000 i.u. 1x Daily

    I know this post is long, but please bear with me because I'm pretty desperate at this point. I suffer from depression and ADD, hence the Wellbutrin and Phendimetrazine. My Dr. chose Phendimetrazine over regular Amphetamines (Adderrall, Vyvanase, etc...) because it supposedly has fewer side effects and less addicition potential. I was under the impression that Wellbutrin was a prolactin antagonist and know it is a DNRI. While I do sense increased libido when I take it, I still can't get and/or maintain an erection. I know that Xanax is a dick killer and am in the process of tapering off of it to very low doses (1mg or less per day). Unfortunately, I can't stop taking Soma. I have tried other muscle relaxants to no avail. I have an f'ed up lower back and I refuse opiates because I take enough medication as it is, but Soma is the only thing that allows me to workout when I actually do make it to the gym and also continue pursuing my career successfully.
    A few final thoughts: I recently read that Hydrochlorothiazide can cause impotence but, despite scouring the internet for literally hours, I can't find any hard facts as to WHY it causes impotence. Any insight would be much appreciated. Also, I did several cycles of Test w/ oral steriods when I was in my 20's (the latest cycle being Test only for 6 months when I was 28). I didn't always follow proper PCT. I have tried Viagra, Levitra and Cialis with fleeting results. Sometimes they work, but only sometimes. That worries me greatly. I have a fiance and we want to have children (not to mention a sex life) and this is really starting to take its' toll on me psychologically. I am open to any suggestions or thoughts and understand that it's not medical advice any of you are giving and I should always consult my Dr. One last thing: I realize some of the medications I take have addiction potential, but I have never "craved" these drugs. Rather, I need them. If not for the Phendimetrazine I wouldn't be able to focus and do my job (I have had ADD my entire life), I have yet to find a short - acting OTC supplement or drug that gives me the anxiety relief that Xanax does (though I am in the process of tapering down to a MUCH lower daily dose) and because of the bulging disc in my lower back I have to take Soma for pain relief. I know it sounds like I'm a walking pharmacy but, again, I am open to any advice or thoughts, even if they're harsh. I just wanted to get all of that out there so as to hopefully eliminate a bunch of the "you're an addict" replies.
    Also, I have access to just about any "research chemical" out there (Clomid, Cabergoline, Nolvadex, Arimidex, Cialis, etc....) and can get quality products cheap. There it is.... Any help at all would be greatly appreciated. Thank you all in advance!

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    Quote Originally Posted by Ceredumbellum
    I've read several threads and see a lot of knowledgeable individuals in this field. I'm hoping someone can point me in the right direction. Here's my situation:
    I have suffered from low libido and inability to maintain an erection going on three years now. It's getting to the point where it's damn near impossible to even get an erection anymore.
    I know the first thing everyone will say (and for good reason) is to consult my physician, but I recently switched jobs and my benefits won't kick in until the beginning of January, so this is not financially feasible at the moment. Plus, my doctor doesn't know her ass from a hole in the ground when it comes to TRT and the like. While I know I should seek out an Endocrenologist and maybe even a new PCP, I don't have that option at the moment and am getting pretty frustratred and depressed over the whole thing. Anyway, here's what I'm working with:

    I'm 32 years old, 5'10", 225 lbs. I haven't had my bodyfat tested but know my ideal weight is between 180 - 190 lbs. I haven't been working out or doing cardio on a regular basis for quite a while and my diet leaves a lot to be desired. I do get 8 hours of sleep per night regularly though.

    List of medications:
    1oomg Wellbutrin 3x daily
    35 mg Phendimetrazine 3x daily
    40mg Lisinopril/ 50 mg Hydrochlorothiazide 1x in the morning
    Xanax 1mg as needed (up to 4x daily sometimes)
    Soma 350mg as needed (up to 3x daily)
    50mg Zinc 1x in the morning
    Omega 3,6,9 Blend 2x Daily
    Vitamin D3 5,000 i.u. 1x Daily

    I know this post is long, but please bear with me because I'm pretty desperate at this point. I suffer from depression and ADD, hence the Wellbutrin and Phendimetrazine. My Dr. chose Phendimetrazine over regular Amphetamines (Adderrall, Vyvanase, etc...) because it supposedly has fewer side effects and less addicition potential. I was under the impression that Wellbutrin was a prolactin antagonist and know it is a DNRI. While I do sense increased libido when I take it, I still can't get and/or maintain an erection. I know that Xanax is a dick killer and am in the process of tapering off of it to very low doses (1mg or less per day). Unfortunately, I can't stop taking Soma. I have tried other muscle relaxants to no avail. I have an f'ed up lower back and I refuse opiates because I take enough medication as it is, but Soma is the only thing that allows me to workout when I actually do make it to the gym and also continue pursuing my career successfully.
    A few final thoughts: I recently read that Hydrochlorothiazide can cause impotence but, despite scouring the internet for literally hours, I can't find any hard facts as to WHY it causes impotence. Any insight would be much appreciated. Also, I did several cycles of Test w/ oral steriods when I was in my 20's (the latest cycle being Test only for 6 months when I was 28). I didn't always follow proper PCT. I have tried Viagra, Levitra and Cialis with fleeting results. Sometimes they work, but only sometimes. That worries me greatly. I have a fiance and we want to have children (not to mention a sex life) and this is really starting to take its' toll on me psychologically. I am open to any suggestions or thoughts and understand that it's not medical advice any of you are giving and I should always consult my Dr. One last thing: I realize some of the medications I take have addiction potential, but I have never "craved" these drugs. Rather, I need them. If not for the Phendimetrazine I wouldn't be able to focus and do my job (I have had ADD my entire life), I have yet to find a short - acting OTC supplement or drug that gives me the anxiety relief that Xanax does (though I am in the process of tapering down to a MUCH lower daily dose) and because of the bulging disc in my lower back I have to take Soma for pain relief. I know it sounds like I'm a walking pharmacy but, again, I am open to any advice or thoughts, even if they're harsh. I just wanted to get all of that out there so as to hopefully eliminate a bunch of the "you're an addict" replies.
    Also, I have access to just about any "research chemical" out there (Clomid, Cabergoline, Nolvadex, Arimidex, Cialis, etc....) and can get quality products cheap. There it is.... Any help at all would be greatly appreciated. Thank you all in advance!
    OK. Let's start with the doctor issue.
    When your insurance kicks in, see an endo or urologist(my new favorite) Pcp's are useless for HRT typically, you are correct on this one.
    Second, the combo of hydrochlorothiazide and xanax is probably your culprits. Plus somas before sex don't help much. Im to assume the h.c.t. is for high bp? Anything that lowers bp will usually soften you up, beta blockers, diuretics, etc. I have add and my thyroid causes hypertension so I am on a beta blocker and ativan. Your doc who actually does understand non-TRT drugs could probably switch meds up for you as I've had only minor limp noodle with this combo. I don't treat my ADD, I just work with it and try to slow down and concentrate when I need to but usually I can use it to my advantage with work and exercise. Maybe switch up the meds a bit and throw in yohimbe and cialis. It sounds like,in January, you need to get on TRT or do one of those test kick start protocols (hcg, clomid, ad ex) which I think are bogus anyways. If you did 6 months of test with no pct you will likely need to get on test and put a needle to your ass for the next 5 or 6 decades. Best of luck.....
    also clean up the diet and start training. Get obsessed, train hard, lift, run a lot. And I bet she'll be calling you thunderc0ck in 6 months

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    I can't speak to all the meds you're taking, but I would place a heavy bet on HCTZ being a major contributor to your problem. It made me effectively impotent at 12.5 mg per day, and you're taking 4 times as much. The impairment comes on slowly, and goes away slowly (as long as 6 weeks to 2 months) after you discontinue. Of course everyone is different, but I found several references that said the thiazide diruetics and beta blockers are both notorious among blood pressure meds for causing ED.

    I also found that lisinopril had similar effects, but not nearly as bad. Everybody prescribes it because it's cheap. On the whole, I suspect you could get equivalent blood pressure control by switching to an ARB (angiotensin receptor blocker) and/or a CCB (calcium channel blocker). While both of these can potentially causes problems, they are far less likely to do so than thiazide diuretics like HCTZ. If you have to take a diuretic for reasons other than blood pressure, you might consider switching to indapamide. I ended up using two CCBs - diltiazem and amlodipine - and they work very well for me.

    When I researched this back in 2008, I found a number of links on HCTZ and ED. One that's unfortunately no longer good had this to say:

    "The incidence of sexual dysfunction in men taking diuretics is between
    two and six times higher than in men taking placebo. Thiazides may cause
    reduced libido, erectile dysfunction and problems with ejaculation."

    If you want the links I found (7 in total as I recall), I'd be happy to send them to you in private mail, or I can post them here. Although I don't even play a doctor on the internet, I would strongly urge you to find an alternative to HCTZ for blood pressure.

    Edit: I should have said - I don't think anybody knows for sure exactly how HCTZ shuts down your erectile function. I never found a good explanation, or even a good guess.

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    Quote Originally Posted by peabody

    But even though I don't even play a doctor on the internet, I would strongly urge you to find an alternative to HCTZ for blood pressure.
    ^this^
    Personally,,,,,
    bystolic @ 5 mg has dropped my bp to a gorgeous 120/70 and a couple male fuels from twinlab every evening has kept the Mrs. very happy.

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    Guys, I really appreciate the advice and info. Yes, the Lisinopril w/ HCTZ is for high BP. It's odd, because it was just by chance or pure luck that I happened to find out there is a link between HCTZ and erectile dysfunction. I was just surfing the 'net not long ago and happened to stumble upon that bit of information. I know Xanax and Soma can cause some of these issues but I had absolutlely no idea that my BP medication could be the culprit. For some reason (don't ask me why) I was always under the impression that the better your BP the better your sex life. I never bothered to research the actual BP meds to see if they were the issue.
    I'm starting back to 5x / week cardio tomorrow in hopes of at least dropping pounds, even if a lot of it is muscle at this point. I just wanna get the weight down to help lower my BP naturally. After the holidays I plan to get back into a regular training routine for muscle mass.
    Now that I think about it, I experienced the exact same thing you spoke of, peabody: When I started the Lisinopril w/ HCTZ the impairament came on slowly and I didn't notice anything for a while. But things gradually deteriorated to the point I'm at now. Funny how something as harmless (or so I thought) as HCTZ can sneak up on a man and effectively kill his sex life. What a bitch.
    Either my doctor is f'ing incompetent or just didn't care to tell a (at the time) 28 year old that the BP meds she was prescribing could cause impotence. The only thing she told me was it was a very mild BP medication and Olympic athletes take it. HA! I guess Olympic athletes don't care about having sex and not being able to get a hard - on doesn't bother them. Who'd of thunk it...
    Again guys, I really appreciate the insight and information. And, peabody, if you have those links and get the chance to send them to me I'd love to take a look. Thanks again fellas.

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    Yeah, I have a woman doctor at the VA who assured me HCTZ does not cause ED problems. But to be fair, I think lots of doctors simply aren't up on this at all. And frankly, the only thing they care about is your BP readings. They don't care about side effects. They just don't.

    I'll send you the links. But I would urge you to at least switch to a different class of meds for your BP, and get off the HCTZ as soon as possible.

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    Quote Originally Posted by peabody View Post
    Yeah, I have a woman doctor at the VA who assured me HCTZ does not cause ED problems. But to be fair, I think lots of doctors simply aren't up on this at all. And frankly, the only thing they care about is your BP readings. They don't care about side effects. They just don't.

    I'll send you the links. But I would urge you to at least switch to a different class of meds for your BP, and get off the HCTZ as soon as possible.
    Yeah, I'm gonna eliminate the HCTZ the next time I see my Dr. and see about switching meds. And thanks for the links.... There's a lot of good, informative stuff there that I was completely clueless about until now.

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