Author: Leann Poston, M.D.

The Truth About Postmenopausal Brain Fog

What causes postmenopausal brain fog? How can you treat and ultimately beat postmenopausal brain fog? These are a few of the top search queries on the internet? You, like many women, may be concerned about the symptoms you are noticing. You don’t need scientific studies to show that fluctuating estrogen levels causes symptoms such as weight gain, difficulty sleeping, mood changes, and the dreaded hot flashes. You may be aware that hormone replacement therapy has gone in and out of favor....

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COVID and ED: The role of Trimix

The list of symptoms, both long term and short term from SARS-CoV-2 or COVID, continue to grow. Long-haulers suffering from exhaustion and other symptoms for months on end have led to research examining the effects of COVID on every system in the body. The list of medications that might treat symptoms of COVID gets longer and longer as the pandemic drags on. Research on the male reproductive system in patients with COVID has added erectile dysfunction and concerns about male fertility to the...

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TriMix Injections: A well-tested solution for ED

Penile injection therapy is a well-tested treatment for erectile dysfunction. Injectable medications have been used since 1983 and are considered by the American Urologic Association to be one of the most effective non-surgical solutions for ED (American Urological Association, 2018). Trimix injections are compounded medications that require a prescription. Men can buy Trimix injections online after consulting with a physician and receiving a prescription. Trimix is an alternative treatment option...

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Trimix: Is it safe and effective?

You may have heard that Trimix injectables, like many other compounded medications, are not evaluated by the FDA or are used off-label. What does this mean? Are Trimix injections safe? Injectable medications have been used since 1983 to treat ED and are considered the most effective non-surgical solution for ED, according to the American Urological Association (American Urological Association, 2018). What makes up Trimix injectables? Trimix is a combination of three medications: papaverine,...

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Trimix injections for ED: The Risks and Benefits

Trimix injections are a combination of three medications that are used to treat erectile dysfunction. Injecting medications into the penis may sound extreme and more than a little painful. As you learn more about Trimix injections, you may find this option may be a better one than you might think at first glance, especially if you are in the 22-35% of men who have not been helped by oral ED treatment or have a medical contraindication to using medications such as Viagra (Guay et al., 2001). In...

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Who should use Trimix injections?

Trimix is a combination of three different medications that a man can inject into his penis to treat erectile dysfunction. Most urologists consider Trimix injections second-line therapy after oral ED treatments. However, men can buy Trimix injections online with a prescription after a medical consultation with their physicians. Not all physicians are familiar with the wide range of treatments available for ED. Penile erection requires three physiologic changes simultaneously; cavernous smooth...

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Testosterone cypionate: What is it?

TRT or testosterone replacement therapy is medically indicated for men with low testosterone. It sounds simple, right? You get a blood test, your testosterone level is low, whether from aging or other causes, you get a prescription for testosterone cypionate injections and your testosterone level goes up. Testosterone cypionate is the most common form of injectable testosterone prescribed in the U.S. to treat low testosterone levels or hypogonadism. It is available legally with a prescription,...

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Who uses TRT? What is their TRT dosage?

Who is using TRT therapy, and what dosage are they using? Approximately one percent of the U.S. population, regardless of age, gender, or intention, use anabolic-androgenic steroids (AAS) (Pope et al., 2014). We know the negative impact on health from misusing these drugs. Even more concerning is the use of designer anabolic-androgenic steroids to evade legal detection as these drugs’ side effects are typically unknown (Joseph & Parr, 2015). In this article, we explore the non-medical...

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Is it legal to acquire testosterone online?

It is legal to buy testosterone online, but only with a prescription. The DEA prescription guidelines require patients to have a validly diagnosed medical condition from a physician with whom they have a legitimate doctor/patient relationship (Clement et al., 2012). You should expect that U.S. online doctors prescribing testosterone will follow a protocol that requires a preliminary blood panel, a history and physical exam, and a discussion on the risks and benefits of using testosterone based...

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TRT: Separating Myths and Truths

Over 40% of men over the age of 40 suffer from symptoms of low testosterone levels such as low sex drive, erectile dysfunction, lack of energy, depression, and an increase in percent body fat. Should men experiencing these symptoms write them off as symptoms of aging, or should they investigate whether they have low testosterone? Men can buy testosterone injections, one type of testosterone replacement therapy (TRT), online with a prescription, should they? Questions such as these are discussed...

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Online TRT questions: Is your source Reddit?

Two of the most common questions on the testosterone forum on Reddit are how to interpret testosterone labs and where to get online testosterone replacement therapy (TRT). Testosterone testing and prescriptions have nearly tripled in recent years. There are also many men using TRT without receiving proper testing and guidance. Studies show that up to 25% of men do not have their testosterone levels tested prior to starting TRT. On the other hand, a large percentage of men would benefit from TRT...

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Testosterone replacement therapy: online options

After the age of 30, men have a natural decline in testosterone levels of about 1% per year. In many men, symptoms such as low energy, decreased muscle strength, and decreased libido will result from low-T. For the last decade or so, interest in testosterone supplementation has increased. Clinical trials to evaluate the benefits of testosterone supplementation for men have concluded that testosterone supplementation does work in appropriately selected men. They describe the benefits as moderate....

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Testosterone Injections for low-T

It has been well-documented that testosterone levels decrease after age 30, and overall the population is aging! Nearly 55 million or 16.3% of Americans are over the age of 65 (U.S. Census Bureau, 2004). Testosterone has many beneficial effects, such as increasing muscle mass and strength, increasing bone density, stimulating libido and spontaneous erections, improving energy, mood, and motivation, increasing red blood cell production, and restoring hair regrowth. Most men do not want to suffer...

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Testosterone replacement treatment and programs

Testosterone is a male sex hormone tightly controlled by a feedback loop involving the brain, pituitary gland, and testes. The term hypogonadism is applied to any disorder that results in decreased production of testosterone. Both medical conditions and lifestyle factors can cause a decrease in testosterone production. Aging is one such factor. For this reason, there has been increasing interest over the past several decades in testosterone replacement therapy options. Men with low testosterone...

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Vitamin B12 Supplementation: An Overview

Vitamin B12 is a water-soluble vitamin that is naturally found in some foods and added to others. Vitamin B12 can also be supplemented in oral and injectable forms. You might be surprised by the statistics on B12 deficiency. The prevalence of vitamin B12 deficiency is approximately 6% in persons younger than age 60 and nearly 20% in those older than age 60 in both the United States and the United Kingdom (Hunt et al. 2014). In developing countries, the rate of B12 deficiency is even higher. Foods...

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Trimix Injections for ED: All your Trimix questions answered

The long-term standard of care for treating erectile dysfunction has been to use medications that increase blood flow into the penis, such as sildenafil and tadalafil. However, oral medications that work by blocking phosphodiesterase to increase nitric oxide and relax the walls of blood vessels do not work for all men. Trimix injections are an additional option, an injectable that delivers medications right to the site. You may have visions of large needles and pain when thinking about injectables,...

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Oral ED Medications: An Overview

Sildenafil and tadalafil are oral medications prescribed to treat erectile dysfunction or ED. ED is a common problem that affects as many as 30 million men (NIH Consensus Development Panel, 1993). The prevalence increases with age. ED has many causes, including decreased blood flow to the penis, stress or emotional factors, or as symptomatology of heart disease, high blood pressure, or diabetes. The first step in treating ED is for a health care provider, such as the licensed physicians at Invigor...

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Finasteride for Hair Loss: An Overview

What’s the best hair loss treatment for men? Talk to anyone that is currently or has already lost some hair, and they will tell you it feels like you are fighting a losing battle.  Androgenic alopecia, more commonly referred to as male pattern baldness, affects an estimated 50 million men and 30 million women in the United States and can be extremely detrimental to these individuals’ self-image and self-confidence (Genetics Home Reference, n.d.). The Androgenic Hormones There are two...

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Sermorelin and Ipamorelin: Anti-aging peptides

You may have heard about the plethora of dangers associated with injecting growth hormones for anti-aging. You may have also weighed the anti-aging benefits of growth hormone with the risks. Don’t take a chance on your health! There are safer ways to increase growth hormone levels in your body and reap the benefits. Namely, using sermorelin or ipamorelin or both. In this overview, we will consider what is known about these compounds from the scientific literature. As a caution, there are...

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Online Pharmacies: The U.S. and China

Did you know that Americans frequently go to Mexico and Canada or use online pharmacies to buy prescription medications at a fraction of the U.S. price? They risk buying contaminated or counterfeit products, but sometimes “desperate times call for desperate measures.” Yes, this practice is technically illegal (Wolfson, 2019). However, the cost savings can be significant. For example, Canadian drug prices can be 28-35% of the price of U.S. prescription drug prices (Neuman & Cubanski,...

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