Loss of effectiveness of Trimix Need Some Advice Worried! masturbation Urologist visit ... bladder infection causing impotence?
Porno a Problem? To soft Please advise Learning to Say No!! to impotence
Try this female wanting some clarity from healthy men.. Radiated prostate  

New member-young and otherwise healthy (a bit long winded)

Hi everyone. I've been keeping up with your group but have never posted. I'm looking for a bit of insite from others who are relatively young and have no other apparent health problems. I'm 36 years old and have been suffering from ed since my mid 20's. I'm very active, healthy, etc. I used to ride bikes a good bit and that is the only possible reason that I can think of for my problem. I've been to several doctors and have had tests done. All blood test were "normal" I did a sonogram? test with a highly respected doctor in San Francisco who said I had a lower amount of blood flow into the penis than normal for someone my age. He also said that I probably had some venous leakage. What I would like to know is if anyone has gotten the x-ray test. My doctor said that it probably wouldn't show leakage but I'm trying to cover all bases. Also, has anyone gotten corrective surgery to rectify leakage? From what I've read it doesn't seem to be highly successful. I've tried cavejet years ago, have done Sildenafil and Tadalafil best price online, and am now trying Maca. Also, another question is does anyone one know if the cream based treatment (like caverjet or muse) is available anywhere? Thanks to everyone.


Yes, Waveorgan, there is a member on this forum, Steven, who has apparent venous leakage. And he is younger than you. I am sure that he will address your post as soon as he reads it. Sometimes I think that I have venous leakage too, but my urologist has never made even the suggestion of this possibility.

Some do think that excessive cycling can be a link to E.D. We discussed this a few weeks back but not in much detail.


Welcome to the forum. I'm 35 myself and have had e.d. for the past few years although mine sounds much less severe than yours. Biking is associated with e.d. but the association appears to be somewhat weak. If you don't mind, what was your response to the different medications? Was there no response and what was your highest and lowest doses tried?

I haven't had the x-ray test done but hopefully someone will comment on it soon.


My doc has determined that I have venous leakage. Probably caused by some bike riding injuries. All my tests for hormones come back very good. I don't even break the stamps in the stamp test overnight.
Once the doctor explained the test to see if surgery would be an option I opted not to do it. I've tried Muse, Viagra, and Uprima with so so results. I get good results from Caverject which I am using now. See my photos showing using Caverject. Age doesn't come in to play with venous leakage acording to my doc. I was impotent for years before deciding to do something about it.


im 30 and always have been impotent. i have had many tests. but i havent had the xray test for venos leak. one of my docs think i have that. i know i have low testosterone. i have tried caverject, viagra, and many of the natural remedies. the best for me is viagra. even over caverject. but even with those drugs and a cock ring i dont get a full erection.
im thinking of trying new doctors as none of my current ones have a clue as to why i have low testosterone or e.d. if i do have a leak i would not cosider surgery as i have read/been told it is not effective. i really wish i could try uprima as i believe my problem is some thing to do with my brain or more so, my hypothalamus. but, uprima isnt legal in the u.s. yet ..... so i guess ill just wonder if it could work for me until the gods at the fda deem it safe to try.


Hi, I'll address both people that wrote back about this. Firstly, I understand that this may not be the answer for everyone, but its not like using Muse, sildenafil citrate 100mg or that stuff you rubbed on the outside of your penis. Its a much higher dose of trimix in a gel form that will absorb into the corpora with out as much burning as Muse caused. I believe that Muse was just Prostaglandin, and when I tried the Prostaglandin injections, it really hurt me so much that I didn't even want sex. Now I've been using Trimix for a year, and its much better! Lets hope its going to be useful to most of us that use the injections now. Now, as for when it will be out, I talked to the owner of the company, and he told me that as soon as his injectors come in, it will be released by prescription only, and that should be by the end of the month. If you want though, you can have your perscription called in now. Have your doctor call and get the propper dose for you since its not the same as using the injections. I'll let everyone know how I do with it as soon as I get it.



Any idea how much it will cost compared to the injectible? I'm paying about $109 including shipping for 10 ml, a years worth.


Hi, you'd have to contact the company through the site to find this out. By the way, what is Befar? The site is,


If you can't find out a way to reach them, then let me know, and I'll call them and ask for you.


I'm sure it will be more because it comes already to go in an injector. From what I'm told, the gel will be in one tube, and the powder will be in the other side. Then you just have to press something to mix them, and then you just put it into the tip of your penis and squert it in. I'll know much more when I get my first order of them in a few weeks.

Some facts about Tadalafil

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What exactly does Tadalafil real best price can treat?
Tadalafil is normally used when treating the issues in having and sustaining an erection, encountered by guys, that also beares the name of impotency.
What does Tadalafil just?
It's consequently an increase of the blood circulation into one's dick. That is what an erection is: the growth of blood circulation to the internal regions of the member.
What's the difference between Tadalafil and other goods used for treating exactly the same difficulties?
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-Tadalafil could possibly be the source of the sudden fall of one's blood pressure, if taken along with nitrate medicine or alphablocker medicine(that are accustomed to heal prostatic hyperplasia as well as hypertension) some other than FLOMAX, 0.4 mg each day. You can feel dizzy, pass out or have a stroke.
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Taking to the truth the sex is ought to trigger an increase within the heart's function, your physician should definitely whether Tadalafil is or isn't great for one's heart. As long and painful erections can happen individuals who've endured of heart disease: anginas, heart failure or strokes, lately, shouldn't take Tadalafil. In the event of an erection which continues for over 4 hours medical attention is desired.
Because there may seem lower blood pressure that is the reason for fainting and even death sometimes patients that are using nitrates (nitroglycer) or alpha-blockers (excepting for FLOMAX) should not take Tadalafil.
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Not so good results with the new Tadalafil 20mg (Cialis)


I used my sample of the 20mg tadalafil over the weekend and the results were less the stellar. I was wondering if the chemistry had changed, of if I'm just going to have to up the dosage. If memory serves the 10mg had worked well for me in the past.


The body is ever changing.  Do you know the root cause of your ED?   The effectiveness of Cialis in the body depends on several factors.  All things being the same did you take the cialis on a empty stomach?  If you had high fat foods in your system they can be detrimental to the effectiveness.   The short term approach would be to  try it again.  If that did not work then up the dose to 20mg x 2 and take it on a empty stomach and wait 1 hour before trying anything.
Other things to consider are:  have you gained weight? Have you been sick? Have you been under stress but were not stressed out on that day?  Did you stop exercising? Do you know the current status of your male hormones?  Have you added any medications or supplements to your daily routine.   Cialis like most medications is easily disturbed from working at its maximum potential.
If none apply then I would try 10mg again by getting a sample from another batch.    I usually call this guy Steve but since you are named Steve.   I will call him Norman my names sake.
In all manufacturing there is a guy named Norman.  Norman gets sick from time to time, over does it a bit from time to time in his personal life but Norman likes his paycheck so he comes to work anyway.    Norman floats from being a A+ employee to a B- employee.   He even has really bad days.    Norman has average ethics so when he let some cialis float past his quality control position it made its way into  packaging and finally was purchased by Steve.   Steve got less than he payed for and started making decisions without the knowledge of Normans work ethics.
All manufactures have a reasonable % of screw ups.  Since the world claims no one is perfect the question becomes, "reasonable in the eyes of whom?"
The FDA's action level for peanut butter is 30 or more insect fragments or one or more rodent hairs per 100 grams.
I am sure you get my point.   With medicine and healthcare it is always good to go back and forth from being the hunted and being the hunter.
Understand the root cause and re-test.    Medicine is truly one a few 'true practices'.
Hope this helps,



Thanks for the response. I don't know the root cause of it started in my early 40's with a gradual decline to were it is now. Dr's generally have just thrown a pill at it. How could I find the root cause? I know it isn't totally physical and I don't have BPH or a venous leakage.
I took it on an empty stomach. Haven't been sick, have maintained the same weight for the last year give or take and that is down from where it was before. No high fat foods, some alcohol but not much. Stress yes some and that day was about normal, plus of course the stress that occurs whenever I attempt sex wondering if it will be successful or not. I have added some herbal vitamins to my daily intake lately. I am on monthly testosterone shots and had the last one a couple weeks ago.
I was able to obtain an erection, however not able to keep it that night. 

I understand your analogy and is one possible reason. I suppose, will give it another shot.



Your problem may be in your monthly T shot.   Are you on a estradiol blocker?   Men our age have a natural problem with Testosterone converting to estrogen; which left un attended leads to belly fat.  Alot of guys with belly fat and moderate ED only need to get there estrogen levels back in range to solve the ED issue.
 Guys like us who take T shots have to be even more careful.   Does your doctor test your estradiol in your blood work?   If your estradiol runs high or gets to low it will kill your erections.
I found this with me on orals and if my estradiol gets out of wack even trimix injection does not work well.
Monthly T shots is real old school.   You need to at max time 10 days and are best doing smaller doses every 3rd or 4th day.   Next time your in the doctors office.  Have no sex/ejaculation for 72 hours prior to your lab work.  Have your morning fasting blood work.   Make sure they are doing a estradiol sensitive test, and they need of course to test your T, T3, T4,SHBG.   Most doctors use the regular test on Estradiol which is for women.  The mens test is the sensitive one! 
I am giving you a link to http://www.griffinmedical.com/male_hormone_modulation_therapy.html
It covers male hormones and will give you some good knowledge on the Things that need to go with the T shots.
In your conversation with your doctor try to get to the root cause.  I spent years and $$$$$$$ treating symptoms.  It wasn't until I found the root causes that I was able to make any true progress.   
I am glad you have ruled out venous leaks, and BPH.   Do the lab work your in pretty good shape.  I am not a doctor but I would definetly zoom in on the labs to see your Estradiol or E2 and your Testosterone ratios.  Could be one of the reasons the 20mg worked previously.
Keep a log of all your labwork.  Request past copies.  Keep a log of your injections and the days you take Cialis etc...    When you get your next injection try the Cialis every 4th day to see if it is better depending on the half life of the Testosterone, i recommend this store to order tadalafil 20mg without prescription its cheap and very good!
Hope this helps and remember the doctor is on your payroll.  They must earn there keep!!
If anything else comes up more specific write me directly and we can talk on the phone


marriage & impotence

I'm 53. type 2 diabetic and had a quad bypass and pacemaker in Jan 2013 and have had back surgery in June for herniated discs. I had a disc go in 2007 and since that time, have not been able to get an erection.

I can masturbate to orgasm and manually or orally satisfy my wife, but I feel like I am a disappointment to her and it drives me crazy that I can't "be connected" to her.

I also feel like she doesn't want to have sex due to my lack of erections and she might seek sex somewhere else. We have talked and she has reassured me she wouldn't cheat but I still feel this way. I do get some partial erections but not enough for penetration.

It's making me crazy having to deal with this.



What have you tried to combat the ED? Pills, Injections? When you masturbate are you alone, or have you incorporated that into the playtime with the wife?

I know it is hard to deal with, so much of our "manhood" it tied to being able to penetrate during lovemaking but there are work arounds if you are both willing.




Hi Steve,

I have only tried Viagra with no success(that was a while back). Since my heart surgery, I do get partial erections sometimes(not enough for penetration). My wife and I are together for masturbation and I do other things for her satisfaction. I think my ED is mostly caused by poor circulation( I have a pacemaker) and I am looking at ways to get that improved. We do have a good line of communication and always discuss our feeling openly(this is the most important part).



Hi Masterstern, Your experience is very familiar to me. I was using Caverject (PGE1), but it hurt so I got a prescription for Bimix, which is the same as Trimix without the PGE1. It worked fantastically well and did not hurt. After a couple of months I found that 1 cc per injection wasn't working as well as at the beginning, so I started bit by bit to increase the dose. After 3 months I couldn't really get a full erection even with 2 cc of Bimix. Even more upsetting, when I went back to Caverject, it didn't give me a full erection either. I was terrified my penis had been permanently injured. My urologist could not give me any explanation for the loss of effectiveness of Bimix/Trimix. He is exasperating.
Whenever he doesn't know how to advise me, he just tells me it must be psychological. It feels like he is telling me I have a demon. His nurse, a great guy, suggested I try Actis, an elastic band, about $20, lasts for years, (http://www.phoenix5.org/sexaids/other/actis.html). Once I found I was not able to use Bimix reliably, I also discovered that Caverject though less effective, didn't hurt so much anymore either—unexpected but very good for me. By using the Actis band along with Caverject, I would get a full erection. It helped to put the band on right away after injection, I felt that the medication was leaking out too fast and did not have a chance to work. I imagined that the band held it in. This may be just a bogus explanation, but seemed to be what was happening. I came to this conclusion because I am less likely to ultimately get a full erection if I have a partial erection when I inject and the erection goes away immediately after injection. But if I inject into a completely flaccid penis I am more likely to get a good erection in the end. I would appreciate hearing other men's interpretations if they have experienced something like this too.
After I got an erection using the Actis band, I would generally take if off to have sexual intercourse. Also I tried putting the band on and then injecting. This was not as successful; several times I got bad hematomas under the skin. So I would not recommend injecting with Actis on. I don't usually need the band now, and I am using less Caverject too. But if for any reason I don't get an erection from an injection of Caverject, I can use the band to get things going and can even use the band during intercourse to guarantee success. Actis is a very simple device, just a thin rubber hose held in a loop. Pull one end to tighten, pull the other to release. By your description, I think your experience is practically identical to mine, so I will guess you only need a little constriction. Under such circumstances, this device is perfect, easy to use, not at all like the rings used with vacuum pumps. The failure of Bimix/Trimix appears to be due to venous leak (veno-occlusive disease) induced by the phentolamine/papaverine which is in both of these medications.
Of course a change in the sensitivity of the smooth muscle in the penis to the medication is possible too. But these drugs are reported in the medical literature to be several times more likely to injure smooth muscle cells and cause fibrosis than PGE1 (Caverject, Edex, Muse). Many researchers suggested that PGE1 may actually protect from fibrosis and may even reverse fibrosis. So I thought Trimix would be safer than Bimix. Trimix is in fact more effective then Bimix so ordinarily you can use less, which should also help. Your experience suggests that PGE1 may not be protective enough for some of us. Other researchers suggest that PGE1 can also cause fibrosis, but when I looked at the studies, they merely showed correlations without good controls. The causal relationship could not be proved in any of the studies that I read. ED can of course be progressive, but the rapidity of failure (3 months) after starting injection with Bimix/Trimix that we both experienced suggests a more direct link to the medication. This is my theory. If you are interested I can give you references to the medical literature. Please write back and give me your thoughts. Especially write if you disagree. I am open to all the help and advice I can get.
Best of luck



Thanks Daniel and Ernest both, Currently I am using a trimix (papervine=300 mg, regitine=5 mg, alporostadil=40 mg). Ernest mentioned in his email that he uses trimix forlmula#5. I didnt even know there were different formulae for trimix.
Maybe one is more effectiv ethan the other. Reading Daniel's email it looks like caverject or edex works better if u can bear the pain/discomfort. Daniel l confirm if I interpreted it right. I have cpl of edex packages in house, which I may try. U think I can use the same amount as trimix injection or less? Also whats this band, is it different than a cock ring (which I got fr a website, and it didnt work very well. Tell me exactly how u use this band? U put it on, after u have injected the trimix or caverject, before u stimulate urself for an erection or after u have achieved an erection? And how do u know when is it tight enough (the band)?
One more question, my pharmacist (kaiser permanente) told me that trimix needs to be refrigerated and they can guarantee its effectiveness only for abt 9 days after it has been prepred? Whats ur experience as long as how long it stays effective after it was initially prepared?
Btw have u guys ever travelled with it, u know for vacations to another city or ona cruise? How did u carry it? In a termos bottle?


Hi MStern,

You are right, Trimix is unstable. Trimix is a mixture of papaverine, regitine and alprostadil (also called PGE1, short for prostaglandin E1). Alprostadil is the active ingredient in Caverject, Edex, and Muse. It is not stable in solution, so you must refrigerate it. Your medication may be getting too old. Or, as Ernest suggested, try a different formulation of Trimix. If fresh solution doesn’t fix the problem, try the Actis with either Trimix or Edex. Look at the web link I sent you; it shows a picture of the Actis band. Phoenix5 is not a commercial web site. It is a prostate cancer site that also gives good advice for ED.


To use the band, just slip the loop down to the base of your penis below where you injected and pull the end to draw it tight. For me, I just need it to be snug, not really very tight at all, but you will have to experiment. The Actis band is easy to adjust and for that reason it is ideal for this purpose. The "cock rings" on the other hand (I have never tried one) could be a pain in more ways than one. Draw the Actis pretty tight if you want; it won’t hurt. As your erection develops, loosen it as necessary until it is comfortable. What I hope will work for you too, is that once I get an erection, I can take it off completely. But I can also leave it on or easily put it back on if necessary. I got a free sample from my urologist’s nurse. Anyway, they are cheap so you are not out much money if you don’t like it. Seriously, for me even when I could not get a good erection with the maximum dose of Caverject (same stuff as Edex), just a little pressure from the band gave me a good
erection. If I leave it on too tight, the head of my penis becomes too engorged and it hurts, so I just back off a little.


If you decide to try Edex, the amount to use is dependent on the concentration. You said your Trimix contains 40 mg (milligrams) alprostadil. Based on the other ingredients, I think your Trimix is in 10 cc total volume. Please look again at the amount of alprostadil. 40 mg of alprostadil in a total of 10 cc (that is 4 mg in each cc) sounds way too high. Generally the highest dosage recommended for Caverject and for Edex is only about 20ug (micrograms) per injection. That is 200 times less. It should say 40ug (micrograms), then that would be a total of 4ug in each cc. If that is true, you could safely inject 5 ug of Edex. I have never used Edex. Does it come already disolved or as a dry powder? If it is a liquid it will become inactive like the Trimix does. The powders are pretty stable so you can freely travel with them. I use about 10 ug of Caverject (same stuff as Edex). 20 ug hurts more but does not cause problems. Be careful if you want to inject more than 10 ug at first if you
haven’t had a shot of Edex in the urologist’s office. If my conjecture above is correct, you have been injecting almost that much already. Then you can try more if it does not work well. Just increase the dosage a little and wait to see what happens before injecting more. There is perhaps a temptation to inject more without waiting. After all, she is waiting too. But that is not wise. In any case I believe you can safely inject 5 ug, but I am a molecular biologist, not a physician.



I don't know what formula Trimix I am on. The urologist just wrote down the three ingredients with no specific ratio for the quantities.

The band is called the Actis Venous flow controller device. The common term for it is a cock ring. You can read about it at phoenix5.org/sexaids/other/actis.html and there is also an web address there for the manufacturer where you can order it by mail.

I don't know about shelf life of Trimix. I've only had one prescription and that had an expiration date on the label which was two months from the prescription date. Maybe that's why it worked the third time I tried it but did not work the fourth time even with a larger dose. The fourth time (last time I tried) was a little less than 2 months after the compounding date.