MUSE STOCK SHORTAGE

I used my prescription at a large Boots branch today . They had some in the fridge ! I do not know if they have an ongoing supply, the pharmacist could not tell me. I was just pleased to get a 6-pack today.

Edited by member 17 Aug 2017 at 20:56  | Reason: Not specified

Vitaros is the least efficient way to deliver alprostadil. In needs to get in to the corpus cavernosum, but the glans is on a separate blood supply (via corpus spongiosum), which is erectile, but is not the main erectile part of the penis (it's job is to pump the urethra during ejaculation, rather than erecting the penis). This means the alprostadil has to diffuse through the glans and then across from the corpus spongiosum to the corpus cavernosum, and it all adds up to being less effective, although it does work for some men. Muse works the same way, but is more easily absorbed through the urethra than Vitaros is through the glans. I suspect Vitaros may be less effective in circumcised men too due to less absorption through the glans, but I've no idea if that's really the case.

Dave, if you didn't have ED before treatment and since your nerves are likely intact (based on your bio), it's probably lack of arousal due to the HT hitting libido. If so, you might try some other things. Did you try PDE5 inhibitors (Sildenafil/Viagra, Tadalafil/Cialis, etc) before trying a vasodilator (Muse/alprostadil)? PDE5 inhibitors will amplify what arousal you might have had, possibly enough for an erection. If not, you might try adding some other things with the PDE5 inhibitors to improve arousal. These would be things like sex toys - vibrating rings. Another thing to try would be using erotica/porn (soft porn if you haven't used porn before - hard porn can generate feelings of regret for what you've lost, which is counterproductive). Obviously, both you and your partner have to be happy to try these - if either of you are uncomfortable, it could damage your relationship, which you definitely don't want just at this time, so be very careful there.

If you only tried one or two of the PDE5 inhibitors, it's worth trying another (there are 4 of them). Unfortunately, none of them are only PDE5 inhibitors, they all inhibit some other PDEs too, different for each one, and different PDEs have different effects on other parts of the body. It's usually inhibiting those other PDEs that give side effects, and you might find by trying another, you get one which doesn't cause you side effects. Also, you might find a smaller dose is still enough for erections, but reduces the side effects.

My background is as a software engineer, come data scientist. My day job was looking after loads of computer storage servers around the world, and I logged every parameter I could get out of them. This enabled me to spot trends and predict in advance when one was going to fail.  I basically turned that analytical method around and pointed it at me, hence I measure everything I can think of, including leakage (which is fortunately gone now). Unless you know how much you leaked, you don't know if you are getting better or not, hence weighing pads.

My urological radiologist was fascinated by a graph I'd plotted of varying erection length during EBRT and HDR brachytherapy. They don't get that sort of data, so they can't tell patients what to expect. He carefully counted off how many weeks recovery took, so he has at least one datapoint from one patient for future reference. At the Chorleywood Men's Health Day last year where many top urologists (including the country's very top urologist) came to talk with men, one of them looked through my data for a while. He said, if I was his patient, he would be asking for a presentation at the end of treatment - they simply never get that sort of detail back from patients. I've offered that to one of my consultants so far, and it looks like I may do it in March.

Edited by member 05 Jan 2020 at 14:18  | Reason: Not specified

Interesting theory; not considered by the ED consultant or John's new ED nurse though. John is circumcised and I can confirm that all it does is make the end of his penis very, very pink. It may be no use for penetrative sex but I can find it in the dark 🤣 

Sometimes, men think the tablets don’t work because they don’t leave enough time; in our house, John would take a Viagra in the afternoon if we plan to have sex in the evening, or at bedtime for sex the next morning (not that that happens very often these days). Levitra works 3-4 hours after he takes it. Both need to be taken on an empty stomach.

Andy, you just caused me to chuckle :-)   "he would be asking for a presentation at the end of treatment"  set me wondering as tp what form a "full" presentation might take.

John