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Suicides among Swedish men decreased after Viagra became more affordable (sapienjournal.org)
167 points by hheikinh on Oct 10, 2021 | hide | past | favorite | 101 comments


Sildenafil (Viagra) is old and busted. Tadalafil (Cyalis) has a longer duration of action and less side effects (17 vs 4 hours half life) due to a lesser reduction of PDEs besides the targeted PDE5.

Additionally, studies show that daily tadalafil is much better in managing or even “curing“ ED.

Want a little extra boost? Consume 6g of L-Citrullin a day. One of the few proven, freely and cheaply available substances that improve erections. L-Citrulline gets converted to L-Arginin and is better that L-Arginin supplementation.

If you want to increase the half life, consume pomegranate juice.

Warning, L-Citrullin and PDE5 inhibitors potentiate each other.

Need even more arguments? Daily PDE5 inhibitors are cardioprotective and cardioregenerative.

Studies used 5mg Tadalafil daily, I am on 20 -why not?

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7261690/


Careful with pomegranate juice if you take any prescription medications. It doesn’t get along with several, including some popular blood pressure medicines.


Yeah I'm not really sure why anyone uses Viagra when Cialis exists.

As long as you don't have heart or blood pressure problems, it's perfectly fine for healthy people to take, and even if you don't have ED it elevates you to a sex god. Truly amazing stuff.


I tried both and get headaches from both. So I'd prefer a 4h headache vs a 24 hour headache


Fair enough. Do you have low blood pressure?


Do you happen to know any drug or supplement which helps Preventing an erection?

(Serious question)


Anti-androgens and GnRH agonists like Spironolactone, Cyproterone Acetate, Goserelin Acetate, Bicalutamide to name a few. Also to a lesser extent 5α-reductase inhibitors like finasteride (Propecia) which only suppress the more potent dihydrotestosterone.

All of these work by suppressing androgen production (mostly testosterone and dihydrotestosterone), this will suppress most of the male libido. While they don't remove the ability to get an erection if you try, they will prevent the hormonal lead-up that would normally lead to one. You'll likely stop thinking about sex entirely, there won't be much of a drive. GnRH agonists like Goserelin Acetate (zolodex) are highly effective, spironolactone is very weak and a potent diuretic.

On the downside... an adult human body expects to have a dominant sex hormone, either testosterone or oestrogen, and a lot of things hang off this. For one, initial breast growth is inhibited by testosterone, so you will likely develop gynecomastia (unwanted breast development). Your body hair will reduce, though facial hair is mostly unaffected, and your skin will become softer. Long term you are at increased risk of developing osteoporosis, and your testes and genitals will shrink. Sperm count and viability will reduce, though for some people this is recoverable.

It will halt any male pattern baldness though.

Most of these drugs are used for treatment of prostate and testicular cancer, so their effects are well known.


Do you happen to be a doctor/scientist? I’ve had an unbelievable experience which I’m looking for a scientific explanation to / trying to replicate, but I’d rather not share publicly. Is there a way to get in contact with you outside hn?


Alas no, just someone on those medications so I've done a lot of research in to them.


Is that what they use for “chemical castration”?


Yes, sometimes.

I'd recommend that any man thinking about taking these for ANY REASON (including transitioning) have his T levels measured first - Low T is more likely to cause adverse behaviors and mental issues than high T (contrary to the "roid rage" hypothesis of "male toxicity" BS).

Roid rage can be a thing but it's more complex than simply having too much T - it's a dynamical system so it's very much like getting a sugar high and then insulin shock afterwards: you will rebound from high T intake to very low intake and that better explains most of roid rage.


Where I live high doses of cyproterone acetate have been used for chemical castration (>200mg), but at these levels there's a chance of developing benign brain tumours, so they try not to do this.

I think zolodex is also used in this manner, and it's more effective since it's a long-lasting implant rather than a daily pill.

In both cases they're not 100% effective, different people respond differently.


There is a widely circulated rumor that in the Romanian army they used to put a small quantity of bromide (sodium or potassium? don't know) in the evening tea; it is not supposed to prevent an erection, but total lack of sexual desire. This was 30-40 years ago, I was not able to find any official documents related to that, but any men over 50 years old is telling that story.


This legend circulated across the entire Eastern Bloc in general, and possibly beyond it. It's not based on anything.


In Finnish army this was in the tasteless dessert pudding they served at every meal. The theory was frequently tested and proven to be true. You would get annoying and embarrassing morning wood if you skipped the dessert.


So many come to mind, I could write a whole article about it.

None of them have an acceptable side effect profile, many of them can potentially cause persistent inability to have sex to the point where not even megadoses of pde5 inhibitors help.

I strongly advise against ever taking SSRI or 5ari for this purpose. They are now known to cause persistent ED in susceptible individuals.


SSRIs tend to reduce libido. That’s not exactly the same thing, but they are connected.


For the interested: You can prevent ejaculation (i.e. there is a loss of seminal emission, but not orgasm) using silodosin. It can be used as a male contraceptive. Low doses tend to work, but I recommend testing it before the real action[1]. You will still have orgasm, but without ejaculation. Be cautious though, because it is not without side-effects. Do your research!

It is funny how there is not much of a mention of this substance for this purpose, even though it is indeed effective for it. A male contraceptive pill.

[1] Do not forget about the importance of dose, onset of action, duration of action, stomach content, and so forth.


Interesting. How did you get this knowledge?

Do you have experience with it?

Would it enable the ability of having unlimited orgasms?


> How did you get this knowledge?

Medical curiosity and some research. My friend and I got the idea, discussed it, and he decided that he should put it to a test. It worked! He has done a lot of experiments on himself.

> Would it enable the ability of having unlimited orgasms?

This is an interesting question. I will ask my friend to do some research on that. I am not sure that ejaculation is necessary for the compounds responsible for the longer refractory period to be released.


Would it be possible to get in contact with you outside hn? I’ve got something which might interest you but I’d rather not yet share publicly.


I created this throwaway e-mail:

    trepiprara at matra dot top
Alternatively, if you have a Matrix account, we could talk there.


Sent you an email from hnmsketohun at protonmail dot com


Drugs that lower testosterone will typically accomplish that outcome. Men that go through prostate cancer treatment for example will often have erectile dysfunction (due to hormone therapy targeting testosterone - androgen deprivation therapy).


Pretty much every drug that lowers your T or DHT to the point where you can‘t get an erection anymore can permanently ruin your (sex) life.


If your issue is Sleep Related Painful Erections (SRPE), then Baclofen works well.


HRT


Great way to get PM's from girls :)


Absolutely!

Cialis is my "go to" also - because it's half-life is about 24 hours so you can take it once a day and not "plan" what is often unplannable.

Also agree with citrulline. Good choice plus it also helps with working out by increasing NO which increases blood flow to muscles as well as the penis. Being "always ready" actually makes no-fap and confidence with women easier thus you can be less ruled by your cock and more by your brain!

Viagra was originally being researched as a blood pressure medicine because of the NO effects but it was accidentally discovered to help with ED during clinical trials!


Does anyone have experience supplementing L-Citrulline for sports performance?

I tried beta-alinine and I couldn't do it; made me have this horrible uncomfortable pin pricking/itchy reaction for over an hour each dose.


Are you asking about amateur or profesional sports? I competed in amateur mountain bike races for a number of years, but I never took any medication to improve performance and I see no point in doing that. As an amateur, going to competitions every couple of weeks and getting in the top quarter was the purpose, not winning it; it was a strong enough motivator to do sport - the atmosphere, the tracks and the views in the forests were a great reward.

For profesional level, medics can tell what is allowed and what is not. I am not a doctor, but most performance-improving drugs are forbidden.


I climb but didn't climb for like 7 years in my 20s due to poor life choices. I think I used to be grouped in idk maybe 'pro-am' if that is a thing, e.g. top of top % but didn't get paid to do it. Especially back then even the very few full time 'pros' barely were able to eat. Would get killed if I tried to compete right now ;)

I don't think USADA or WADA prohibits it or creatine etc.

I've been back for a couple years now and have been interested in ways which help me train more effectively without injury, since I just can't do what I could when I was 20.

sleep, water, and stretching make the biggest difference. I have not gotten into Testosterone or other anabolics which seem like the only legit way to feel 20 again lol


Citrulline isn't on the WADA prohibited substances list.


Oh wow, I thought I was the only one who had that exact reaction. Very strange feeling, like a thousand warm caterpillars walking over your skin.

It was enough for me to stop using it (though I don't think I ever really saw any benefit, so it's not like the choice was hard).


I use it for bodybuilding. Helps with the pump. It's in a lot of pre-workouts.


'the pump' would be valuable to me if that means reducing lactic acid or enabling you to push further (I'm a climber)!


ha, no the pump has nothing to do with lactase. It refers to blood filling your muscles -- you probably get a pump in your forearms from climbing. Feels like someone stuck a bike pump in your arm and "pumped" you up.


Interesting. Yeah it's a different feeling I think for climbers. From what I've read it's lactic acid build up, like when I fully crimp it hits the forearms hard after a bit just not able to grip anymore


What kind of performance?

We always got our all star creatine.

I didn‘t notice any changes in workout performance from tadalafil or l-citrulline and I consumed insane amounts of them.


I would assume protein synthesis from what I've read?

The research on creatine does seem like it's not total BS in some specific cases. For instance I'm pescatarian and it seems like that I might get an actual benefit with lower non-meat creatinine. At first I definitely felt what was probably psychosomatic but I can't tell if it's helping still.


Creatine is a very, very proven substance that increases physical performance, muscle growth and cognitive performance.


Doesn't tadalafil affect your sleep? Also, it doesn't feel nice if you take it and seat in front of the computer for four hours doing focus stuff.


Worsens sleep apnea, improves nocturnal urination.

If you suffer from having to get up at night to urinate, PDE5 inhibitors COULD improve your sleep, if you don't, they will probably worsen it.


Im not entirely at that point in my life yet but here here - I'm going to be buy 10 litres of Pom juice and recording the data. Hopefully recording useful data.


There is only weak evidence it increases sildenafil half life -I shouldn‘t have mentioned it.


6mg? I think you mean 6g.


correct


How long before we see the "suicide dropped when lsd, magic mushrooms and MDMA are legalised"


Well, the hangover after rolling can be pretty scary for someone who's already prone to depression.


I once accidentally took about 500mg (tested). Felt depressed for weeks. Everything felt wrong on my skin. It gave me an understanding of what it means to be depressed. Few weeks later I was fine again. But definitely a scary experience. I began to hallucinate parts of conversations. Then the muscles (?) In my ear started to feel really painful. Then I realised I had actually taken too much


Hey I had ear muscle issue after one trip too. It does come back occasionally (seems to weirdly correlate with eating Indian food (!) or big alcohol hangovers).

Was the feeling same as when you tightly shut your eyes? It's the Tensor Tympani muscle, but I'm not sure what could be causing it to spasm exactly.


Yes, like a fluttering in the ear if that makes sense. Maybe try magnesium in your case?


hallucinating on mdma is wild, no one seems to mention it really


Something like 10% of MDMA is converted to MDA on average (this varies heavily based on genetics) so it’s not super surprising. I totally agree it’s not talked about nearly enough though. I haven’t had visual hallucinations (assuming we’re talking actual hallucinations not “visuals” like tracers) but have definitely had auditory hallucinations where it sounded like people were talking just outside the car my friend and I were cuddling in.


Never happened to me. Likely someone laced it with lsd or 2cb


Those are strange choices to cut mdma with. It usually happens if I binge a bit.


How i that strange ? lsd / mdma is called candyflipping and known as one of the best mix.

lsd / 2cb is not common in US / europe but quite frequent in south america


Like I said we lab test all our stuff here in the Netherlands. Its actually free to do so. So this wasnt laced with anything. Go do some more research on mdma and hallucinating because you are clueless. Many people experience this


Well I don't distrust you.. it's just I have'n ever heard of it apart for some "minor audio hallucination". But if you say so I'll take your data point.


500 is way too much (even if you are from the UK lol).

Its 5 times the fun dose. Try doing that with some other drugs and it can be life threatening..


Even with pure MDMA a lot of the time 100mg - while an amazing time - isn’t really the “fun dose”. Ideal for me is 250 across a night (maybe 125 then 75 then 50) if it’s like a full on music festival. In a mellower context (camping or a house roll or something) I’d recommend one 100mg dose and no more though


Across a night why not. But 280 at once was defenitely too much for me..


Really depends on weight


Yes! I wish this was known. Mine lasted a couple of days. Thought I'd never feel joy again.


It's a well known problem. Finishing the night with any kind of actual sex (not masturbation) greatly mitigates the depression stage.


Hey thats true actually ! Never noticed but all my best rolls were with some sort of sex included ^^


Pre-load 5-HTP for a week


Well you need to educate people for sure..


After we see “mental illness increased when lsd, magic mushrooms and MDMA are legalized”

These drugs have huge potential to mess up a person’s brain if not taken with caution and under direct supervision of experts.


It’s definitely theoretically possible but having been pretty involved in the scene I’ve only ever seen LSD, shrooms, and other classic psychs bring out psychosis/schizophrenia in people who were probably going to develop it anyway (or at least were pre disposed). This was around college age when schizophrenia usually emerges. In general they don’t seem to cause mental illness in people who weren’t already pre disposed. (Obviously this does not mean psychs should not be treated with enormous respect)

I’ve seen a lot of people get low-grade cognitive dysfunction from mdma abuse (neurotoxicity due to “doing it wrong” ie overheating/overdosing), and while not in the class of drugs we’ve been discussing I’ve seen xanax ruin more lives than any other drug by far


You really need to abuse for a super long time some lsd to be messed up. I know a wide bunch of people in the party scene who absolutely abuse MDMA but they dont have more mental illness than the avetage smoker


Time series correlations like this have next to no evidentiary value.


Right. I use the example that the number of circulating guns in the USA always increases.

So you pick a ten year period where per-capita homicide rate went up or down to 'prove' whatever correlation you want about guns and homicide.


Just reading the title reminded me of https://i.redd.it/4h8emlr5z3c41.jpg


Well, internet use -> computer use -> better economics + indoors more often.

Contrived but not ridiculous



More importantly I completely misread the trend of the graph i.e. for my hypothesis to hold the internet mark share should be increasing!

Must've wrote that half asleep or something


Read the paper maybe? There is a clear regime shift in the suicide data. Maybe there is some other trigger. But the argument of the paper is not without merit.

[1] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8159839/


I don't agree with this paper's statistical analysis, and I think there's probably a different trigger for the change BUT I came here to say that I strongly agree with you that the paper has to be taken on its specific merits. It's perfectly possible to have good epidemiology based on time series data.

(I feel like I should cite something. It's been a long time since I was a professional epidemiologist and I'm way too lazy to look up anything recent, but Oli Miettinen's book "Theoretical Epidemiology" is an example of how some epidemiologists are very clever and very careful.)


What? Are you telling me I can’t make a paper out of https://www.tylervigen.com/spurious-correlations ?


and divorce rates skyrocketed right before a swedish divorce reform of some kind went through which made it less financially beneficial for women to initiate the divorce. and this surge of divorces was, as always, almost all women initiating.


So the women were trying to get hay while the sun shines?


A more nuanced take on this: https://www.youtube.com/watch?v=21NxJS_zYDY



Does viagra affect the brain too or is it (as I assumed) mostly a mechanical booster (more blood to your genitals) ?


PDE5 inhibitors improve dementia, so they definitely do something good to the brain. Truly wonderdrugs.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6705107/


from a quick glance it seems PDE5 are mostly part of the cardiovascular system metabolism, I was more wondering about direct neurological effects.


It affects blood flow by relaxing muscles that constricts blood vessels. It was originally intended as a blood pressure medication.


I've heard that it can give horrendous headaches, bad enough to put a fellow off the mood.


I guess it's the increased blood flow to the head. Same reason the porn industry aren't huge fans of Viagra - it tends to make the face red.


For most porn stars Viagra et al is useless, because you still need to be "in the mood" for it to work. Most male talent are so desensitized to sex, that they must resort to other substances that they inject directly into the penis, like Papaverine [0]. Of course that comes with its own set of challenges, like the risk of prolonged erections, called priapism [1], which sometimes can only be stopped by surgically draining the stale blood from the penis.

[0] https://en.wikipedia.org/wiki/Papaverine

[1] https://en.wikipedia.org/wiki/Priapism


What a terrible day to be literate.


I'm looking for research into the neurological basis of arousal (not necessarily erection, which is only a small part of it). If anybody knows, spam me.


I might have something related which might interest you, also looking for info on your topic. How can I get in contact?


check my profile, it should list my mail

thanks already


"I'm sickened but curious."



In MOST countries of the world, viagra, et al. are "over the counter" and have been for nearly 20 years.

Requiring a prescription raises the price of any drug quite radically.


The CIA used it to bribe tribal leaders in Afghanistan too.


I took wellbutrin for depression once, and I tolerated that for less than two weeks. Can confirm: no release valve = even worse depression.


Most antidepressants really do take several weeks (4-6) to "work". I use quotes there because we don't really understand how or why they work, and there is more to alleviating depression than taking a pill. Cognitive behavioral therapy, developing a healthy routine, and alleviating environmental stressors are also important.

That said, I do so much better with all of that plus lexapro that I dont know if I'll ever stop taking it.




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