Hello all:
I want to report an improvement in the sexual side effects:
Last week I had a full erection withou manipulation, just watching some porn and having mental fantasies. It’s been the first such an erection since the last years with finasteride and all the time thereafter; maybe totalling around 8-10 years. I purposedly engaged in such activity to test to which extent I could get an erection. On the previous day / weeks I had been feeling a connection with the penis, I was having stronger and more frequent nocturnal and morning erections and I had a bit of libido and ocassional sexual thoughts. When I tried this previously, the most I could achieve was significant vascularization of the penis and its humectation, but no erection at all.
I discussed this with my doctor and he said that maybe it is the mirtazapine, but we don’t really know.
Nocturnal and morning erections are more frequent and stronger; as many as 3 days in a row and 4 or 5 days in a week, but not every single week. I still can’t mantain morning erections when awaken, though.
During a window of 2-3 weeks’ time and 3 weeks before this happened, I had been weight lifting intensively and having around 18 gr. of creatine monohydrate per day on the first week, then around 7gr per day; plus glutamine after exercising 3-4 times per week, and 5 - 8 IU daily of Vitamine D3. However, I don’t think this is the cause of the improvement as I had creatine monohydrate and high doses of Vitame D3 before and didn’t experience any improvements. I also tried on three ocassions having 20 grs. of L-arginine before sleep to see if I could have better nocturnal / morning erections, but it didn’t happen (actually on those days I had no morning erections).
Also, at the doctors’ clinic I had an injection in my penis to check for venous leaks and it seems I don’t have any, as I had almost a full erection (and artificial and painful) lasting more than an hour. I had a delayed reaction, though, as it took more than the usual time to have the effect.
On the brain fog side, I am on 8mgs./ day of reboxetine, which helps significantly, but is not optimal.
Depression is gone at 60mg of mirtazapine and 8mgs of reboxetine per day.
Good things about mirtazapine: helps me conciliating sleep (haven’t got any issues here anymore); makes me rest well and have vivid dreams that I can recall, which didn’t happen before, and gives me serenity, relieving anguish feelings and making me feel more myself. The only bad thing is that it makes me sleep too much and leaves me sluggish furing the day, so I have to resort to caffeine pills and to teas / coffees to function well at a mental level and have energy. This is a major drawback as it is incapacitating for a normal work / study life, so I am lowering the dose of mirtazapine now and might switch back into buproprion.
Overall energy levels are better than before, but I am still lacking a morning kick that’s sustained during the day.
I had bloodwork done, which I will post when I get it from the doctor. Testosterone came lower than the last time: 14nmol/L vs 20.80 nmol/L (9.00 - 30.00), but I got tested at nearly 4pm, and according to the doctor testosterone levels will be lower at that time. My 14nmol/L would correspond to aroun 18nmol/L in the morning, which is a normal testosterone level for adults.
With all this, the next steps will be:
- going back on tamoxifen daily during 2 months, to raise my testosterone levels to the upper third of the normal range. Objective: trying to have increased energy levels and an improved sexual function (the latter didn’t happen last time I was on tamoxifen)
- lowering mirtazapine to 30 mgs. to try to get rid of the excessive sleep and sluggishnesh.
- potentially substituting mirtazapine with buproprion
My doctor also mentioned that I may try modafinil to improve focus, but that we will assess this later, to act upon one thing at a time. Also, there’s some interaction problems of modafinil with the other drugs, so I will have to quit some of them if I follow the modafinil route.
That’s all for now; will post the test results soon.
Keep on fighting, guys; we have to believe that there will eventually be something that fixes us and meanwhile there’s a number of ways we can explore to patch up some of the more incapacitating issues.