Met with Urologist at Mount Sinai

Yesterday I met with a Dr. Yonah Krakowsky at Mount Sinai (same clinic as Dr. Keith Jarvi). Sadly it was about what I expected it would be. He was very sympathetic and kind, even going so far as to call my GP and confirm a DX of PFS. Unfortunately he told me that the prognosis wasn’t good and that there wasn’t much he could do. He recommended to my GP to let me try methylphenidate for my EF problems and also Fibanserin to see if that could help with my libido. Beyond that he said I could try Yohimbime.

It was nice to have someone validate my experiences in person, but it was a bit of a crushing blow at the same time. Not feeling to great about it all.


Did he not recommend any form of TRT or offer any additional tests?

I am thinking of going to Jarvi and asking for TRT.

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He mentioned TRT but there’s obviously infertility risks with that. He seemed pretty openminded though so he’d maybe be willing to pursue it. He had my tests from 2017 that all came back normal and his thinking was that they probably would again.

HCG with TRT will keep you fertile, so it’s not that big of a concern. I talked to people on other forums that have used that combo and were able to conceive.

I guess I just wonder what TRT will do if I already have normal T levels?

It really depends on normal, most of our T levels are in range, it depends if you’re on the lower spectrum or higher spectrum. I know there are some on the higher spectrum before, I believe James a former medical student that cured himself was on the higher end of the range and still experienced side effects.

If 5ar is not working, as there is evidence and theory for, you will get inadequate androgen signal even with high T. So you would need even higher T to counteract that, although that will come with side effects as well.

Someone got cured permanently with super high levels of T?

Guys, I subscribed to this forum years ago but never participated. Well, until now, I got my TRT levels checked and they were abysmal in the 200 range, then in the 300 range. Dr’s will tell you 300 is normal. For us it aint trust me. I got my levels boosted up to 1000 and for the first time got an erection and started to look at women the way I did before PFS. It is not a cure but it will elevate your mood and clear the fog thinking. Pls get your TRT levels checked and ask for the results. If they are in the 300 range get on TRT ASAP.

How long have you been on TRT?

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Close to two years

Did you notice increase body hair/hair loss?

No increase in body hair. Hair loss I guess i lost all the gains I had with propecia and I balded to where I was genetically predisposed to. No worries there. Hair is awesome but not awesome enough to lose your manhood.

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I am glad TRT helped you. Just be aware that TRT (or raising androgens by other means) can others substantially worse, regardless of the T levels.

I took TRT for 3 years and had blood levels from around 450-1000 at various times (depending on when last injection was-90% of the time I kept it around 900 but occasionally got busy and let injections slide) and my libido never changed in any direction one iota. In my opinion TRT has no benefit and can only cause harm.

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@vkg1, I found TRT very hard to manage many ups and downs. I believe it’s not just T levels that need to be balanced your other hormones need to be balanced properly as well. I did give me super strength but I was shedding hair like crazy on it and was extremely moody.

I took Nebido so my blood levels were very consistent as long as it had been 3 months or less since last injection. All my blood tests always looked great. Problem is I experienced zero benefit. Even when I came off of it and had suppressed levels I still felt the same as when T levels 1000.

What’s EF?

Erectile failure

Was this worsening (through TRT usage specifically) ever permanent?