• question-icon

    Suggest treatment for low testosterone levels

default
Posted on Wed, 9 Aug 2017 in Urinary and Bladder Problems
Question: Can a lower lever of testosterone cause ED issues?
doctor
Answered by Dr. P. T. Patil 5 hours later
Brief Answer:
Low Testosterone level indirectly cause Erectile Dysfunction .

Detailed Answer:
Hello
Thanks for query .

Erection is a very complex process and So many theorizes have been postulated about role of Testosterone in Erection. Truly speaking role of Testosterone in this process of Erection is still not clearly understood .

However low Testosterone levels in blood leads to loss of sexual desire (Libido) which is the basic factor in getting erection .This loss of sexual desire (Libido) in turns causes anxiety which causes Psychogenic Erectile Dysfunction .

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
default
Follow up: Dr. P. T. Patil 1 hour later
Thank you very much!
(1) Two days ago (for some unknown reason) all day long I felt itching in my testicles, and in the evening I was normal as if I was myself again before ED issues - bottom line: I was able to have a long passionate sex... however yesterday, I had ED issues again, and no erection... is this sign of low testosterone? Could you please explain to me why do I have full strong erection one day and feel no erection the next day????? What has changed, the testosterone level all off a sudden decreased?
(2) how can I fix the issue of "loss of sexual desire"?
(3) Does 5 mg of Cialis help me to get my sexual desire back?
I don't want to use Cialis for the next thirty years.
Thank you very much!
doctor
Answered by Dr. P. T. Patil 58 minutes later
Brief Answer:
Your problem of ED seems to be basically Psychogenic in nature .

Detailed Answer:
Hello
Thanks for follow up .
To have a normal erection on one day and no erection on next day itself indicates that you problem of Ed is functional in nature and not due to any organic cause .

In majority of cases it is due to what is called as Performance Anxiety .Following measure will help you to boost up your confidence and getting good erection and have enjoyable sex.
1) Practice regular exercise for 45 minutes followed by meditation for 1/2 an hour in the morning.
2) Take high protein diet rich in vegetables and fruits and Vitamin A,C,D,E.and Zinc
3)Take anti oxidants like Almonds 5-6 everyday..
4) Avoid alcohol and smoking.

Thanks and Regards.
Dr.Patil..
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
default
Follow up: Dr. P. T. Patil 10 hours later
Hello, thank you!

(1) What is the time frame to improve my erection if I follow your 4-item recommendation? By the way, I don't smoke or drink alcohol.

(2) Can I exercise and meditate in the evening after work (instead of in the morning)?

(3) Do you recommend to try Testosterone injections to boost up my Testosterone level? What are the side effects?

(4) What are recommended high protein food?

(5) Do you recommend to use Testosterone natural supplements in my daily diet?

(6) Do you recommend me to visit a Psychiatrist or Neurologist, or both - to help me with Psychogenic ED issue?

Thank you very much!
doctor
Answered by Dr. P. T. Patil 1 hour later
Brief Answer:
Read answers point to point as detailed below

Detailed Answer:
Hello
Thanks for follow up .These are the answers to your queries.
1) It takes 4-5 months to get the results of this regime .

2) Yes you can have exercise and meditation in the evening .

3) There are no major side effects of Testosterone at this age .You can take injection Testosterone Depot once in a month .It will definitely help you to increase your libido .
4) Eggs ,meat ,Cereals ,Soya Bean and Spouted foods are rich in proteins and Vitamins.

5)You can take natural supplements of Testosterone available in market However I am not aware of their efficacy .

6)If you fail to get results better you consult Psychiatrist for counselling .

Thanks and Regards.
dr.Patil.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
default
Follow up: Dr. P. T. Patil 36 minutes later
Thank you!
(1) I took Cialis 5 mg on Friday evening at 07:25 pm, and we had sex. Then 48 hours later, on Sunday evening, I was able to have an erection, and we had sex.

My question is - was my erection on Sunday was as a result of 5 mg Cialis on Friday? Or did I have an erection on my own without 5 mg Cialis?

(2) Can 5 mg Cialis taken daily for 6 month cure my psychogenic ED issues? Or after 6 months I will still have ED issues?

(3) Can 5 mg of Cialis help me to get my sexual desire back?

(4) Does Cialis have any psychogenic (or any other) affect on my brain to trigger erection process?

Thank you!

doctor
Answered by Dr. P. T. Patil 9 minutes later
Brief Answer:
Read answers ad detailed below

Detailed Answer:
Hello
Thanks for follow up .Here are answers to your questions .
1) The action of Cialis lasts only for 4-6 hours .The erection on Sunday was natural erection

2) Cialis acts at local level and has no action and difficult to predict about outcome after 6 months .In majority of patients ED gets recovered over a period of 6 months and one does not have to take these drugs .

3)Cialis automatically helps to improve sexual desire as one gets satisfaction during sex on getting erection .

$) It does not have an effect on brain .

Thanks and Regards.
Dr XXXXXXX


Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
default
Follow up: Dr. P. T. Patil 25 minutes later
Thank you!
My Free Testosterone level is 40, and the normal range is 30 ~ 100 (I am not sure about units).

(1) Would you recommend me to take Testosterone injection (if I was your patient)?

(2) If yes, how fast do I see the results, 3-4 days? Do I need to do blood test after 1st injection?

(3) What if there is no result after 1st injection, do I wait for a month to take a 2nd injection?

(4) Are the side effects from Testosterone injection irreversible, and harmful?

(5) Is Testosterone injection generally recommended to treat psychogenic ED issues?

Thank you very much!


doctor
Answered by Dr. P. T. Patil 15 minutes later
Brief Answer:
Read detail answers as mentioned below

Detailed Answer:
Hello
Thank for follow up .

1) Having low sexual desire with positive report of low testosterone demands exogenous Testosterone .either in the form of Topical Gel or Injectble form

2) It takes a week to see the results and one has to repeat blood test and adjust the next dose as per level of Testosterone

3) One is bound to get results after injection

4) Side effects will wane away after the effect is over ,

Testosterone is indicated for loss of libido due to low Testosterone levels in blood and not for Psychogenic ED .

Thanks and Regards.
Dr.Patil.


Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
default
Follow up: Dr. P. T. Patil 42 minutes later
Thank you!
(1) I don't have morning erections any more (as a month ago), does it mean low testestorone level?
(2) For the last 2 weeks, my penis is completely shrinked, "dead" and cold, it has no signs of getting hard, and and it has no blood flow - is this a sign / indication of low testestorone level in my body?
(3) Do I need Testosterone injections every month for the rest of my life?
(4) Why do I need two injections instead of one injection?
(5) If my Free Testosterone level is 40
(6) Will Testosterone injections completely mess up my health?
(7) What could be the reason for free Testosterone to drop so low? Is something in my body causing drop in Testosterone level?
Thank you!
doctor
Answered by Dr. P. T. Patil 7 hours later
Brief Answer:
Read detail answers as outlned below

Detailed Answer:
Hello
Thanks for follow up .

1)Morning erection has no relation with low testosterone levels in blood

2) The penis in flaccid state is always soft ,The size of the penis in Flaccid state has no significance at all .In Flaccid state the function of the penis is of a tube to pass urine out of body .It is hardness of penis on erection that matters for sexual enjoyment and satisfaction .

3) No you have to check blood levels and decide whether you need to take it more or not .

4) Free Testosterone of 40 units is normal for your age .

5) Testosterone Depot is only one injection and has to be repeated if required depending upon the symptoms of sexual desire and level of Testosterone in blood after one month .

6)It will not mess up with your health .

7)It is difficult to find the reason for low Testosterone levels .

Thanks and Regards.
Dr.Patil.


Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
default
Follow up: Dr. P. T. Patil 12 hours later
Thank you!

The first blood test from 08/28/2017 (Urologist doctor) showed free testosterone level calculation = 1.5 % on 1.6 ~ 2.9 scale, which is not good.

The second blood test test from 07/13/2017 (Physician doctor) showed free testosterone level of 40 (on 30 ~ 100 scale), and you said for my age it is normal.

(1) Can testosterone level be modulating and jumping up and down much within 2 weeks of time? Is it jumping up and down during the day?

(2) Is it normal to have good results for "Total" Testosterone (579 ng/dL on 300~890 scale), and the same time to have bad results for "Free" Testosterone?

(3) Based on my free testosterone level, do you still think I have psychogenic ED issues? Or do you think my ED issues are due to low level of "Free" Testosterone?

(4) I found at GNC store very expensive Testosterone supplement pills (Nugenix).
These pills have the following:
- D-Aspartic acid (3,000 mg);
- Fenugreek Extract (700 mg);
- Epimedium sagittatum (650 mg);
- Stinging nettle (360 mg);
- Maca (250 mg);
- Mucuna Pruriens extract (250 mg);
- Eurycoma Longifolia extact (150 mg).
Per Nugenix manufacturer: I need take 4 pills daily for four weeks, and then 2-4 weeks off period.
Per manufacturer: all of these ingredients boost free testosterone, maximize muscle and strength, increase drive vitality, modulate androgenic activity.

Do you think if take these pills for a month, they will help me to boost my free testosterone level? Or do you still recommend me to have testosterone injection?

(5) Is "testosterone injection" is to add more "free" testosterone? Or is it a complete replacement of my existing "total" testosterone?

(6) If I get testosterone injection in the morning, should I go to work the same day, or should I go home to rest for day? What are typical side effects?

(7) Is my "free" testosterone produced only during my sleep?
(8) Is my "total" testosterone produced only during my sleep?

Thank you very much!
doctor
Answered by Dr. P. T. Patil 41 minutes later
Brief Answer:
Read detail answe as under.

Detailed Answer:
Hello
Thanks for follow up .

1) Different laboratories use different methods to estimate Testosterone hence reports of two laboratories can not be identical and can not be compared with each other .

2) As I have explained in my earlier reply that Testosterone is present in blood in two forms free and conjugated .It is total testosterone that is considered as a base line for deciding whether one needs to be treated or not and also on symptoms treatment.

3)Having a normal Erection on one day and no erection on next day points a diagnosis of Psychogenic cause for ED .

4) E.D is not directly due to low testosterone levels .

5) The Testosterone pills that you have mentioned about is not available in XXXXXXX .I have never used the same for my patients hence can not comment about efficacy of (Nugenix)..

6) Testosterone injection is analogue of natural Testosterone secreted in body ..It does not replace the normally secreted Testosterone in body .

7) You can go to office immediately after taking injection .

8)Secretion of Testosterone is a continuous process and does not vary during sleep or when is awake .

Thanks and Regards ,I here by close our discussion from my end .

Dr.Patil.

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

Urologist

Practicing since :1971

Answered : 10189 Questions

premium_optimized

The User accepted the expert's answer

Share on

Recent questions on  Vitamin a

doctor1 MD

Hi I would like to ask if this Gloxi drink Height enhancer will still work for a 28yr old? here are the ingredients:ALFALFA is high in protein,...

doctor1 MD

Hi I have been feeling light headed every morning now soon after I wake up while i am preparing breakfast and it stays fir about hours then I am...

doctor1 MD

I have a scab forming at the tip of my tailbone..( butt crack) I ve tried everything from Vitamin A D, Neospirin, fungal ointments.. What is it and...

doctor1 MD

hi i am a 24 year old male i currently have a mucus discharge that is really annoying on my day to day life i am a vegetarian and take a mens multi...

doctor1 MD

Hi sir. My sperm report first time I have taked,my total sperm count is 15 million /ml, active motile 5%,non motile 90%,sluggy motile 5%,how can I...

doctor1 MD

Hello, I am 29 years old male. I leak a lot of precum almost all the time. It does not just happen when I have sexual thoughts. It can happen just...

doctor1 MD

I have problems in my mouth for the past year. I started off by losing my voice all of a sudden for a few seconds. Sometimes I would have the...

Get personalised answers from verified doctor in minutes across 80+ specialties

161 Doctors Online

By proceeding, I accept the Terms and Conditions

HCM Blog Instant Access to Doctors
HCM Blog Questions Answered
HCM Blog Satisfaction
Questions Answered By Dr. P. T. Patil
  • Q - Have stomach pain, fever and loose stool. On omniprzole and ciplox. Any...

  • Q - Have had cyst removed from lips and noticed rigidness. Will it cure on...

  • Q - On medication for BP, body pain and frequent urination. Getting weakness...

  • Q - Having pain in testicle and noticed dark skin on it. What to do?

  • Q - Took medication for neurological problem and never had a desire for...

  • Q - Experiencing prolonged menstrual periods. What to do?

  • Q - Have increase frequency and urgency of urination. Any treatment?

  • Q - Why does my penis look small when not erect?

  • Q - Having on and off mouth ulcer. What is causing this and how to get rid...

  • Q - Noticed movable lump on the side of abdomen. What could it be?

backtotop2