Male Hot Flash & ED

Erectile disfunction, premature ejaculation, delayed orgasm, etc.
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Earl
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Male Hot Flash & ED

Postby Earl » Fri Apr 08, 2016 5:11 pm

I typically have no problem initially, but sometimes when DW and I having foreplay, I will get hot and start sweating (male hot flash? :oops: ). When this happens, ED will set in and the fun is over for a while. We typically don't have time to reengage after I cool down, at least for me (I take care of DW in other ways!), as we typically ML shortly before bedtime (I'm a morning person, but DW isn't :( ) so I don't know if it would happen again. Anyone else have a hot-flash symptom along with ED? I don't get typically get those at other times.

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Re: Male Hot Flash & ED

Postby be64 » Fri Apr 08, 2016 8:35 pm

Hot flashes and ED tend to have a connection to low testosterone and high estradiol.
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Re: Male Hot Flash & ED

Postby SquarePants » Fri Apr 08, 2016 11:33 pm

I've had hot flashes. They only occurred to a significant degree when I first began testosterone therapy when my estradiol was not under control. My testosterone was in the medium range (maybe slightly above medium), and my estradiol was high. I seemed to notice the heat mostly near bedtime, and especially during sex. We'd have to stop because I'd loose my breath and I'd be dripping sweat all over the place. ED problems began to occur for the first time in my life. The hot flashes and ED problems went away after I was prescribed Arimidex to lower the estrogen levels.

Are you on testosterone therapy? Do you have lots of body fat? Body fat contains enzymes which convert testosterone to estrogen.

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Re: Male Hot Flash & ED

Postby Earl » Sat Apr 09, 2016 4:06 pm

SP: Neither. At my last T check a few years go, was at 636 total, free wasn't tested. I'm in very good shape, especially for early 50s, just a few pounds over what I would consider ideal with multiple 3 mi. runs a week as well as resistance training. I have considered trying Estroblock or DIM as it does sound like too much estrogen in spite of the good T numbers. I have discussed the ED with my urologist and given my T numbers, he just defers to ED meds. I plan to discuss the hot flashes at my next annual. The strange part is that they only seem to occur during LM sessions.

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Re: Male Hot Flash & ED

Postby be64 » Sat Apr 09, 2016 7:29 pm

It's not like I know anything about it but I would think that if it only happens during sex then it would not be hormone related, but rather it may be related to something that takes place in the body during sexual excitement.
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Re: Male Hot Flash & ED

Postby Elevation » Sun Apr 10, 2016 3:41 am

What is your diet like? Quality of water? Sleep levels? Stress levels?

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Re: Male Hot Flash & ED

Postby Earl » Sun Apr 10, 2016 9:29 am

Elevation: Diet is generally healthy although my exercise routine allows me to generally eat what I want w/o gaining wt. Most of the time I sleep well (morning person that goes to sleep shortly after the lights are out and wakes up early before the alarm goes off) but I go through periods (4-5 days) of having a hard time going to sleep and waking up often during those nights. I'm currently in one of those now. Work stress can be a problem and it has increased over the last few weeks. While I focused my question on the problems with hot-flash correlation, I do have problems w/o them. Last night for example, we were having a great time with no problems at all (a cat couldn't scratch it!); shortly before it really mattered, things "went south" w/o any signs of a hot flash. In spite of taking Cialis earlier, and I was able to barely finish as things partially came back while taking care of DW. Very frustrating for both of us especially as the Cialis usually works well, but not always!!

bd64: It does sound like something non-hormonal given the initial vs. later contrast. There is usually a "break in the action" right before PIV as DW almost always needs lube. When that is often when the problem occurs, I try to stay focused on the "bigger task at hand" and not the immediate steps to get there. My next step is to see if DW is open to pre-lubing to reduce the break.

I've considered keeping a log of sleep/stress-level/diet/sex performance to see if I can see a correlation as the symptoms definitely come/moderate/go but haven't done that yet.

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Re: Male Hot Flash & ED

Postby be64 » Sun Apr 10, 2016 2:43 pm

I'm leaning toward my low testosterone high estradiol idea. That would pretty much explain everything. While your testosterone may have been fine a few years ago it may not be now. While I've never had hot flashes I've had the ED problems exactly as you discribe. When my testosterone was low I could become erect but if I lost my erection before penetration it was hard to get back. I would also lose it occasionally during intercourse. Reaching orgasm could be difficult as well. Cialis didn't help much either. Once on testosterone replacement everything is back to normal.

I'd recommend having your total, free, and bioavailable testosterone levels checked as well as estradiol. This may well give you the answer to your question.
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Re: Male Hot Flash & ED

Postby Earl » Mon Apr 11, 2016 5:38 pm

Thanks for the feedback. I'll review the symptoms with my urologist and ask him to check those levels. ::tnx

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Re: Male Hot Flash & ED

Postby Earl » Sat May 07, 2016 6:44 pm

To follow up, I did go to an endocrinologist and had a blood test. My estradiol (estrogen) was high at 49 (<= 39 pg/mL is considered normal). They prescribed a low dose of anastrozole with a follow up blood test in 3 mo. T was at the higher range @ 996/161, which is a higher than usual for me (was 776/110 in 2014). Will see if this addresses the symptoms.

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Re: Male Hot Flash & ED

Postby be64 » Sat May 07, 2016 8:33 pm

While below 39 may be normal, it's my understanding that around 20 is optimal.

How much anastrozole was prescribed?

A low dose could take several weeks to get your estradiol down and then you'll have to figure out how to keep it in the optimal range. That can be tricky. Lowering your estradiol will likely also effect your testosterone level to some degree either up or down. I could explain why but it would be a lengthy answer.

Something to watch out for is getting your estradiol too low. One indicator of high estradiol is lack of morning erections. If you are experiencing this then when it gets to a more optimal level morning erections will come back. If you then stop having morning erections again you have likely gotten your estradiol level too low in which case you'd want to cut back on the anastrozole until erections come back. It can become a challenge to remain in the sweet spot.

Other things to watch for should estradiol get too low would be aching muscles and sore joints as well as ED, low libido and difficulty reaching orgasm.
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Re: Male Hot Flash & ED

Postby Earl » Sun May 08, 2016 10:53 am

It is in 1 mg pills and I take one twice a week. Thanks for the info. I'll look for those indicators.

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Re: Male Hot Flash & ED

Postby SquarePants » Sun May 08, 2016 11:49 am

1 mg twice a week isn't a very low dose, and I wouldn't be surprised if that's too much. You can go an internet search and get variety of symptoms that people have when estrogen is too low. My knees hurt. It's like the lubrication in my knees gets depleted, and it can be painful to bend my knees when there is pressure on them. You may have other symptoms. I didn't have ED problems when estrogen was too low, but it seemed like it reduced sensitivity, and made orgasm difficult. Some of the symptoms of low estrogen are the same as the symptoms of high estrogen, so it can be tricky sometimes to determine if it's too high or too low. I'm very sensitive to Arimidex, and my estrogen levels bounced between too high (>40) and extremely low (~2) several times before we finally found the correct dose. (FYI: I'm taking 0.05 mg once a week, so your dose is 40 times my dose. Most people need much more than my dose, but 2 mg/week seems a bit high for someone who isn't on testosterone therapy.)

My experience with Arimidex seems to be different from be64's in some ways. With me, a Arimidex seems to lower estrogen very quickly (within a day or two), and it will slowly rise afterwards. If estrogen gets knocked down severely, it can take a weeks for it to return to normal.

If you suspect that your estrogen levels get too 2low, I'd suggest contacting your doctor to get rechecked, rather than waiting the full three months.

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Re: Male Hot Flash & ED

Postby be64 » Sun May 08, 2016 1:37 pm

I agree that 2mg per week is a fairly high dose. I wouldn't be surprised if your level came done pretty quickly. Perhaps in as little as one to two weeks.

I would suggest that as soon as your symptoms subside that you cut your dose back a lot or quit taking it altogether. To maintain a proper estradiol level while on testosterone replacement, I'm only taking about .25mg once per week or less.
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Earl
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Re: Male Hot Flash & ED

Postby Earl » Sun May 08, 2016 5:17 pm

I'll look out for that and contact the doc if I get those symptoms. 1 mg twice a week just sounded low! Thanks again for providing details on your experience.

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Re: Male Hot Flash & ED

Postby be64 » Sun May 08, 2016 5:50 pm

I believe the normal dose of Arimidex for women with breast cancer is 1mg per day.
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Re: Male Hot Flash & ED

Postby Earl » Mon Aug 22, 2016 4:56 pm

Here is an update. I had another blood test & endo visit. While she prescribed 1 mg twice a week, after a few weeks of that and some sleep problems, I reduced it to 1/2 mg twice a week. My Estradiol dropped from 49 to 37 at my next blood test, still at the upper end of what the lab sheet shows as normal (<= 39 pg/mL). My T dropped a bit from 996/161 to 952/139. Overall, the occasional moodiness hasn't happened in a while and I'm generally sleeping better. Given that I'm still a bit high, I've went back to the original 1 mg twice a week and plan to maintain that until my next visit in Nov. unless the symptoms get worse.

I must have a lesser sensitivity than some of you given the relatively marginal reduction for that dose. I wonder if sensitivity tends to be higher if on TRT?

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Re: Male Hot Flash & ED

Postby SquarePants » Mon Aug 22, 2016 6:39 pm

Thanks for the update. From what I've ready, there is a lot of variation in sensitivity among men. Some men require a lot more than others.


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