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Dr. Andrew Rynne

Family Physician

Exp 50 years

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Suggest treatment for intermittent erectile dysfunction which has persisted for 6 months

Answered by
Dr. Ashok Kumar


Practicing since :2000

Answered : 2951 Questions

Posted on Fri, 20 Jul 2018 in Mental Health
Question: I was working with Dr. XXXXXXX XXXXXXX and delayed in responding to the questions he asked me.

1. How long you are facing problem with erections?
- About 6 months

2. How the problem started whether it was sudden in onset or build up slowly over the months or years?
- I think it was sudden

3. Frequency of the problem in a week/month ? Are you able to have some successful sexual intercourse?
Yes intercourse has been successful but not able to satisfy my partner and not myself to the extent it usually used to be. The problem is infrequent.

4. In a typical month out of what number of sexual interactions do not achieve success?

5. What are the factors that increase the problem ?
I am not able to point out a reason

6. Factors that relieve the problem- thoughts, situations, partner, place etc.

7. Do you get early morning erection?

8. If yes how frequent and how intense?

9. Your partner details- Is she very critical, demands sex more than what can you think, does she feel superior to you or bothers you in some other regards?
No my partner is just fine and exepectation are very fair. She is also cooperative and helps things make exciting

10. Effect on your relationship so far due to problem
There is no effect so far since we able to talk about it

11. Details of medical illness like duration, any complications, treatment received till date.
12. Medications you are receiving currently, if any including ayurvedic homeopathic or any other.
13. Medication you received in past and their effect?
14. Do you have any psychiatric illness (like anxiety, depression, fear)?
15. Investigations done till date and reports of most latest investigations- serum testosterone, TSH, T3, T4 and any other?
Nopes, haven't done anything

I must assure you that once we identify cause it will be easy to correct it.
I look forward to see more details.
Answered by Dr. Ashok Kumar 3 hours later
Brief Answer:
Follow up

Detailed Answer:
Thanks for follow up.

As per the available details there is possibility of organic cause for the problem. As suspected by you, I see little reasons for psychological cause for the problem.

Since I suspect organic cause I feel it will be better if you can go for relevant testing. In such situations I recommend following tests to be done.

1. Complete blood count
2. Liver function test with GGT
3. Blood urea
4. Serum creatinine
5. Lipid profile
6. T3, T4 and TSH
7. Serum testosterone
8. Serum prolactin
9. LH and FSH
10. Penile doppler study

Once these tests are done revert back to me.
Thanks again.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
Answered by Dr. Ashok Kumar 2 days later
Brief Answer:
Follow up

Detailed Answer:
Thanks for follow up.

As per the available two reports there is evidence of hypothyroidism. Although it is limited direct role in erection but it affects the erection by different mechanisms.

Having said this I look forward for other details for final opinion.

Thanks again.
Above answer was peer-reviewed by : Dr. Vaishalee Punj
Follow up: Dr. Ashok Kumar 1 minute later
Attached are some of my reports. I wasn't able to get a Penile Doppler test but have few results ready. Will upload others as soon as I get them.
Uploaded complete report
Answered by Dr. Ashok Kumar 4 hours later
Brief Answer:
Follow up

Detailed Answer:
Thanks for follow up.

Although the details of all tests are limited (specially related to sexual problem) but the available details itself indicate there is severe deficiency of vitamin B12 and vitamin D3. Both of them are need to be supplemented with use of appropriate medications.

Without delay there is need to start following medications
1. Cap Neuro D3 60000 unit one capsule per week
2.Tab Methylcobalamin 1500 microgram per day (Corus (intas) or neuron forte (ipca)

There is also need for further thyroid assessment.

I hope this helps you.
Thanks and regards.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

The User accepted the expert's answer

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