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Dr. Andrew Rynne
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Dr. Andrew Rynne

Family Physician

Exp 50 years

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What causes lack of erection and hardness in penis during intercourse?

Answered by
Dr.
Dr. Ashok Kumar

Psychiatrist

Practicing since :2000

Answered : 3120 Questions

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Posted on Mon, 6 Jun 2016 in Sexual Health
Question: I am 35 since a 5 days my pennies is not becoming big while sex and sperm is also reduced here temperature is 40+ I do daily walking. i dont drink nor smoke. what to do to overcome. I got married in 2 1/2 yrs back dint take any pill only condoms and now planning for kids so since 4 months used to have 20 intercourse per month. no tablets or no other health issue yet. can I take stay on or any such tablets now.
doctor
Answered by Dr. Ashok Kumar 19 minutes later
Brief Answer:
Please provide more details

Detailed Answer:
Dear XXXXXXX
Thanks for using Health Care Magic.

I read your query and understand your concerns.

Before we can make any conclusions I request you to provide following details so an impression can be made about the cause of problem.

1. How long you are facing this problem (ED) ? Do you mean it is just 5 days or there was some problem in past?

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

3. Frequency of the problem in a week/month ? Are you able to have some successful sexual intercourse?

4. In a typical month out of what number of sexual interactions/masturbation ?

5. What are the factors that increase the problem?

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

7. Do you get early morning erection?

8. If yes how frequent?

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

10. Effect on your relationship so far due to problem

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?


I must assure you that once we identify cause it will be easy to correct it.
I look forward to see more details.

Thanks and regards
Above answer was peer-reviewed by : Dr. Arnab Banerjee
doctor
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Follow up: Dr. Ashok Kumar 16 minutes later
since five days I am feeling so. had good sex early my wife has no such demands as planning for kids so thought of having frequent sex so had approx 20 times a month. I am a vegetarian. no effect on relationship my wife said may be due to frequent sex it may be the cause. had kidney Stone treatment one year back had undergone stone crush. I drink around 3to 5 Ltrs water a day early morning errict since two days I started sleeping without underwear. no tests yet. till last month I was OK with sex around 6inch big pennies. since five days not getting hard enough. I don't have any depression or anxiety problem yet. no medications
doctor
Answered by Dr. Ashok Kumar 7 hours later
Brief Answer:
It will be appropriate to go for tests

Detailed Answer:
Dear XXXXXXX
Thanks for reverting back to me.

In view of the above information it will be appropriate to go for further testing as for permanent solution we need to identify the root cause of problem.

I request you to get following tests from nearby laboratory in early morning withoout taking any food.
T3, T4, TSH
LH
FSH
Serum Testosterone
Serum prolactin
Blood sugar
Lipid profile

After doing these tests revert back to me with reports.

In addition also monitor early morning erection (yes/no or change from the previous level) and report of this along with blood investigations.

Thanks and regards
Above answer was peer-reviewed by : Dr. Deepak
doctor
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Follow up: Dr. Ashok Kumar 3 days later
Doctor as suggested by you I have undergone following tests and the report are as attached. let me know what kind of specialists doctor should I consult should I consult a urologist. is it a serious issue is it curable. plz brief me doctor. and suggest doctors to whom I should consult or can it be cured by medication
doctor
Answered by Dr. Ashok Kumar 2 hours later
Brief Answer:
One crucial information (early morning erection) is missing

Detailed Answer:
Dear XXXXXXX
Thanks for reverting back to me.

Regarding reports everything is normal and there is nothing to worry.

Since one part of information is missing I am delineating the specialty which will be most suitable for you.

If you do not have early morning erections you need to visit a urologist in your city. He may ask for penile doppler to evaluate further.

In case early morning erections are present it will be appropriate to see a psychiatrist. He will proceed with more history and counselling to guide you through success.

I must assure you that conditions is largely treatable either with medicines and counselling.

I hope this helps you.
If you have more questions feel free to write back to me.
If not, you may close the discussion and if possible you may rate the answer for my future patients.
In future if you wish to contact me directly, you can use the below mentioned link:
http://doctor.healthcaremagic.com/doctors/dr-ashok-kumar/67386
Thanks and regards.


Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Ashok Kumar 31 minutes later
Sir thank you for your kind support and building my confidence. about early morning erections I dint find since past 3 days sir only if urine is filled in bladder it becomes bit big. and sir one thing which is making me worried is that in the report clinical significance it is mentioned that clinical evaluation of serum testosterone along with serum LH assist in evaluation of hypogonadal males major causes of lowered testosterone in males include hypogonadotropic hypogonadism, testicular failure Hyperprolactuema, Hypopituitarism some type of liver and kidney diseases and critical illness was mentioned, what it means sir. and testosterone value is 233.07 is it normal sir how to increase it sir. I am planning for my first parenthood so what all precautions and care should I take sir. I had kidney stone operated dose it has any side effect if any small stone is left will it too create a problem sir. and how to make pennies stuff now sir. kindly suggest me with guidance. and sir I have never smoked or had alcohol nor non vegetarian. do regular walking in fact 8 days back started with cycling too.
doctor
Answered by Dr. Ashok Kumar 3 hours later
Brief Answer:
The details are for doctor and there is no significance in your case

Detailed Answer:
Dear XXXXXXX
Thanks for follow up and your compliment.

The details you mentioned above do not have clinical significance in your case. They are general description of the tests and usefulness but in your case all tests came back normal. In regard to LH, FSH, Prolactin and testosterone along with other tests are within normal limits and as I said there is noting to worry.

Renal stones are not known to cause any sexual problem and I think they is mere coincidence rather than anything else.

Regarding testosterone 233 is completely normal for 36 year young male and there is no intervention required. In addition testosterone is responsible for desire and libido which I guess you have enough. In case you are particular to get more testosterone there are tablets, capsules, injections and patches available but I must acknowledge again that they are not required for you.

Regarding planned parenthood the most important thing is to eat healthy and regular exercise. In addition if your job involves heat exposure to your testis it is advisable to use ice in trouser pockets to keep the temperature of your testis down.

Regarding sexual issues before you meet urologist it will be appropriate to use Tab Megalis 10 mg once in a day preferably 2 hours before going to your partner.

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