Medicine is not an exact science, and most doctors work within a system that promotes managing symptoms rather than treating root causes. The medical system's problems are many and too complex to detail here. Nevertheless, my previous doctors and I made many mistakes in treating my ED.
I've had ED for about ten years. For most of that time, my doctors were telling me my hormone levels were fine when they weren't. There was no attempt by any of my doctors to find the root cause of my ED. Instead, they just gave me Viagra and Cialis. Until a couple of years ago, I never questioned their judgment. I assumed they were providing the best treatments available. Then, inevitably, the pills stopped working, and I started looking for answers.
Fortunately, I found my way to Dr. Rachael Ross, MD, Ph.D also known as Dr. Rachael. Dr. Rachael is unquestionably the best doctor I've worked with and a wonderful person who I admire. She is also one of those rare individuals who makes the world a better place.
Working with Dr. Rachael has helped me understand the mistakes my previous doctors and I made with my treatments. I hope by reading this that men seeking treatment for ED can avoid these mistakes.
Normal Is Not The Same As Healthy
Do not assume your doctor understands testosterone levels. Many doctors, perhaps even most, confuse normal testosterone levels with healthy testosterone levels. Unfortunately, unhealthy levels of testosterone are now normal. "Normal" is a statistical calculation based on the average levels in the population, not on levels required for good health. In recent years, the average testosterone level in men has dropped dramatically, dragging down the norm. It is essential to understand that "normal" is not the same as "healthy" for testosterone levels. If your testosterone is in the lower range of what is normal, it’s time to dig deeper. Most doctors will tell you everything is fine, and that might be true, but it probably isn’t.
When I first got ED, my doctor referred me to an endocrinologist who tested my levels for many hormones but not my free or bioavailable testosterone. Free and bioavailable testosterone are more critical than total testosterone because they represent the usable forms of testosterone in the body. There is no excuse for an endocrinologist not to understand this and test appropriately. My total testosterone although below average, was much higher than my free and bioavailable testosterone. Had he tested properly, it would have saved me years of living with the effects of low testosterone levels.
Over time, I saw two urologists several years apart. They both tested my free and bioavailable testosterone. Each time, my levels were barely within the normal range. As I stated earlier, "normal" and "healthy" levels are two different things. My levels were normal, but unhealthy. These urologists should have understood this nuance, but as far as they were concerned, my levels were normal, and everything was fine.
When I started treatment for my low testosterone, I noticed I was getting very emotional. That's a symptom of high estrogen levels. When taking testosterone, some men will convert some of it into estrogen, and the endocrinologist treating me didn't pick up on this. When I started getting my testosterone up to optimal levels, I started having symptoms of high estrogen, and I needed to go on estrogen blockers. Dr. Rachael was the only doctor I worked with who understood this.
Treating Symptoms Rather Than Root Causes
The medical system in the US encourages doctors to treat symptoms rather than root causes. My doctors immediately turned to Viagra and Cialis, and there was no discussion about finding or treating the root cause. Unfortunately, because they did not address the actual problems several years down the road, the underlying issues just got worse, making my treatments more challenging.
When Viagra and Cialis stopped working, this was a wake-up call for me to dive deeper into the issue. So I asked my primary care doctor for a referral for a urologist. Like my previous doctors, this urologist had no interest in looking for the root cause, and he just wanted to treat my symptoms with medication.
Initially, I wanted him to test for vascular issues. I suspected, correctly, that I might have a problem with blood flow. He told me that the testing was unnecessary because there were no treatments for vascular issues. That was incorrect. There are treatments. Although vascular problems are more difficult to treat, there are treatments. As a urologist treating ED, he should know this. He also told me my unhealthy levels of testosterone were acceptable. He clearly didn't know what he was doing, so I walked out of his office and never contacted him again.
Dismissing My Concerns
The urologist I mentioned above was also dismissive of my concerns. Having ED was a big deal for me, and it didn't fill me with confidence that he was minimizing my problem. Which was another reason I walked out of his office and never returned.
Not Understanding That ED is Usually Multifactorial.
Once I found doctors willing to treat my low testosterone levels. A pattern developed. Testosterone would help my ED for a couple of weeks and then stop working. My doctor would then increase the dosage, and the same thing would happen again. Unfortunately, ED usually has multiple contributing factors, and it is actually very unusual that treating low testosterone alone will cure ED. My doctors either didn't understand this or didn't communicate to me that testosterone was a part of the problem, but it was not THE problem.
Mistakes I Made
I Didn't Educate Myself
When all this started, if I had done a little research, I would have caught my doctors' mistakes with my hormone levels. I naively assumed my doctors knew what they were doing. Even when the first urologist I saw said that once Viagra and Cialis stopped working, the next step would be to get an implant. While it shocked me, he would go directly from pills to an implant. I didn’t question his judgement. Opting for an implant is not something that should be taken so lightly, I should have pursued a second opinion, but I didn't.
I Used ED Drugs Without Knowing the Potential Side Effects
I started taking Viagra and Cialis without understanding the potential side effects. I will admit that they worked very well, but only for a few years. Here is a link to the side effects of Viagra and Calis - https://www.rxlist.com/cialis_vs_viagra/drugs-condition.htm.
I Became Fixated on Testosterone
I allowed myself to become distracted from seeking proper treatment. Between my doctors’’ incompetence and my intellectual arrogance, when I realized that my testosterone levels were a problem, I became fixated on that issue. I assumed that fixing my ED was just a matter of treating my hormone levels. Thanks to Dr. Rachael, I later learned that my testosterone was a problem, but there was much more to treating my ED than addressing my low testosterone levels.
I had done a lot of research, and my research indicated that the answer to my issue was getting my hormone levels optimized. Even though I did my homework, I still didn't have the complete picture. Initially, I suspected I had vascular issues, but I completely forgot about that when I saw how low my testosterone levels were. Now I wish I had continued to pursue vascular testing. I didn't realize that ED usually has many contributing factors, and I wanted the solution to be simple and easy. As a result, I wasted a lot of time and energy trying to cure my ED by simply treating my hormone levels.
My Story Isn't Over Yet.
Over time, it has become apparent that my issues were more complex than I had initially imagined. I had low testosterone, low Nitrous Oxide levels, and vascular problems. Dr. Rachael has referred me to a new urologist to treat my vascular issues, and the early results are promising. I'm optimistic about where things are going for the first time in over two years, and I owe it all to Dr. Rachael.
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