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Suffering form severe sexual dysfunction, numbness in hands and back pain. What should I do?

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Practicing since : 2004
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I've been dealing with severe sexual dysfunction for several years now. Both my primary care physician and urologist believe that the issue is psychological. I'm still concerned because I have also had neuropathic symptoms. I feel strange sensations on the bottom of my right heel, especially when I stretch my right leg. I am also having electric shock sensation whenever I cup my hands, especially my right hand. This occurs mostly when I'm at working on my computer. I also get numbness in my hands whenever I wake up in the morning. I also have occasional lower back pain it was more sever whenever I weighed more. I have also been diagnosed with depression since I was 11 years old and have severe anxiety as well. I am a hypochondriac but I'm concerned that I may have MS. My PCP does not think I need to see a neurologist. I don't have any coordination issues. I have spent a lot of money and have gone into debt to trying to find an answer for my sexual dysfunction but nothing has helped. I've been dealing with numb hands and feet on and off since I was a teenager. I has never really been a major problem with it and still don't. I've had some level of sexual dysfunction since I was in my early 20s but it has gotten a lot worse in the past 2 years. My anxiety about MS have increased in the past year and now I think about it everyday. I also have low testosterone but my levels have been brought back to normal. I am currently 50 - 60 lbs over weight but have lost 35 lbs in the past 6 months in an attempt to help my ED. My question is should I continue to spend money and try to see a neurologist or should I take a wait and see approach? In the mean time I am focusing on getting to my ideal weight. I quit smoking a year ago. I currently take 300 ml of testosterone every two weeks. 1-2 Klonopin a day for anxiety and wellbutrin. Any advice would be helpful. Thanks!
Posted Wed, 1 Jan 2014 in Sexual Problems
Answered by Dr. Ashish Mittal 1 hour later
Brief Answer: Your problem is due to multiple issues. Detailed Answer: Hello, Thanks for your query. I appreciate your efforts for medical consultation in so much distress. Important aspects of your query are: • 31 year old male • Known case of obesity, low testosterone, anxiety, depression and hypochondriasis. • Currently on testosterone, Klonopin and wellbutrin • Complaints of sexual problem. In treatment sexual problem first step is to identify cause of the problem. It can be a result of a psychological or physical problem. Psychological causes: Most common cause in young patients. These include performance anxiety, emotional weakness, inferiority complex, stress, marital or relationship problems, low mood, and the effects of a past sexual and emotional trauma. Men with psychological problem usually have normal nocturnal erections and erections upon awakening, whereas men with physical problem often do not. Physical causes: Include neurological disorders, alcoholism, smoking, hormonal imbalances, diabetes, hypertension, blood vessel disease and chronic diseases. Structural problem: Deform penis and tight foreskin problem. Your sexual problem is due to multiple problems. In your case following are the issue which need to deal with following steps: -Low testosterone: You are already on treatment. Get your thyroid function test (T3/T4/TSH) done, as its imbalance also affect sexual life. -Smoking: It is good that you have already stopped it. -Weight: There is need to reduce weight further. Focus more on aerobic exercise at-least 30-60 Minutes per day. Reduce fat intake. Do not reduce weight fast, just reduce 2-3 kg weight every month. -Start some multivitamins daily. -Treatment of anxiety, depression and hypochondriasis: Unexplained somatic symptoms (weird sensation/electric shock like feeling) and fear of different medical illness (like MS) are common in anxiety disorder. You do not need neurologist opinion if your physician do not feel need for it. But you need psychiatrist consultation to deal with these issues which take time to solve, so keep patience. Continue medicines (Klonopin and wellbutrin). Apart from that start some non drug treatment like cognitive behaviour therapy (CBT) from nearby psychologist to deal with anxiety, depression and hypochondriasis. I hope this information has been both informative and helpful for you. In case of any doubt, I will be available for follow ups. Wish you good health. Regards,
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