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Dr. Andrew Rynne

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Exp 50 years

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Not able to get erection for long time. Have pain in testicles. Got testosterone levels checked. Any problem?

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Dr. S Patra

OBGYN

Practicing since :2011

Answered : 4047 Questions

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Posted on Thu, 31 Jan 2013 in Men's Health
Question: I am 25 years old male, not married. My problem is that i am not able to sustain erection for long and i tend to ejaculate in 10 to 15 seconds only during masturbation. This problem is from the beginning. And after masturbation i feel little pain near testicles area like thighs, hips and all. Also i am feeling that erection is not so hard. Is this impotency? Can it be cured? I am worried about my "to be married life". Please advice.
I got my total and free testosterone levels checked which were 296 ng/dl and 28.30 pg/ml respectively. My vitamin 25 Hydroxy (OH) Vit D level is 6.90 ng/dl.
doctor
Answered by Dr. S Patra 3 hours later
Hello,

Thanks for query.

You maybe suffering from Erectile dysfunction with Premature Ejaculation. Both can cause sexual dissatisfaction in married life,specially to your partner.

In erectile dysfunction,a man is unable to get or maintain erection for certain time, which is needed firm enough to complete sexual intercourse. In Premature Ejaculation,male ejaculate within 1 min or prior to intimate/sexual intercourse with partner. If both condition last for long time,they can cause impotency/loss of libido / infertility after married life.

Your all lab test values are below normal range. Normal values for Total & Free Testosterone are 300-1000 ng/dl & 35-155 pg/ml and normal Vitamin D level is 20-56 ng/dl. You have low testosterone with much more deficiency of Vitamin D.There are several reasons to be ruled out like Hypogonadism,Psychological, Smoking/alcohol, Some drugs,Prostate Hypertrophy/Prostatitis, Varicocele/hydrocele, Arthritis or Autoimmune disorder,High BP,Diabetes,Thyroid problem,Neurological causes etc.

A complete clinical examination is needed by urologist/sexologist to confirm diagnosis.Please do consult with any one of them to take suggestive measures.

Do the following things for life style modification & Prevention of above condition:
1) Quit smoking and alcohol.You may need psychotherapy /counseling.
2) Decrease frequency of masturbation if you do.
3) Take healthy diet, do physical exercise regularly and maintain personal hygiene.
4) Avoid stress/psychological upset/depression by regular XXXXXXX breathing/ yoga.
5) In Premature Ejaculation:
a) Master & XXXXXXX / Stop & Start Technique are very good and much helpful. You can google about them.
b) Use anaesthetic gel to desensitize penis or condom for temporary delaying
c) Certain drug like Dapoxetine, a class of SSRI,short acting and well approved.
d) Intracavernous Therapy with injecting vasodilator substance to control premature ejaculation & maintain erection.
e) Kegel exercise or strengthening of PC muscle by contraction and relaxation as on holding & releasing urine.
6) Drug like Sildenafil may be helpful in treating erectile dysfunction. Discuss with urologist/sexologist.
7) Need Vitamin-D supplements with Testosterone Depot Inj /Androgenic drug to increase testosterone level.
8) Need proper sleep,Avoid hot working place and tight underwear.

Hope I have answered your query. If you have any further questions I will be happy to help.

Wish you good health.

Regards
Above answer was peer-reviewed by : Dr. Mohammed Kappan
doctor
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Follow up: Dr. S Patra 46 minutes later
Thanks doc for the answer.
Shall i start the drugs suggested by you now or after marriage? As in are there any side effects of the drugs? And can this be treated successfully?
Also please tell whether i should stop androanagen tablets?
doctor
Answered by Dr. S Patra 22 minutes later
Hello,

Thanks for follow up query.

You might need a complete clinical examination with some investigations as done by Urologist / sexologist to pin point a diagnosis. A complete treatment can be done based on the evaluation. Therefore consider consulting them before starting treatment.

Vitamin and Testosterone supplements may be started after complete examination and obviously before marriage to get rid of those problems.
Drugs like sildenafil have short lived effects and are helpful only when taken a few hours before sexual activity. Should you need this drug, it can only be taken a few hours before sexual intercourse.

The drugs have some side effects but are tolerable. You may consult with your physician if any drug reaction occurs.

In the interim need not change Androanagen tabs as it is very much helpful in treating hair fall and without sexual side effect.

If you do not have any clarifications, you can close the discussion and rate the answer.

Wish you good health...

Regards,

Above answer was peer-reviewed by : Dr. Prasad
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