Doctors Lounge - Fertility Answers

"The information provided on www.doctorslounge.com is designed to support, not replace, the relationship that exists between a patient/site visitor and his/her physician."

Back to Fertility Answers List

Forum Name: Male Sexual Disorders

Question: My sexual problem


 MANAZER - Sat Apr 17, 2004 12:15 pm

One year back I had undergone testosterone hormone replacement therappy as it was prescribed a physician after a blood test to see the levels. He said I am having hypogonadism and had used andriol tablets for three months during the treatment and the results during the treatment were better. At present I am taking medicine for lowering cholesterol in the blood and ranitidine for duodenal ulcer in the stomach. Doctor said to continue these medicine for one month. Now after 10 days this tratment will be over.

My present problem is I am not getting erection and not having the desire for sex. My age is 36 and that of my wife is 30. My penis looks very very soft and is small. Even if I do a massage it is very difficult for an erection. I noticed some veins gathering on the left testicle but no pains. It looks like a gathering of veins curled on the left side of the testicle. Could you please advise what type of treatment I should undergo to solve my erection problem and which doctor I should consult. Even if erection comes when she is around, it does not last and the strength is not enough to have sex. I do not have any other physical or pshychological problems. Are there any treatment available ? if yes please advise it will be a great help.

Thanks and regards,

Man
 Dr. Yasser Mokhtar - Mon Apr 19, 2004 9:33 pm

User avatar Dear Abdul-Nazer,

Thank you very much for the update.

Regarding your sexual problem, as discussed before, you look like you have a problem in your endocrine glands, having a low testosterone means that either the testicles are not producing any and this means that you either have a problem in your testicles and the treatment for this will be to take testosterone for the rest of your life and this will have to be under strict medical supervision.

The other possibility is that you might have a pituitary gland (the master gland that controls the testicles) or hypothalamus problems (the organ that controls the pituitary gland). In addition to checking the testosterone level in the blood, you have to have other hormones checked including fsh, lh and prolactin levels. This is mandatory because you might have a pituitary tumour.

You have to see an endocrinologist (specialist in endocrine glands).

Taking viagra might be beneficial once we know for sure that there is nothing else that should be dealt with.

Thank you very much for using our website http://doctorslounge.com and i hope that this information helped.

Yasser Mokhtar, M.D.
 MANAZER - Wed Jan 05, 2005 7:39 am

RESPECTED DOCTORS,
PLEASE SEE MY MAIL BELOW.

THOUGH HAVING STRONG DESIRE FOR SEX, PHYSICALLY THE ERECTION IS NOT STRONG AND NOT LASTING. PLEASE ADVISE FROM THE BELOW TESTS IF ANY THING YOU COULD MAKE OUT TO ADVISE ME.


TESTOSTERONE : 4.47
PROLACTIN: 13.01
CA : 9.6 MG/DL
CREATININE : 1.0 MG/DL
FERRITIN : 150.4 NG/ML
GGT : 22 U/L
ASAT(SGOT) : 19 U/L
MAGNESIUM : 1.6 MG/DL
IRON : 131 UG/DL
TRANSFERRIN : 3.40 G/L
TIBC : 431.80 UG/DL
FE SATURATION : 30.3 %
HBSAG : NEGATIVE
OCCULT : NEGATIVE
ESR : 05 MM/1HR
WBC COUNT : 8.1 10^3/UL
RBC COUNT : 6.09 10^6/UL H
HGB : 16.9 G/DL
HCT : 50.0 %
MCV : 82.0 FL
MCH : 27.8 PG
MCHC : 33.9 G/DL
RDW : 12.1 %
PLATELET COUNT : 204 10^3/UL
MPV : 8.9 FL
DIFF TYPE : AUTO DIFF
ABS NEUTRO : 4.8 10^3/UL
ABS LYMPH : 2.5 10^3/UL
ABS`MONO : 0.4 10^3/UL
ABS EOS : 0.4 10^3/UL
ABS BASO : 0.0 10^3/UL
NEUTRO : 60.4 %
LYMPHO : 30.3 %
MONO : 4.6 %
EOS : 4.7 %
BASO : 0.0 % L
RBC`MORPHO : ERYTHROCYTOSIS
SPEC.DESCR. : URINE
SPCL REQ : IBS
CULTURE : NO GROWTH
REPORT : FINAL 08122004
COLOR : YELLOW
CLARITY : CLEAR
PH : 5.0
PROTEIN : NIL
GLUCOSE : NIL
WBC : 0-5
RBC : 0-5
EPITH CELLS : FEW
MUCUS THREDS : 1+
HIV AG/AB : NEGATIVE
ALBUMIN : 4.9 G/DL
ALKALINE PHOS : 75 U/L
ALAT(SGPT) : 22 U/L
BILIRUBIN, T : 0.5 MG/DL
TP : 8.0 G/DL
GLOBULIN : 3.1 G/DL
CHOL : 238 MG/DL
TRIG : 138 MG/DL
HDL : 58 MG/DL
LDL : 152 MG/DL
CL : 106 MMOL/L
CO2 : 28.6 MMOL/L
K : 4.2 MMOL/L
SODIUM : 141 MMOL/L
UREA : 25 MG/DL
ANION GAP : 6
FT4 : 16.4 PMOL/L
FT3 : 4.8 PMOL/L
TSH : 1.610 ULU/ML
PT : 12.7 SECS
RATIO : 0.97
INR : 0.96
PT CONTROL : 13.1
APTT : 29.2 SECS
APTT CONTROL : 34.0
_________________
______________
MAN
 Dr. Yasser Mokhtar - Wed Jan 05, 2005 9:33 am

User avatar Dear Abdul-Nazer,

Thank you very much for the update.

The complete blood count are normal, the liver function tests are normal, the iron studies are normal, total cholesterol is just a little bit elevated but the good cholesterol is also elevated (so no need to worry), kidney function is normal, electrolytes (including calcium and magnesium) are normal. Urine analysis is normal.

Regarding the hormone profile, the thyroid functions, prolactin and testosterone, you have to provide us with the range of normal in the lab where these tests were done.

But in general, there is no problem with prolactin until it is above 20. The tsh looks normal. Regading the testosterone, i am not sure about the testosterone level that you sent and whether it is normal or not. Hormone levels have many pitfalls to their measurements and levels and you need to see an endocrinologist (a specialized doctor in hormones) to make sure that everything is in order and if your testosterone level is actually low and you need to take testosterone then he will be the one adjusting the dose. Please, no delays, see an endocrinolgist as soon as possible.

There is also one thing that i would like to suggest and that is to have a doppler ultrasound of the arteries of the penis to see whether there is a blockage.

If you are smoking, please, stop smoking.

Thank you very much for using our website http://doctorslounge.com and i hope that this information helped.

Yasser Mokhtar, M.D.
 MANAZER - Thu Jan 06, 2005 1:30 am

Dear Doctor,


Thank you very much for the reply. I will soon be seing an endcrinoligist. With regards to the range of testosterone from the lab report it is read as male 3-10.6 ng/ml

Prolactin range 1.5-19 ng/ml

Thanks a lot once again for your valuable advise and timely replies

Abdul Nazer
 Dr. Yasser Mokhtar - Thu Jan 06, 2005 3:07 am

User avatar Dear Abdul-Nazer,

Thank you very much for the update.

i would suggst that you also get tested for 2 other hormones before you see your endocrinolgist and these are lutenizing hormone (lh) and follicle stimulating hormone (fsh).

Have you ever had an ultrasound of the testicles to see whether or not their size is normal or abnormal?

Thank you very much for using our website http://doctorslounge.com and i hope that this information helped.

Yasser Mokhtar, M.D.
 MANAZER - Thu Jan 06, 2005 3:54 am

Dear Doctor,
Thank you very much for your valuable advise. I will do the tests advised and soon see an endocrinologist and will update the results. With regards to testicles, I had seen an Urologist and he had checked the size. He found some curved viens on the left testicles gathered and the size is little smaller than the right one. He had also applied an injection on the penis and the erection was full at that time. The penis looks very soft most of the time. However, the doctor said nothing to worry about the size of the left testicles and the viens gathering there. the gathered viens are some what black shaded nerves and curled together and placed just below and around the left testicles. For the right one there is no such nerve. My lower abdomen is little fatty and I doing regular jogging to reduce the tummy.

Thanks a lot for your valuable advise and support as always.

Best regards,

A.Nazer

| Check a doctor's response to similar questions

Are you a Doctor, Pharmacist, PA or a Nurse?

Join the Doctors Lounge online medical community

  • Editorial activities: Publish, peer review, edit online articles.

  • Ask a Doctor Teams: Respond to patient questions and discuss challenging presentations with other members.

Doctors Lounge Membership Application

Tools & Services: Follow DoctorsLounge on Twitter Follow us on Twitter | RSS News | Newsletter | Contact us