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Erectile dysfunction and Depression - Online Doctor Chats

Date : 21-Feb-2012
User rating for this question
Very Good Posted in: Erectile Dysfunction
Answered by

General & Family Physician
Practicing since : 2005
Answered : 2582 Questions
User :   Hello, I was wondering if I could get someone's advice about whether I should seek advice from an endocrinologist. I recently had blood work done to determine my testosterone level. It came back 447, which I know is within "normal" ranges, but for my age it is on the lower end of what is considered normal. I'm a male btw, and 30 years old. I've had surgery for gynocamastia when i was in my teens. The last four years or so I've difficulty in maintaining erections and my libido has gone down, which cause a pretty serious bout with depression. However, I'm thinking that there may be underlying problems with my hormones that may be the problem and I don't think one testestosterone test is sufficient in seeing the whole picture. Any advice would be great
Doctor :   Hi
Doctor :   Let me read the query.
User :   hi. Okay.
Doctor :   Do you have any other symptoms apart for the loss of libido and erection dysfunctions?
User :   Depression for sure, but that may have been caused by situations.
Doctor :   Have you seen a doctor to determine the cause for your symptoms?
User :   I also did an online saliva test that said I have high cortisol, borderline high estradiol, low progesterone.
User :   I have seen a doctor, but I just don't feel like the standard evaluation is sufficient.
Doctor :   Was he a specialist?
User :   No, just a G.P. That's why I was wondering if I should seek advice from an endo.
Doctor :   Ok.
Doctor :   Let me explain.
User :   I also have used smokeless tobacco for a number of years, which I know can be a problem with bloodflow.
Doctor :   The most common cause of sexual problems are psychological.
Doctor :   The other causes which includes hormonal, vascular and other medical conditions are less common when compared to the former one.
Doctor :   A urologist would be a better person, who can help you than an endocrinologist.
User :   I know, but when it started I was in a healthy relationship for a year and had a great sex life and then all of a sudden I started having problems out of nowhere. Since then performance anxiety is an issue for sure, but I don't think it's the whole story.
Doctor :   You may see an endocrinologist if needed but only after consulting a urologist.
User :   Okay.
Doctor :   In the mean time, you would also need adequate treatment options for helping your depression.
User :   I'm dealing with the depression okay now. It's not as much of a problem.
Doctor :   Depression and anxiety are one of the major causes for erectile dysfunction.
Doctor :   That is good.
Doctor :   Continue with the treatment of depression, which should also include home remedies such as good bed rest, regular exercises,.
User :   I know it's a double edged sword with depression meds., in that they cause sexual problems sometimes. I've been on Wellbutrin and did not like it. I'm not going to take any more meds.
Doctor :   physical exercises, meditation, yoga, breathing exercises.
User :   Yeah exercise helps a lot.
Doctor :   These measures are equally important in dealing with the depression and your sexual problems too.
Doctor :   Do not feel that medication alone will be able to solve your problems.
User :   I don't. I'd rather not take any.
Doctor :   As most often these are the ones that are going to help.
Doctor :   So continue with these.
Doctor :   Consult a urologist for evaluation of other factors such as vascular, neurological.
User :   I am, but I think it would be wise to further explore possible physical problems too.
User :   I will
Doctor :   You may see an endocrinologist after these.
Doctor :   Do you have any other query that I can assist you with?
User :   No not right now. Thanks for your help.
Doctor :   Please fill the feed back form too.
Doctor :   Thanks for consulting me. Bye for now. Please refer your friends to our service.
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