Sorry for all the medical details, but they are as background for what I am suggesting below.

I was prescribed spironolactone eighteen months ago by a cardiologist for resistant hypertension. With the reading I have now done, it seems that this was to test whether my high BP was caused by aldactone, in which case there should have been a dramatic improvement. There wasn’t, and two weeks later my doctor prescribed a calcium channel blocker which did and has continued to produce a dramatic improvement in average BP, down into the ideal range with dips into very low BP. The day before my next visit to my doctor to report and to renew or adjust my prescriptions, she died suddenly. In the resulting confusion, I had to get my prescriptions renewed by my pharmacist, and I am now under the (very good) care of a nurse-practitioner, having been unable to date to find a replacement family doctor.

Since the original spiro prescription was issued by a specialist, no one has liked to stop it. The spiro has effectively locked out my normal male function, as well as having various other effects and providing a good basis for NBE. It has also helped with my BPH symptoms.

Since finding this board, and with great help direct and indirect, of some of the people here, I have come to realise that the spiro is not a good thiong, and I want to try to reclaim my male function - but without giving up on NBE.

I have an appointment with the cardiologist next Friday. On Wednesday last I ran out of spiro and have not used the renewal of the prescription. I will tell the cardiologist that I have gone off the spiro (no significant change in my BP so far), and also ask to be taken off beta-blockers as well. The NP has already cut my dosage of the latter by 75% to the level it was at before my doctor twice doubled the dose in trying without success to control my then very high BP. This has reduced the dips but paradoxically lowered my average BP well below the normally accepted ideal range. To deal with this she has also halved my dosage of the CCB and another antihypertensive without noticeable effect. I very recently discussed with her whether I could replace the terazosin that is presently prescribed for my BPH with daily Cialis, which was recently approved in the US for treating BPH alone or in combination with ED. She was agreeable in principle, but wants to get the cardiologist’s OK and see my BP a bit higher before issuing a prescription,

On stopping the spiro and thus losing its strong antiandrogen effect and anti-BPH effect, I restarted SP, and also beta-sitosterol, both of which are 5-alpha reductase inhibitors and antiandrogens in that they reduce DHT formation, and thus good for both NBE and BPH. I also learned from the pharmacy the cost of daily Cialis which has rather damped my enthusiasm for it.

Although I will get and hold the Cialis prescription if forthcoming, my present inclination is to follow Bryony’s lead and use Butea Superba and maca in an attempt to restore male function. I have already started taking maca powder from the local bulk food store, and have ordered some red maca which is supposed to be best for ED, and also some Ainterol butea superba (BS).

In the course of my researching these various pharmaceuticals and supplements, various interesting points have emerged.

PM, BS and maca all contain significant amounts of beta-sitosterol. Although I have not been able to find any hard figures for the first two, there is a lot in maca.. Thus they each have a built in 5-alpha reductase inhibitor. On the other hand SP, although said by some to rely on its beta-sitosterol content for its functionality, in fact contains very, very little. This seems to be why some promoters allege that beta-sitosterol is 300 times as powerful as SP. SP must rely on some other constituent.

In view of the beta-sitosterol content of these supplements, I would assume that it is not necessary to take more separately.

BS (and PM and maca) seem likely to provide, like Cialis, some relief from BPH symptoms as well as ED since both Cialis and BS act as PDE5 inhibitors as well as 5-alpha reductase inhibitors.

I was surprised to find that beta-blockers are widely prescribed for anxiety. I found it alleged that nearly half of professional musicians take them to allay performance anxiety. This may explain why I have been so free of anxiety for the last few years despite some considerable external stresses. If I stop, it may be interesting to see what happens.

While some of my proposals could act to increase my BP, it is low enough at present that a modest increase would be a good thing. So far as I can tell, none of the additional supplements is very likely to interfere with NBE.

I am very new to all of this, and if I am wrong or misguided in any of the above,, I hope that some of the very knowledgeable people here will put me right.

All I have to say is WOW! and kudos on doing your research/homework. It sounds like you could even plausibly tell your MD's about BS, PM and Maca without raising any alarms based on the hoped for control of BPH symptoms and restoration of male function. Of course you will have to omit any info on the high estrogenicity of PM. One thought though, in order to more easily see if any of them have strange/deleterious interactions with your meds, perhaps you should add them one at a time, and wait a week or two before starting the next.

I did want to add a caution: avoid coleus forskohli (active ingredient forskolin) as long as you are on the BP meds as one of it's effects is to lower BP. You could possibly get a dangerous interaction between the forskohli and your meds.

Good luck with your journey. I hope you keep us up to date with any progress since I am sure there other lurkers interested in NBE with similar medical issues .

I'd just like to add that I think it would be a very good idea to not start the PM until you find out if the Maca and BS start to restore your erections. Give it a few weeks at least... otherwise you won't know if the effects of the spiro are reversible. Once you are back in working order, I can testify that the worst a high dose of PM does to you (at least with BS and Maca) is to make them voluntary (at least for me).

B.

PS good luck from me too!

Chrishoney
I'm very grateful for your post and good wishes. I'm certainly a believer in trying one thing at a time, particularly when I am trying to retreat from an over-medicated state.

I was very interested in your warning re forskolin since I had noted it as a possible way of controlling BP if stopping the beta-blocker and subsequently possibly the alpha-blocker (terazosin) which is not compatible with Cialis, caused my BP to rise substantially. Having looked into it again, there seem to be a couple of other potential issues, namely increased pulse rate and interaction with warfarin. My personal experience over more than twelve years is that while there are a great many things listed as possibly interacting with warfarin, for me only a minority actually do so to any significant extent - and when my INR does step out of bounds (not often) it is sometimes impossible to tell what did it. Likewise a dangerous increase in pulse rate seems to be an occasional side effect rather than an expected result, My average resting pulse rate at the moment is in the range normally reserved for athletes, which I am not. If I try forskolin I shall be -very- careful.

Bryony
Thank you also. I have already been taking PM for more than a month, and I think that I'll continue at least until I see what happens initially when and if I stop the beta-blocker, since that is unknown territory in various ways both physical and mental. No extra results yet but that may be because I have lost 13lbs during the same period - a lot at first but now much more slowly, and some of it seems to have been from my chest.

... I have already been taking PM for more than a month, and I think that I'll continue at least until I see what happens initially when and if I stop the beta-blocker, since that is unknown territory in various ways both physical and mental.

Hmm. It's your decision, of course, but I wonder why? I hope you don't mind me asking, but:
(a) I would think a reversal of the e.d./impotence was a bit more important than a temporary halt to NBE which is going to take 2-3 years to complete.

(b) PM is well known for reducing the ability to achieve erection. This is the last thing you want to take if you are ending a drug which is notorious for inducing ED. If you don't stop PM now, you will have no benchmark, and no idea if a lack of return of function would be due to permanent problems caused by the spiro, or a much delayed return of function due to PM.

© If you are worried about losing any spiro/PM gains, over a short timeframe, e.g. a week or two, no development would be lost. Before I started on BS, I documented on a daily basis my "cold turkey", achieving full functionality on day 6, I think. However, given the length of time you have been ED due to spiro, I wouldn't be surprised if it took longer.... that's why I think you should reconsider a break from PM.

But, I won't go on about it! Just trying to help...

No extra results yet but that may be because I have lost 13lbs during the same period - a lot at first but now much more slowly, and some of it seems to have been from my chest.

Once your E level is up, fat gains and losses concentrate more around the breasts and hips, not so much around the navel "diameter". Real breast growth is ductal tissue which is firm, not squishy like fat. So when you lost the 13 lbs, a proportion would come from the fat deposited there under the influence of spiro.

I think some people refrain from dieting because they like the extra boob size, but it's a big mistake. Cellular division takes a finite amount of time... but whereas fat can go on almost instantaneously, real breast growth takes years.

B.

I think that you may have slightly misinterpreted my intentions. Both my beta blocker (currently atenolol) and PM are capable of numerous and considerable effects on people that take them, and both have or can effectively have anxiolytic properties (as you know in the case of PM). I want to stop the atenolol first to see what the short term effects will be: I would expect the more obvious effects to be apparent in a week or two. If I then stop the PM, at least there is a possibility of attributing the effects (particularly BP and mental) that occur to the correct agent. I have been taking beta blockers for 11 years. Ten years ago I found myself as an co-defendant and principal witness in an eight figure lawsuit which only finally faded away a few months ago. In discussing what I have just found out about beta-blockers and anxiety with J., she said that she had been surprised that I had been able to take the lawsuit and various other things so calmly (laid-back was the term she used) and wondered whether the BB had something to do with that. So perhaps there was an unsuspected benefit.

Another complication I need to sort out before starting butea superba, which hasn't arrived yet in any case, is that the terazosin I take is incompatible with PDE5 inhibitors and thus probably with butea superba. I'm hoping I can do without the little it apparently does or get it changed (when I see the NP in two weeks or so) to tamulosin (Flomax) which would probably have been prescribed to me in the first place had it then been available as a generic. It avoids the PDE5 problem and some others of terazosin and may be more effective.

Once these matters are (hopefully) cleared up, then your advice makes excellent sense (and is welcome as ever).

I, too have been prescribed Atenolol, since 1996. For blood pressure. I had no noticeable mental effects from it for approximately 6 months. When my doctor added Benicar HCT to the mix, I then began feeling more relaxed and at ease. So much so, in fact, that I rechecked my bp a few consecutive nights at work, and found it quite low. I felt like "top of the world, ma!!". That was the result of bp of 80/55. Revisit to the doctor resulted in a lowering of Benicar HCT dosage. That was years ago, and all normal until after 1&1/2 tears of Premarin use, I went off it and went to PM. Using PM has mainly had the effect on me of lowering my desire to crossdress , though not stopping it. It has also revived the sense of calmness that left with the Benicar dose change, and was never relit when I took Premarin.
What I'm getting at, is, that Atenolol had no noticeable effect by itself. It was only after another item was added to the mix, that things changed. My suggestion, therefore, would be to lose the PM before the Atenolol, since it seems to be rather innocuous in and of itself. That would be a safer approach in my mind. Also, many docs here are now getting up to speed on the fact that herbals can have effects on prescription meds, and are including them when they ask us for a list of meds we are taking. That is probably something you should make your NP aware of. Only my experience, but that's the way it worked out. Good luck! Patti

I was very interested in your experiences with atenolol. I should mention that I have been taking an ACE inhibitor (ramipril) together with first furosemide then HCT since well before I started on BBs, first bisoprolol and more recently atenolol. Increasing doses of BB had very little apparent effect on rising BP (to peaks of over 200/120) most of the time (although an increasing severe and ultimately killing effect on male function), but once BP was very effectively controlled by a CCB (amlopidine), atenolol appeared to be causing deep dips in BP, even as far as 67/42, and very regularly into hypotension territory. I have also been suffering from Raynaud's syndrome which is a known side effect of BBs. Reducing atenolol has helped even out the dips, but average blood pressure has actually gone down to around 100/65, while the Raynaud's is still with me. So I am keen to see what will be the effect of stopping atenolol altogether, as I take successive steps to clear the decks for an attempt to at restoring male function (which will include stopping PM for a while).

I find your own achievements fabulous. I was also intrigued by your comment in another thread that they don't seem to attract particular attention in public provided you don't wear a bra, possibly because so many older men sport moobs in any case. This was something I hoped might be the case, although the breast development of my female blood relations makes me think that I am very unlikely ever to achieve anything approaching your own success.

I duly saw my cardiologist, who OKed my having stopped the spiro, and also stopped the beta blocker, as well as the terazosin which he replaced by tamsulosin which has much less effect on blood pressure. His attitude was in effect that I could do what I liked with the various antihypertensives and their dosage provided that I keep my average blood pressure within bounds. After some days of instability my average blood pressure seems to have settled down to something near ideal levels. I stopped PM and started taking BS shortly after coming off the beta blocker. There has been no noticeable improvement in male function so far, but there have been complications.

Last Sunday I spent most of the day in the ER of the local hospital with what has ultimately turned out to be a severe gallstone attack. Following a Cat scan and subsequent assessment, I am now awaiting gallbladder surgery. This is likely to be done on an elective rather than an emergency basis unless I have another severe attack, since they would prefer to take me off warfarin several days in advance.

Having understandably been reading up on gallbladder issues, it turns out that estrogen is a significant factor in gallbladder problems (which is why they are more common in women than in men). While the gallstones which I apparently have must have formed quite slowly and had remained quiescent up to now (I have never had any previous trouble), the attacks themselves can be triggered by various factors, of which a change in estrogen levels is a common one, e.g. periods in younger women or HRT in older women. On this basis I am inclined to believe that my problem may have been caused by stopping PM! I certainly won't restart it until they have operated, at which point the root cause of this particular problem should be gone for me! But see one interesting item I noted in passing:
http://optimalhealthcave.forumotion.com/...-dominance

Sorry to hear about your Health Issues.

Prayers and best wishes that you have a full and speedy recovery.