Aa
Testosterone?
Hello Dr.
I'm a 36 year old male. In 2001 I had a bout with Peyronie's that left me functional, but with a little distal rigidity issue (the glans doesn't fill up and get hard like it used to). I was prescribed Viagra, as this makes my erections very hard and prevents the lack of firmness at the head from interfering with maintaining the erection.
However, for the last 5 years or so, I've noticed that my nocturnal erections have disappeared, as well as no morning erections and no spontaneous erections. This got me thinking maybe my testosterone was low, so I had it tested.
The results were as follows: Total T 235; Percent Free 1.71; Free T 40.2; FSH 5.1; LH 3.4; Prolactin 6.1.
Based on the low total number (235), I've scheduled an appt with an Endocrinologist, but I'd like to ask you if you think these numbers seem to indicate that testosterone could well be the cause for my lack of nocturnal/morning/spontaneous erections. I'm hoping that testosterone replacement might even make me not need Viagra at all.
One last related question: though I always take Viagra on an empty stomach, some times Viagra has worked on me less effectively than others - for instance, usually, an hour after I take it, if my girlfriend and I just start kissing, etc., I'll get erect, but on some occasions, it would require direct stimulation for a few minutes to get erect. Once I was "up" it was clearly a Viagra erection though - very hard and durable. This would scare me though that the Viagra was losing it's effectiveness on me, but in light of my low testosterone, might it not be that the Viagra is keying off fluctuations in my hormone levels - sometimes really kicking in hard, while other times not working as fast?
As I said, I'm going to see an Endo, but I'd like to hear if you'd support this course, based on the test results.
Thanks for your counsel, I appreciate your thoughts.
I'm a 36 year old male. In 2001 I had a bout with Peyronie's that left me functional, but with a little distal rigidity issue (the glans doesn't fill up and get hard like it used to). I was prescribed Viagra, as this makes my erections very hard and prevents the lack of firmness at the head from interfering with maintaining the erection.
However, for the last 5 years or so, I've noticed that my nocturnal erections have disappeared, as well as no morning erections and no spontaneous erections. This got me thinking maybe my testosterone was low, so I had it tested.
The results were as follows: Total T 235; Percent Free 1.71; Free T 40.2; FSH 5.1; LH 3.4; Prolactin 6.1.
Based on the low total number (235), I've scheduled an appt with an Endocrinologist, but I'd like to ask you if you think these numbers seem to indicate that testosterone could well be the cause for my lack of nocturnal/morning/spontaneous erections. I'm hoping that testosterone replacement might even make me not need Viagra at all.
One last related question: though I always take Viagra on an empty stomach, some times Viagra has worked on me less effectively than others - for instance, usually, an hour after I take it, if my girlfriend and I just start kissing, etc., I'll get erect, but on some occasions, it would require direct stimulation for a few minutes to get erect. Once I was "up" it was clearly a Viagra erection though - very hard and durable. This would scare me though that the Viagra was losing it's effectiveness on me, but in light of my low testosterone, might it not be that the Viagra is keying off fluctuations in my hormone levels - sometimes really kicking in hard, while other times not working as fast?
As I said, I'm going to see an Endo, but I'd like to hear if you'd support this course, based on the test results.
Thanks for your counsel, I appreciate your thoughts.
MEDICAL PROFESSIONAL
Hi Sonvolt,
It sounds to me that you have 3 issues - possible previous Peyronie's disease (mild), possible testosterone dieficiency, and varying responses to Viagra. It sounds like what worries you the most is the testosterone deficiency.
First off, the level of circulating testosterone in the bloodstream varies through the course of the day, being highest when you first wake up, and then decreasing through the day. As a result, I would suggest that you validate the testosterone results again when you visit your Endocrinologist - ideally, the test should be performed between 7-11am.
Secondly, it is not very likely that you have significant testosterone deficiency (what we term hypogonadism), as you are young and still very sexually active with good libido. Testosterone replacement is usually only given to older men with clinical symptoms arising from their low testosterone - tiredness, loss of concentration, and lack of libido associated with ED. You don't sound like you have any of those.
Lastly, it is worth noting that giving patients testosterone may increase their risk of porstate cancer - the jury is still out on this as the evidence is conflicting. Nonetheless, we would recommend that you get a baseline exam by a urologist before you start testosterone, followed by regular visits. Patients with occult prostate cancer may develop aggressive progression of their disease after being started on testosterone - therefore, follow-up is important.
With regard to the varying responses to Viagra, this could be due to the differing neurochemical secretions during your sexual encounters. Each encounter is different, producing different responses by your brain. Nonetheless, the fact that Viagra still achieves consistent erections for you is good news, and nothing you should be worried about.
Yours sincerely,
Dr Ash Tewari, MD
It sounds to me that you have 3 issues - possible previous Peyronie's disease (mild), possible testosterone dieficiency, and varying responses to Viagra. It sounds like what worries you the most is the testosterone deficiency.
First off, the level of circulating testosterone in the bloodstream varies through the course of the day, being highest when you first wake up, and then decreasing through the day. As a result, I would suggest that you validate the testosterone results again when you visit your Endocrinologist - ideally, the test should be performed between 7-11am.
Secondly, it is not very likely that you have significant testosterone deficiency (what we term hypogonadism), as you are young and still very sexually active with good libido. Testosterone replacement is usually only given to older men with clinical symptoms arising from their low testosterone - tiredness, loss of concentration, and lack of libido associated with ED. You don't sound like you have any of those.
Lastly, it is worth noting that giving patients testosterone may increase their risk of porstate cancer - the jury is still out on this as the evidence is conflicting. Nonetheless, we would recommend that you get a baseline exam by a urologist before you start testosterone, followed by regular visits. Patients with occult prostate cancer may develop aggressive progression of their disease after being started on testosterone - therefore, follow-up is important.
With regard to the varying responses to Viagra, this could be due to the differing neurochemical secretions during your sexual encounters. Each encounter is different, producing different responses by your brain. Nonetheless, the fact that Viagra still achieves consistent erections for you is good news, and nothing you should be worried about.
Yours sincerely,
Dr Ash Tewari, MD
Yes, the shots, gel, and these pellets increased my 224 T-level to the mid 700's but that was all it did. My sex drive was even less. No libido at all. Caused anxiety and less sleep which HELLO Doctors! causes less sex drive. My conclusion after 3 Urologists and 1 physician is that they have no clue what to do except scribble the next prescription and get you out the door. Not one of my doctors has even followed up with me to check my status. I'm trying to sleep more, exercise a little, eat healthier, and deal with my anxiety by taking 300 mg of St. John's Wort daily. I don't know what else to do. Viagra works and the woman doesn't complain, but it's not a solution to the problem. In fact it causes more problems. You mentally depend on it and the side effects are horrible. $35.00 a pill without insurance is $$$. I don't use the whole pill since that would kill me. I break it up into quarters.
I seriously feel that there is more to what they are telling us about chemicals in foods and heated plastics that have shut down our systems. Best of luck to you guys because I don't see any help in the near future.
I seriously feel that there is more to what they are telling us about chemicals in foods and heated plastics that have shut down our systems. Best of luck to you guys because I don't see any help in the near future.
hi in the morning time and afternoon time i have no problem with erections and maintining them even without viagra or any other pill.. but in the night time im not able to get even a little bit erection even if i take viagra or any other pill they just dnt work on me in the night. what can be the reason behind this. im so scared
Have an Answer?
You are reading content posted in the Erectile Dysfunction Community
Millions of people are diagnosed with STDs in the U.S. each year.
STDs can't be transmitted by casual contact, like hugging or touching.
Syphilis is an STD that is transmitted by oral, genital and anal sex.
Discharge often isn't normal, and could mean an infection or an STD.
STDs aren't transmitted through clothing. Fabric is a germ barrier.
Normal vaginal discharge varies in color, smell, texture and amount.
