My AMI experience

[Flavio]

Flavio, what dose of Cialis and Vigamed do you take - half a tab of each, for instance?

I take a full Cialis 20 mg pill (3 hours before sex) and Vigamed 40 mg (30 minutes before sex) and I've had no problems so far, but it's not the most sensible thing to do. I advise you not to do it. Start with a smaller dose and then see how it goes.

[Flavio]

I'm afraid I have bad news. I had sex last Sunday but this time things didn't go as well as they normally do. After several months of continuous success in bed, (coital) anxiety showed its ugly face again.

It started very well, I got hard in a split of a second - which really impressed my partner - and foreplay was great. My erection was always perfect. I was able to penetrate, but my partner wasn't too comfortable and asked me to change position. Then, I lost my erection. There was that infamous 'click in the brain' and I simply couldn't focus on sex again.

So, why did this happen? Possible reasons:

- I had a lavish meal 1 hour before, which was a really stupid thing to do (with or without meds)

- I was extremely nervous before (we had to hide from her parents - it's a long story) and this didn't help, of course

- My partner was inexperienced and didn't help. I prefer when the woman comes on top of me and has all the 'hard work', this really helps with my anxiety, but she didn't want to try that position.

- When that 'click in brain' happened, my arousal was gone and when it's gone, it's gone. Erections start in the brain and if the brain is not sending the right signals, erections are blocked.

Does this mean my regimen isn't working anymore? Well, not necessarily, but I may need to do some readjustements. If my problem lies in the brain, I need something that acts centrally (Cialis and Vigamed are great but only act locally) and, until Zoraxel becomes available in 2013, apomorphine seems to be the best option (bremelanotide is another option).

I have made up my mind: I am going to book that consultation at the AMI clinic in London and try their apomorphine nasal spray. I don't care if I have to pay a small fortune, I'm convinced this is the ideal solution for me.

I'm angry and a bit depressed, but I won't give up. Like Winston Churchill once said, 'never never never give up'.

[Flavio]

I recently saw a You Tube video about testosterone and dopamine that said something like this: 'testosterone gets you in the mood and dopamine makes you stay there'. I'm not an expert but I believe this is exactly what I need: something to 'make me stay there'. Dopamine may be the key here. Maybe the 'click in the brain' is, in reality, a sudden change in mood and dopamine levels in the brain.

[Nemo]

Flavio, man, I think you're overthinking it. You're questioning your whole regimine based on ONE stressed out, nervous experience. I've been where you are, and it sucks all the fun out of sex when you're constantly worrying and tweaking and measuring how your body is reacting. Don't start messing with stuff until you establish a pattern ... trust me, I know this is the easier said than done, but you've got to try not to obsess about this or it just becomes a self fulfilling prophecy.

Nemo

[Flavio]

Flavio, man, I think you're overthinking it. You're questioning your whole regimine based on ONE stressed out, nervous experience. I've been where you are, and it sucks all the fun out of sex when you're constantly worrying and tweaking and measuring how your body is reacting. Don't start messing with stuff until you establish a pattern ... trust me, I know this is the easier said than done, but you've got to try not to obsess about this or it just becomes a self fulfilling prophecy.

Nemo

Thanks Nemo.

Yes, I was definitely overreacting, but that's me - neurotic, obsessive, whatever you want to call it (and not just about sex). I have invested so much time and energy in this, I really want it to work every time - but nobody's infallible, I guess. And my experience this Sunday was actually not that bad.

I still believe in my regimen, though. I know these drugs really work but I may need to do some minor readjustments (e.g. add apomorphine or another centrally acting drug to my regimen).

Anyway, I'm feeling much better today.

[Nemo]

I also believe taking time off a drug is good. I thought Viagra had quit working for me last year and switched to Levitra. But I tried a Viagra the other day and it worked, so I think we build up certain tollerances that need to be broken periodically. Just a guess.

Nemo

[Flavio]

Today, Tuesday the 3rd of November, was an important day in my AMI odyssey. I finally called their confidential advice line to book an appointment in early December. I had already called them in September but it was still too early, so today was the big day.

I was a bit nervous but I was greeted by a lovely woman who was extremely efficient and answered all my questions - except the price of the treatments, but I already know it's going to be expensive. She consulted my file, everything was in order and booked my appointment for Friday the 4th of December. She told me they accept debit and credit cards at the clinic, which is great. And she told me there are actually two AMI clinics in London, not just one:

AMI UK Clinic
100 Harley Street
London W1G 3RZ

AMI UK Clinic (2)
106 Weston Street
London SE1 3QB

The Harley Street clinic is closed on Fridays, so I'm going to the second clinic (5 min walk from London Bridge station). They even texted me a message with the complete address: now that's British efficiency!

So, my first impression couldn't be better. I'm really excited about this and I have a good feeling. I'll bring you fresh news in December.

For more on AMI UK, call their advice line: 0800 456 1033

[exfinuser]

Save yourself the money and just come off proscar I guarantee your problems will vanish. Take your head out of the sand.

[Flavio]

Save yourself the money and just come off proscar I guarantee your problems will vanish. Take your head out of the sand.

You'll be happy to know that I'm no longer taking Proscar - even though I'm convinced that my ED problems are purely psychological and finasteride has nothing to do with them. I only lose my erection just before penetration and this started long before I started taking Proscar.

Again, I'm not saying that finasteride is harmless. It's not, it can have sexual side effects and you should always take it under the supervision of a doctor.

In my case, Proscar worked for several years but it stopped working in the last months (my hairline has receded a lot this year), so I guess it's no longer worth the risk. So far, I haven't felt any changes (positive or negative), but I'll keep you posted on that.

[Flavio]

Hi everyone. I've just come back from a short trip to the wonderful city of London. I had a great time there and I also had the opportunity to visit one of the local AMI clinics.

To cut a long story short: the AMI nasal spray works but I'm not entirely happy with their services.

Here's what happened.

I arrived at the AMI London Bridge clinic 30 minutes before schedule. I was greeted by an adorable Australian secretary who took me to the waiting room. Other patients were already there: men of different ethnic and age groups but all with the same embarassed expression on their faces.

The secretary then asked me to fill in a questionnaire regarding my current sexual problems and my medical history.

Because this is Britain, the consultation started right on time. The Australian doctor called my name and I went into his office. He read my questionnaire, asked a few more questions and talked about how anxiety can affect a man's sexual performance. I was not impressed with his explanation but he seemed knowledgeable enough.

He also talked about Cialis, Viagra and other available therapies, which seemed like a good, honest thing to do. One of the most frequent accusations to the AMI clinics is that they don't fully inform their patients about the alternatives they possess. I had, however, already mentioned Cialis in my questionnaire and the doctor read that. Would he have been this honest if I hadn't mentioned Cialis before? I don't know.

I was asked to sign a declaration that releases the AMI of any legal responsability in case of side effects. The whole consultation lasted about 10 minutes.

I went into another room, where I was greeted by a middle aged woman - I believe you can guess what her nationality was... - and then catastrophe happened. The woman talked briefly about the 'different stages of ED' (?) and all she said was rubbish. She was obviously no expert. She talked extremely fast, kept calling me 'love' and did her best to avoid my questions. Finally, the middle aged woman asked me to sign a contract and charged a total of 1.109,23 euros for a 1 year supply of ED meds.

I had to be persistent and asked to get the treatments right there. They wanted to send me the whole thing via Express Mail - that's their normal procedure - but I didn't accept that. I got some of my meds but not all because each spray only lasts for three months! This, I believe, is an extremely important information that the AMI employees don't like to make public - I was only told that after I made my payment, not before.

I got a copy of the contract, a receipt, a nasal spray with the instructions and left the clinic.

The listed ingredients of the spray: apomorphine 1.25 mg, metoclopramide 2 mg, phentolamine 2 mg.

I tried the spray the next day and it worked beautifully. In less than 20 minutes (Cialis may take up to three hours to work!) I had an excellent erection that lasted even after ejaculation. This was no placebo effect. I'm not sure if it also improved my libido (the doctor said that it would) but it probably does that as well.

So, my general impression is ambiguous. The AMI is definitely not a scam and I'm glad I went to this clinic but the service was far from perfect.

PROS:

- The spray works really well

- As far as I know, this is the only way to get a phentolamine + apomorphine nasal spray for the treatment of ED

CONS:

- Outrageous prices

- Required discard of the spray after 3 months