Concern · Active

Erectile dysfunction and low libido

Working on it together since December 2025

Active

Latest DHT signal is above range.

Long-standing low libido and ED with normal penile ultrasound and full bimix/trimix response, peripheral hardware confirmed intact...

Next step

Initiate L-tyrosine 500mg AM fasted with subjective libido + AM erection frequency tracking; this is the cleanest available...

What we think is going on

4 connected lines of work are active.

01 / 04Central dopaminergic insufficiencyWorking

Central dopaminergic insufficiency is active.

Central dopaminergic insufficiency limits libido and the central initiation of erectile signaling.

What you're doing

Gate passed 2026-04-27: ferritin 71 > 50

Pregnenolone 50mg AM (existing), neurosteroid floor; indirect support

Lemborexant trial post-return (May 20+), partial test of whether daridorexant orexin...

oral micronized progesterone 100mg HS as alternative to pregnenolone titration

02 / 04Autonomic sympathetic dominanceWorking

Autonomic sympathetic dominance is active.

Autonomic / sympathetic dominance suppresses parasympathetic erectile signaling.

What you're doing

Sobriety since May 2025 (removes major sympathetic activator)

PS 600mg/day (cortisol/sympathetic dampening)

Trigger avoidance: alcohol, PT-141 routine use, kava, schisandra, methylxanthines (all...

Breathwork, sauna, yoga (ongoing)

03 / 04Cortisol tissue burdenWorking

Cortisol tissue burden is active.

Cortisol tissue burden blunts central androgen receptor signaling, producing functional hypogonadism at the brain level despite serum hormones being adequate or above...

What you're doing

Methylation work (folinic 800mcg, B-complex, TMG), supports phase II conjugation pathways for...

Phosphatidylcholine, hepatic clearance support

PS 600mg, production-side dampening to offset slow clearance

DUTCH retest next cycle, confirms direction of clearance change

04 / 04Local bioavailability constraintsWorking

Local bioavailability constraints is active.

Local NO bioavailability constraints at penile nitrergic terminals limit cavernosal smooth muscle relaxation.

What you're doing

NO2U lozenges (sodium nitrite + ascorbate), bypasses NOS3 via dietary nitratenitriteNO pathway

Avoid antiseptic mouthwash (preserves oral bacteria for nitrate reduction)

Beet/leafy green dietary nitrate intake (existing nutrition protocol)

Methylation stack supporting BH4 recycling

What you're doing

Fast COMT

slow DBH

fast NET (SLC6A2)

slow NOS3 ×2 het

DRD2 Taq1A

Next step

Initiate L-tyrosine 500mg AM fasted with subjective libido + AM erection frequency tracking; this is the cleanest available...