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Suggest Treatment For Stress, Sleeplessness And Anxiety

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Posted on Wed, 7 Jan 2015
Question:
Hi,

I am 35 years old make. A couple of months back, I was under a lot of stress and my sleep was disturbed due to that and at the same time I was also thinking about sex but due to my stressful situation, I was trying to take my attention away from sex. However as you know when you try to avoid something, it hits you back hard, so my penis was rock hard but I avoid masturburating for 3 months, infact even touching my penis and at the same time stress was there and my sleep disturbance i.e. my biological clock automatically adjusted to waking up after 4 hours of sleep and then one hour of NO sleep and then sleep ( Infact for a couple of days I got only a few hours of sleep) Also when I was not able to sleep I used to sit on the bed for 2 hours and then go to sleep.
One fine day the same thing was happening my Penis was Rock hard in the morning and afternoon but all of a sudden in the evening I felt something in my testicles, a feeling of shrinking or something . I thought it will go away but next morning I noticed that I was NOT able to get erection. I thought it will go away but it continued for few days. A few days later I started feeling very strong pain in testicles and I went to Doctor. He ordered a doppler effect which came back fine. HOwever the erection problem did not go away. At the same time I also started getting a feeling of gas which never passed away (This problem went away after I stopped sitting on the bed when I woke up during night, so can be XXXXXXX to my sitting position also). I was worried about prostate and doctor ordered Ultrasound on my request which came back Normal. (However I have read on the internet that sometimes ultrasound cannot detect prostate Cancer and you need MRI, so I am a bit worried). Anyhow, I am a big fan of natural recovery and had heard that fasting can solve some problems so I fasted completely for 3 days and then I went to a very low calorie diet for next 6 days. Meanwhile I was still worrried about erection, so doctor ordered hormones test for FSH, LH, Testosterone, Prolactin and thyroid, LFT and Kidney function Test and CBC+ESR. CBC, ESR, LFT, Kidney Function test were normal. Urinalysis was normal. LH was 1.77 mIU/mL which was in normal range as per lab, FSH 3.2 mIU/mL which was in normal range. LH/FSH ratio was 0.55. Procalactin was 4.22 ng/mL and TSH was 0.68 uIU/mL. Total Testosterone was 375.53 which although in normal range I beleive is NOT normal for my age . Free Testosterone was very low 2.93. One thing to note is that I had only four hours of sleep that day when I went for Test and as mentioned was still on a very low calorie diet since last 7 days

Worried about the results I started masturburating now assuming that this will fix the issue. Although the sexual excitement is there(less then before ) , Erection is still missing and I don't get the strong jerks which you get on climax. I also increased my diet. I am going to get another testosterone and hormone test to see if the things have improved now but there is still no Erection.

My worry is lets say if there is a prostate Cancer and since I am unmarried, is there a way to treat the same without effecting the reproductive life. The ultrasound I had for prostate 6 weeks back was normal but it was not an MRI of the prostate.

Regards
doctor
Answered by Dr. Dr. P. T. Patil (29 minutes later)
Brief Answer:
All the symptoms are due to Anxiety.

Detailed Answer:
Hello
Thanks for your query,based on the facts that you have posted it appears that you have erectile dysfunction since couple of months

Since all the tests which are normally done to evaluate cause of E D are normal.The cause of Erectile dysfunction in your case is due to Anxiety Neurosis.

However consult qualified Urologist and get following test done to rule out the same .It will help to allay your anxiety.
1) Colour Doppler Ultrasound Scanning of Penis to rule out any vascular cause of your ED.

As regards your doubts about cancer of the Prostate I would like to state that since you do not have any symptoms related to cancer of prostate and your serum PSA levels being normal there is no possibility of you having cancer of the prostate at all..It is your anxiety that is bothering you .

Please consult qualified Psychiatrist for counselling and further treatment..He is the best person to help you to resolve all your issues.

Hope I have answered your query ,please feel free to ask if you have more questions ,I shall be happy to help you
Thanks and Regards.
Dr.Patil.


Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Dr. P. T. Patil (1 hour later)
Hi ,


I have not got any PSA done yet. I am worried about getting it done. I had an Ultrasound done as you can see in my original question but I read somewhere that Ultrasound is NOT enough to detect Prostate Cancer and MRI is more accurate

Also my Testosterone levels especially my Free Testosterone levels are veryyy LOW as you can see for a 35 years old.

My Erectile dysfunction is still there after 2 months and I do not get strong jerks while masturburating.

doctor
Answered by Dr. Dr. P. T. Patil (3 hours later)
Brief Answer:
Prostate Cancer is common after the age of 50 .

Detailed Answer:
Hello
Thanks for follow up.
In absence of any symptoms there is no reason why you should suspect to have cancer of prostate .As regards your assumption about the efficacy of ultrasound scanning and MRI to detect cancer of the prostate most of the cases are detected on digital rectal examination palpated as hard nodule and Trans rectal Ultrasound Scanning and is confirmed only by multi core biopsy of the prostate and not by MRI.

As regards your free testosterone levels ,a single reading is insignificant and testosterone levels have to be repeated for two to three months before it is labeled to be low.It is ratio of the free testosterone to total testosterone and it is an index for ED.

I would suggest you to consult qualified Urologist and Psychiatrist for evaluation.

Thanks and Regards.
Dr.Patil.


Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Dr. P. T. Patil (11 hours later)
Thanks Doctor,

My question then is what can cause SUDDEN Erectile Dysfunction. In the morning I had Rock hard penis and was dying to mastuburate and was controlling it somehow and the same evening my Penis went down like anything, never to come back again even nocturnal erections are not there.

The only thing is that I have been controlling my mastuburation since last 3 months and also was under stress.

So what causes such a sudden Erectile dysfunction where you have Rock Hard penis in the morning and completely down in the evening

Regards
doctor
Answered by Dr. Dr. P. T. Patil (10 hours later)
Brief Answer:
You need to do Colour Doppler Ultrasound Scanning of Penis .

Detailed Answer:
Hello
Thanks for follow up.
The cause of sudden loss of erection can be ascertained only by clinical examination and Colour Doppler Ultrasound Scanning of Penis.
Thanks and Regards.
Dr.Patil.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Dr. P. T. Patil (12 hours later)
Thanks a Lot Doctor, One Quick question please

Ok, SO What you are suggesting is that sudden erectile dysfunction in Penis can be caused by problems with Penis. Lets say the doppler effect of Penis also comes NORMAl, then what will you suspect next.

Given the fact that I took myself out of the stress state and have been watching laughter shows and mastuburating also now, so if this was a Psycological problem, wouldn't it would have been rectified by now

One more thing I would like to mention is that in the month of May 2014 due to some other reason ( I was having twiching in my scrotum), I went for Scrotal ULTRASOUND and it was normal and the doppler effect this time on 26th October was also normal but there is difference in Testes size and Volume between these 2 studies. In May 2014 My Right Testis on Ultrasound measured 47X30X25mm (volume(18.2 cc) and left 43X27X25mm (Volume 15.4 cc). This time when I went for Doppler, my Right Testis measured 46X32X21 (Volume 15.0 cc). The radiologist performing this mentioned that this was normal an differences can come between readings. Please remember that this time I went for Doppler study as my Testes were paining a lot after Erectile Dysfunction, although the pain went away the same day when I went for Doppler.

doctor
Answered by Dr. Dr. P. T. Patil (59 minutes later)
Brief Answer:
Variationin of 1-2 cms in size of tesicle is accepted as normal .

Detailed Answer:
Hello.
Thanks for follow up.One can get erection while masturbating but may not have hard erection of the same magnitude while performing sex This is common finding in patients with ED.

One gets erection due to excessive stimulation of penis by firm grip of penis with hand while masturbating which is not the case while having sexual intercourse.Second aspect is one is alone while masturbating where as presence of a female partner adds to your anxiety .

As regards your query about report of Colour Doppler Ultrasound Scanning of Penis it is done to rule out any vascular insufficiency as a cause of ED.
Thanks and Regards.
Dr.Patil.
Note: Consult a Urologist online for consultation about prostate and bladder problems, sexual dysfunction, kidney stones, prostate enlargement, urinary incontinence, impotence and erectile dysfunction - Click here.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
Answered by
Dr.
Dr. Dr. P. T. Patil

Urologist

Practicing since :1971

Answered : 10583 Questions

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Suggest Treatment For Stress, Sleeplessness And Anxiety

Brief Answer: All the symptoms are due to Anxiety. Detailed Answer: Hello Thanks for your query,based on the facts that you have posted it appears that you have erectile dysfunction since couple of months Since all the tests which are normally done to evaluate cause of E D are normal.The cause of Erectile dysfunction in your case is due to Anxiety Neurosis. However consult qualified Urologist and get following test done to rule out the same .It will help to allay your anxiety. 1) Colour Doppler Ultrasound Scanning of Penis to rule out any vascular cause of your ED. As regards your doubts about cancer of the Prostate I would like to state that since you do not have any symptoms related to cancer of prostate and your serum PSA levels being normal there is no possibility of you having cancer of the prostate at all..It is your anxiety that is bothering you . Please consult qualified Psychiatrist for counselling and further treatment..He is the best person to help you to resolve all your issues. Hope I have answered your query ,please feel free to ask if you have more questions ,I shall be happy to help you Thanks and Regards. Dr.Patil.