Susan's Place Transgender Resources

I love my male genitals as much as love being a women, thus, I plan to keep my balls in place; however, I just started HRT 3 weeks ago but I know HRT will change my ability to get hard when I am in bed w my partner. Did anyone have used Viagra or Cialis and see changes in rigidity, erection duration, and so on?

if you love your male genitals arent you also worried about atrophy of the tissue  ? hopefully someone can give you a proper answer instead of biased/ ignorant answers

I too love what I am born with, as far as I am concerned you don't need to have an SRS to be a woman, you need to admit it to yourself and accept who you truly are.  This can of course lead into a huge debate :)

So to answer your question, I've been on HRT for over two years, yes they do effect your erection - it's only natural, your T levels will drop regardless if you take Spiro or not, well that's how it affected me anyway.  To answer our question, I have no issues when I used V or C and I don't think they will contribute to anything bad.  As long as you're being looked after by medical professional/s you should be in good hands :)

Quote from: glicious on July 06, 2012, 12:22:50 AM
I too love what I am born with, as far as I am concerned you don't need to have an SRS to be a woman, you need to admit it to yourself and accept who you truly are.  This can of course lead into a huge debate :)

So to answer your question, I've been on HRT for over two years, yes they do effect your erection - it's only natural, your T levels will drop regardless if you take Spiro or not, well that's how it affected me anyway.  To answer our question, I have no issues when I used V or C and I don't think they will contribute to anything bad.  As long as you're being looked after by medical professional/s you should be in good hands :)

how did you figure out transition was right for you ? despite not having gender dyshoria about whats between your legs ? was it a hard decision/ did you have doubts or did it feel very clear to you

Quote from: mementomori on July 06, 2012, 12:38:38 AM
how did you figure out transition was right for you ? despite not having gender dyshoria about whats between your legs ? was it a hard decision/ did you have doubts or did it feel very clear to you

It was fairly straight forward, having said that maturity certainly had the upper hand here.  When I was 17, there was that spirit to go to Thailand and be this 'perfect' woman, but not now.  I know who I am, I am a non-op woman, and this is how I accept myself.  What I have between my legs came with me and they're there to stay until I leave this body. 

My spiritual nature also contradicts with me cutting off my body just so I can feel like a woman.

 Erectile function may or may not be affected, to note, by hormones.

Sort of like yourself I never hated what's down there. Also not too thrilled over owning it either. We've had some good to great times together. But arousal is part hormones and a lot of mental. In my 20's I started HRT twice. Each time after a few months when things started to not work the reality of the road I was on became too much. Trying to be a "normal" guy won that argument.

Flash forward a few decades and once again on HRT. This time for about 3 years now. My T level has been in the sub-basement for a long time now. Emotionally / mentally a lot has changed upstairs about sex as well as a myriad of other things transition related. I still don't hate what's down there. Still never dwell on SRS. Without any real desire for sex these days using viagra has not changed the end result of nuttin happening down there. Yet there are the rare occasions around a very special person in my life that....

gender or sexual non-conforming issues or characteristics can be addressed in many ways but only the individual can decide what is best.

I don't know if Viagra or Cialis works in this case, but I do knew that you can get your hormones adjusted in a way that will still allow for a good sex drive while feminization occurs.  ->-bleeped-<-Girl15 on YouTube has talked about that some.

In talking with my GP a few years ago, she explained that drugs like Viagra can help with the physical part of getting an erection, but a hefty part of arousal is mental and the drugs will not change that aspect.  Viagra and Cialis are vasodilators rather than hormonal in nature, so they should not conflict with HRT but may not defend against physical atrophy resulting from HRT;  as long as you still physically *can* get an erection, the drugs may help it happen.

Note that erectile dysfunction drugs can be dangerous if you have problems with your heart, bood pressure issues, or a host of other cardiopulmonary-related conditions.  If your doctor advises against them, don't use them!

Quote from: Jackie Witt on July 05, 2012, 11:10:38 PM
I love my male genitals as much as love being a women, thus, I plan to keep my balls in place; however, I just started HRT 3 weeks ago but I know HRT will change my ability to get hard when I am in bed w my partner. Did anyone have used Viagra or Cialis and see changes in rigidity, erection duration, and so on?

Don't always believe what you read on the web. I've been on HRT for 2 years (max dosages of E & Spiro)... and I have zero issue getting and maintaining an erection... not that it's something I'm proud of, have a use for or want to keep. I actually get annoyed when it happens... but it still does at times. So basically before spending more money on meds, wait and see your individual results from HRT. Now if you had ED or some other male performance issue before hand, that's a different story. But I'd wait and see first.

As much as you would love to have your cake and east it too it's just not that simple.  You can't pick and choose only specific areas that you want hrt to change and not have any effect on other parts.  If you have that much concern you should rethink your decision. 

Quote from: JennX on July 09, 2012, 07:07:38 AM
Don't always believe what you read on the web. I've been on HRT for 2 years (max dosages of E & Spiro)... and I have zero issue getting and maintaining an erection... not that it's something I'm proud of, have a use for or want to keep. I actually get annoyed when it happens... but it still does at times. So basically before spending more money on meds, wait and see your individual results from HRT. Now if you had ED or some other male performance issue before hand, that's a different story. But I'd wait and see first.

Yes me too exactely the same problem! over 12 years on HRT and Anti androgens and unwanted erections still happen (much to my heartbreaking dismay). I'm one of those who doesn't like what's down there.

I don't know what the original poster Jackie is worrying about? in most cases it still works on HRT.

Quote from: glicious on July 06, 2012, 12:49:15 AM

My spiritual nature also contradicts with me cutting off my body just so I can feel like a woman.

First of all I just want to say, "O_O".

Secondly it sounds like you are saying that transsexuals cut off their bodies so they can feel like women.

Quote from: Noey Noonesson on July 18, 2012, 05:26:35 AM

First of all I just want to say, "O_O".

Secondly it sounds like you are saying that transsexuals cut off their bodies so they can feel like women.

I am so sorry if I have offended you or anyone for that matter.  It is actually the opposite.  I am a transsexual and I don't have to cut off my body to feel like a woman.  All I want to say is that we all have our own believes and what makes us feel the way we are.  Only you can be the judge of your own body and mind.  If something does not feel right then I believe you shouldn't do it and vice versa.  Hope that makes sense... :)

Quote from: glicious on July 18, 2012, 06:23:55 AM
I am so sorry if I have offended you or anyone for that matter.  It is actually the opposite.  I am a transsexual and I don't have to cut off my body to feel like a woman.  All I want to say is that we all have our own believes and what makes us feel the way we are.  Only you can be the judge of your own body and mind.  If something does not feel right then I believe you shouldn't do it and vice versa.  Hope that makes sense... :)

lol, I'm a bit past the debate of what is PC in this regard, but I do find your wording to be funny. To cut off ones body? What is that thing attached to anyway  :laugh:

Agree with some of the other remarks above. Thing is, on E, the sensations change and it's not necessarily *bad* but it's tooooootally not the same... at all. While I have no trouble with erection or even rigidity happening without help during arousing situations, the sex is 100% NOT the same and, frankly, I can't stand it (as opposed to apathy before... sooo...). All that said, I'm one of the "gotta go" camp so, YMMV.

Quote from: MariaMx on July 18, 2012, 06:31:39 AM
lol, I'm a bit past the debate of what is PC in this regard, but I do find your wording to be funny. To cut off ones body? What is that thing attached to anyway  :laugh:

'Cut off' is certainly not the right words that I should have used.  :embarrassed:  I shall be a little more sensitive in the future of course.  :)

Quote from: Noey Noonesson on July 18, 2012, 05:26:35 AM

First of all I just want to say, "O_O".

Secondly it sounds like you are saying that transsexuals cut off their bodies so they can feel like women.

I laughed when I read this, after I realized I wrote it ^_^ .

I hope I am still spiritual, I hope my spirit wasn't in my penis.

TBH undisclosed sex with a man after SRS was the most profound spiritual experience I have ever had in my life.

In the second Matrix movie someone said, "People can't see past a decision they don't understand."  I know I couldn't see past my decision to have SRS but I am sure glad I had it because it allowed me to have experiences I never could have possibly imagined.

i dont know , i dont want to look like a man or live as one , but i cant imagine a vagina being on my body ive always though they are really ugly although functionally im sure they are nice , but defiantly not aesthetically what id want

I'm planning to go the non-op route as well, and I'd prefer that it still "work," because my girlfriend and I like that part of our sex life- but if it stops working, it's not the end of the world. After just 6 weeks on estrofem it's more difficult to get erect, but I still can with the correct... ahem... stimulation. But the stimulation I need for that is ALREADY very different than it was pre-HRT.

Quote from: mementomori on September 11, 2012, 05:46:48 AM
i dont know , i dont want to look like a man or live as one , but i cant imagine a vagina being on my body ive always though[t]  they are really ugly although functionally im sure they are nice , but defiantly not aesthetically what id want

Really? Penises are beautiful on the other hand?

People who know I transitioned consider me a gay guy even though I have a vagina so not having SRS would be an easy way to save a lot of trouble and expense and be seen by those people as just another gay guy.

People who don't know I transitioned consider me a woman, even during and after sex.

Quote from: UCBerkeleyPostop on September 11, 2012, 06:24:52 PM
Really? Penises are beautiful on the other hand?

defiantly , i love penises 

Quote from: Kelly J. P. on July 06, 2012, 12:58:25 AM
Erectile function may or may not be affected, to note, by hormones.

I still "function", after 6+ months. Not as quickly as before...but like the little locomotive..."I think I can, I think I can, I think I can, I thi...ooohh boyyy heeeerre weeee goooooooo" LOL

fwiw, I had dysphoria, but not directed specifically at the penis...instead it was the entire male body. As I modify each element, I move on to the next...so the "tackle" will probably be last in my hierarchy of needs.

As was posted earlier, Viagra or Cialis are vasodilators, so are working on blood flow, and will have no interaction with HRT.  Whether one has a penis or neo-vag is another matter entirely.  As it looks like I will have to wait for a year or so for SRS, for various reasons, I will consider the time to be "The Year of Living Non-Op."  I have spoken to my GT about this, and he thinks it will be good that I am keeping a journal of my thoughts and feelings.
Whether I find myself in a situation where performance enhancing drugs are desireable is a matter for the future, but if a partner wanted me to please her that way, I would be inclined to try it.

Karen.

Quote from: UCBerkeleyPostop on September 11, 2012, 06:24:52 PM
Really? Penises are beautiful on the other hand?

Yup, I love them too :P

As others said, just wait and see. HRT might not have as big an effect as you imagine. Actually thinking it positively will cause ED would make it happen :P

I have always had a strong disconnect with the boy parts, so much so that sex was very difficult at best, tried Viagra years ago but it just didn't help much at all...haven't tried having sex in over six years but honestly don't really miss it.
But my strong female traits are being caring, sensitive, passionate and loving, I love all that about me! it just doesn't include a sex drive.

Quote from: Michelle G on September 13, 2012, 02:18:26 AM
I have always had a strong disconnect with the boy parts, so much so that sex was very difficult at best, tried Viagra years ago but it just didn't help much at all...haven't tried having sex in over six years but honestly don't really miss it.
But my strong female traits are being caring, sensitive, passionate and loving, I love all that about me! it just doesn't include a sex drive.

I agree. I have been on HRT and anti androgens for many years but still get unwanted erections and absolutely hate them. I like to be in control and I'm not in control while I still have these parts. 

HRT and an Orchi my spontaneous erections are gone, and I like it that way. However, on that rarest of occasion when my special friend wants that little extra and from something other then an attachment ;-)  a C works for me although after years of atrify it's no where near it's former glory........

why do some people after years of hormones never get any atrophy ?

Most TS issues with getting and maintaining an erection are pretty much pychological issues not actual physical issues. It will work if your psyche wants it to.

I have been on HRT for 3 years and I have been post orchi for 18 months and my T levels are around T<10 nd/dl for the last 3 years and I still get occasional morning wood and could atain and maintain an erection for intercourse if I was so inclined.

A penis pump and cock rings will do allot to help you in this department. With rings and prostate stimuli you can actualy force an erection so there is all that.

If you are worried about long term sexual function I would sugest a revaluation of your goals.
Good luck and best of wishes. I understand how sex is an important part of many peoples lives. (mine included)

One more thing:
Moderator, shouldn't this post be in the sexuality section of the forums?

I had a beautiful penis when I first began transition.  After about five years on hormones it went from being python shaped to sort of apple core shaped O_o ...

I also lost function, erections became less hard and I wasn't able to maintain one as long.  I was on Spiro at times, Androcur during other times and a variety of different forms of estrogen.

Quote from: mementomori on September 13, 2012, 11:53:19 AM
why do some people after years of hormones never get any atrophy ?

I don't know what a atrophy is? is it an American term for an orchiectomy?

I had a lot of hassle with the NHS GIC in the U.K for several years which stalled my progress. I have always wanted GRS a long time ago and still do but I don't have the finances.  I also don't want my GRS in the United Kingdom because I don't like they way the operation is done and want the best possible results.

at·ro·phy (tr-f)
n. pl. at·ro·phies
1. Pathology A wasting or decrease in size of a body organ, tissue, or part owing to disease, injury, or lack of use: muscular atrophy of a person affected with paralysis.
2. A wasting away, deterioration, or diminution: intellectual atrophy.
v. at·ro·phied, at·ro·phy·ing, at·ro·phies
v.tr.
To cause to wither or deteriorate; affect with atrophy.
v.intr.
To waste away; wither or deteriorate.

--------------------------------------------------------------------------------

[Late Latin atrophia, from Greek atrophi, from atrophos, ill-nourished : a-, without; see a-1 + troph, food.]

--------------------------------------------------------------------------------

a·trophic (-trfk) adj.

Quote from: cynthialee on September 13, 2012, 12:22:36 PM
Most TS issues with getting and maintaining an erection are pretty much pychological issues not actual physical issues. It will work if your psyche wants it to.

I have been on HRT for 3 years and I have been post orchi for 18 months and my T levels are around T<10 nd/dl for the last 3 years and I still get occasional morning wood and could atain and maintain an erection for intercourse if I was so inclined.

I'm gonna be a lil gross here. Sorry!

I must be an oddball case then. First of all I almost never got morning erections. But after a month of HRT the random thoughts decreased SO much. By 4 months in my "erections" were curvy and flaccid until the point of orgasm... which is when they became close to a normal erection. The fluid was clear and MUCH less came out, but the orgasm was the same feel. About a year into it, the closest to erect (thanks in part to atrophy) that I get is just a little larger than I used to be when completely NOT erect pre hrt.

Changes have been VERY physical and profound in my genitals. I cross my legs and squeeze... don't feel a thing between them. I was about 5 inches pre hrt... now I'm maybe 3" at best. There are stretch marks on it and black lines running across (damages blood vessels maybe?) I still have nerve sensitivity all over... that hasn't deminished oddly enough.

I never wanted to keep it... and if I ever did want to.. I couldn't  see myself wanting to keep it now... its just useless and embarrassing at this point!

Quote from: Noey Noonesson on September 13, 2012, 07:08:07 PM
I had a beautiful penis when I first began transition.  After about five years on hormones it went from being python shaped to sort of apple core shaped O_o ...

I also lost function, erections became less hard and I wasn't able to maintain one as long.  I was on Spiro at times, Androcur during other times and a variety of different forms of estrogen.

beautiful penis?

pics or it didn't happen! (kidding!)

Quote from: Alainaluvsu on September 13, 2012, 09:11:38 PM
I'm gonna be a lil gross here. Sorry!

I must be an oddball case then. First of all I almost never got morning erections. But after a month of HRT the random thoughts decreased SO much. By 4 months in my "erections" were curvy and flaccid until the point of orgasm... which is when they became close to a normal erection. The fluid was clear and MUCH less came out, but the orgasm was the same feel. About a year into it, the closest to erect (thanks in part to atrophy) that I get is just a little larger than I used to be when completely NOT erect pre hrt.

Changes have been VERY physical and profound in my genitals. I cross my legs and squeeze... don't feel a thing between them. I was about 5 inches pre hrt... now I'm maybe 3" at best. There are stretch marks on it and black lines running across (damages blood vessels maybe?) I still have nerve sensitivity all over... that hasn't deminished oddly enough.

I never wanted to keep it... and if I ever did want to.. I couldn't  see myself wanting to keep it now... its just useless and embarrassing at this point!

is there a hard lump in the tissue where its curved ? 

Quote from: mementomori on September 13, 2012, 09:19:28 PM
is there a hard lump in the tissue where its curved ?

No. Nothing feels foreign. The entire penis feels a little spongier but I think its because the tissue had compacted due to the atrophy.

Quote from: Ave on September 13, 2012, 09:16:50 PM
beautiful penis?

pics or it didn't happen! (kidding!)

I kinda like the idea that it didn't happen ^_^ .

Quote from: UCBerkeleyPostop on September 11, 2012, 06:24:52 PM
Really? Penises are beautiful on the other hand?

Yeah, For whats on my body, I think a penis and scrotum are about as ugly as genitals can get, a beautiful vagina though, sigh...

This is good news to me, I just kind of assumed that all of that stopped working... I am beginning HRT in the new year, and I thought I'd be saying goodbye completely to functionality, and although I'm not completely opposed to SRS, I am only planning to go as far as HRT at the moment. Not that I'm in love with my junk, but it wouldn't be bad if it remained functional.

I have been on E & P for about 4 years, for the first 3 1/2 years I got them off the internet but about 5 months ago I came out and got a Dr. who prescribed both E & P. Like many of you I do not get spontaneous erections and my sex drive, at least the sex drive as I used to know it is gone. My testicals have shrunken to at least half of their previous size and my penis is now inverted to not much more than a rather large clitoris.

That all being said I am married to a CIS female who supports what I am but still has a need for M/F intercourse. So I asked my Dr for viagra and he was happy to oblige. I have found that they do work, however it take a little longer to kick in (30-40 min) and when erect, my penis only gets to about 3" long. I also feel some pain near the base but I find that it is not enough to stop doing what I am doing. My penis will stay hard for 30-45 minutes and I can orgasm but the volume of fluid is minimal (but the intensity is outstanding!)

I can have orgasms without being erect by masturbating much like a CIS female. using two fingers inserted into the skin around my inverted penis, I actually prefer it this way. I can obtain erections without the use of Viagra however it takes a lot of time and energy to achieve them and they go away rather quickly even with stimulation.

Please feel free to comment...

Wendy

What would happen if a F2M took one of those? Would it make my genitals more male looking?

No.

Update on this:

4 years on HRT, orchi in late Dec 2015...Viagra and Cialis no longer produce good results, indeed they never did, at best it firmed things up enough to allow penetration without any size increase.

Although I do get pretty dysphoric, if I put that aside I can actually get "hard enough", but the size is still smaller than pre-HRT.

Like was said earlier, it's embarrassing. My wife makes do with whatever I can achieve, but *I* know what things were like before (even though she doesn't).

The big question (no pun intended) is, "if I could get as big+hard as I was, would I still want SRS, or would I keep the male parts?"

Fortunately I have 15 months to think about it and to talk it over with my therapist. I'm inclined to get SRS, mainly because I don't like the dangly bits at any time other than full-boner+orgasm (and the orgasm isn't the male one, it's a female surge but with a large clitoral O).

I have a cis female girlfriend who enjoys penetrative sex, and I enjoy it too so maintaining functionality is important. At 7 months HRT it's rare for me to ever get hard enough to have sex though. It does happen sometimes, but usually I can only stay hard for a few minutes before softening. I asked my doctor about Cialis but without insurance it came out to like $500 for ten pills so that didn't work out. However, I have found a solution: "male performance" herbal aphrodisiacs. They sell them in most sex stores and you can buy them them online about $5-10 a pill. They work just like Viagra or Cialis insofar as they are vasodilators. They really work. I like the brand "Alpha Man 3000" (though I hate the name obviously). I use it about once a week with my girlfriend to great success - I take it about 1-2 hours before sex and I can have sex like I did pre-HRT. Sometimes it lasts until the next day. The mental game is still really important but because it's a vasodilator there is a physical mechanism that works very reliably so long as you are aroused from foreplay.

Estrogen is also vasodilator.

Cardiovasc Res. 2006 Mar 1;69(4):777-80.

"There is an abundance of scientific evidence for the protective effect of estrogen against atherosclerosis, such as short-term vasodilating effects"

Biochem Pharmacol. 2013 Dec 15;86(12):1627-42

"Acute administration of estrogen in female or male patients improves vasodilator responses"

"Estrogen also enhances the release of vasodilator substances such as nitric oxide (NO) and prostacyclin (PGI2), and decreases the production and effects of vasoconstrictors such as endothelin (ET-1) and angiotensin II (AngII) [1,2]."

Horm Mol Biol Clin Investig. 2014 May;18(2):89-103.

"Estrogens physiologically stimulate the release of endothelium-derived vasodilator factors and inhibit the renin-angiotensin system."

Lancet. 1993 Jul 17;342(8864):133-6.

"Acute administration of oestradiol-17 beta therefore has a beneficial effect on myocardial ischaemia in women with coronary artery disease. This effect may be due to a direct coronary-relaxing effect, to peripheral vasodilation, or to a combination of these mechanisms."

Progesterone, as well.

Steroids. 2003 Nov;68(10-13):831-6.

"Recent work looking at the additional effects of natural progesterone or MPA on coronary blood flow and myocardial ischemia in postmenopausal women shows that progesterone has synergistic vasodilatory effects when added to estrogens [26]."

I am post-op with very low T, I get engorged in the genital area when aroused and had there been a penis there, it would have certainly been erect. I don't think low T causes penis not to be erect but rather it can either be due to improper blood circulation which can be improved by estrogen/progesterone or to lack of arousal.

Quote...Sometimes it lasts until the next day....

Doe this mean it's erect for many hours, or does it come and go as desired?

Quote...but without insurance it came out to like $500 for ten pills so that didn't work out...

I got both V and C from my Dr, he had coupons for free samples. Group Health doesn't accept them, but most other pharmacies will. My endo was also able to give me 8 V tablets "to see if they work."

;D

Quote from: Beth Andrea on March 24, 2016, 06:00:38 AM
Doe this mean it's erect for many hours, or does it come and go as desired?

No it's not a constant boner for hours. It's more like, when I am aroused I get hard. But my arousal doesn't last for hours. It comes and goes.

Rev Endocr Metab Disord. 2015 Sep;16(3):177-98.

"5α-DHT plays a key role in erectile physiology [96–100] (Table 1). Castrated animals exhibit poor erectile response and T or 5α-DHT treatment reverses this effect on erectile physiology [101]. Administration of the 5α-Rs inhibitor 17β-testosterone carboxylic acid (17βTC) to castrated animals blocked the stimulatory effects of T propionate (TP) on erection [97, 102]. Administration of 5α-DHT with or without 17βTC, restored sexual behavior in long-term castrated male rats and mice suggesting a critical role for 5α-DHT in erectile physiology [103]. Treatment with T together with finasteride did not restore erectile response in castrated animals while administration of 5α-DHT together with finasteride restored nitric oxide synthase expression and activity and also restored the erectile response to electric field stimulation [104]."

"Castration in male animals eliminates non-contact erections and this response was restored by 5α-DHT implantation [105, 106]. Reduced erectile response and reflex erections were observed in castrated animals and treatment of castrated animals with T or 5α-DHT restored the number of erectile responses and reflex erections [107]. However, only 5α-DHT restored erectile responses and reflex erections, when animals were treated with daily injections of the 5α-Rs inhibitor MK-434 (1 mg/kg) together with T or 5α-DHT [107]."

"preclinical studies demonstrated that finasteride and dutasteride have a significant pathogenic impact on penile histo-architecture, and attenuate the nitric oxide synthase (NOS) signaling pathway. Thus, these drugs are likely to contribute to erectile dysfunction (ED) via well-established and characterized mechanisms [94, 95]."

Thus, DHT like estradiol appear to be both vasodilators and promote erection. If DHT is reduced, an adequate compensatory increase in estradiol should suffice to restore erection.

Quote from: RachelsMantra on March 23, 2016, 06:34:19 PM
I have a cis female girlfriend who enjoys penetrative sex, and I enjoy it too so maintaining functionality is important. At 7 months HRT it's rare for me to ever get hard enough to have sex though. It does happen sometimes, but usually I can only stay hard for a few minutes before softening. I asked my doctor about Cialis but without insurance it came out to like $500 for ten pills so that didn't work out. However, I have found a solution: "male performance" herbal aphrodisiacs. They sell them in most sex stores and you can buy them them online about $5-10 a pill. They work just like Viagra or Cialis insofar as they are vasodilators. They really work. I like the brand "Alpha Man 3000" (though I hate the name obviously). I use it about once a week with my girlfriend to great success - I take it about 1-2 hours before sex and I can have sex like I did pre-HRT. Sometimes it lasts until the next day. The mental game is still really important but because it's a vasodilator there is a physical mechanism that works very reliably so long as you are aroused from foreplay.

Are there any alternates to Alpha Man 3000? They aren't available where I live. What about vigrx plus or something similar to that?