what is worng with me????

[dither77]

Hello everyone. I have a big problem and hope to find some assistance here (sorry if my English is incorrect, I come from Bulgaria)

So here is my story. I am 36 years old. I have never had normal sexual functions (meaning: no libido, no erections even morning ones, erection achieved rarely and only manually and not very complete). My genitals are very small - in fact they have not grown at all since I was 13. Penis is childish size when flaccid, when erect reaching 5,5 inches. Testicles are very small, about 12 ml. The first time I achieved an erection manually was when I was in my early twenties. Otherwise I am very masculine, I have beard etc... Never had sexual life.

I've been to many urologists throughout my life and they kept telling me there was nothing wrong with me. A couple of months ago I read somewhere on the Net about hormones and decided to test them on my own, without being referred by a doctor. Testosterone is 18 nmol/l (range 10 to 27) so I presume it is not very low, but I have low Inhibin B equaling 77 (range 120 - 400) and high FSH at 14 (range 1 to 12). Prolactin, LH are normal.

Then I went to an endocrinologist and he said my testicles were small but this does not account for my erections and sexual activity. He made me do semen analysis and I have normal low amount of sperm though with reduced motility.

So what might be wrong with me? I constantly search the Net for conclusions. I even read about a genetic disorder causing small genitals call Klinefelter syndrome which makes me damn scared although I do not have the typical symptoms.

Please anyone help me. It's been a life-long embarassment

[dither77]

Dear Dr Kaur,

Thank you so much for your reply. In my opinion the motility should be the least concern since it fluctuates and can also be amended with herbs. What bothers me is the very small size of my genitalia. In fact they have not grown since I was 13 - could it be that something went wrong, or it is just individual and size varies. In fact my penis reaches average size when erect, but it is very small when flaccid and especially the testicles are very small... not more than 12 ml and I know they should be at least 20 ml. The high level of FSH points to a primary testicular failure but I am unsure of the reason for it and whether it can be cured.

Could testicular volume be related to sexual functioning? Are there ways to increase testicular volume. I know there is a substance called HCG that when injected raises testicular size but as far as I know it mimics LH whereas my LH levels are normal.

Sorry for asking all these questions but in my country I get lots of contradictory opinions - some endocrinologists say there's nothing wrong with me, others that I have undeveloped testicles causing my condition.

Thank you.

[Bhupinder Kaur, MD]

Hello,
You are having normal penis length. Motility is the percentage of moving sperm in a sample and an evaluation of their rate and direction of travel. At least 50% should be motile one hour after ejaculation. Usually in such cases, we do another semen test after four to six weeks to see whether sperm quality has improved on its own. If there are still large numbers of abnormal sperm or a low sperm count, then we check for any infection. In such cases even with abnormal sperm morphology, motility problems or a low sperm count, pregnancy may still be possible once the infection is treated.

It is very difficult to precisely confirm a diagnosis without examination and investigations and the answer is based on the medical information provided. For exact diagnosis, you are requested to consult your doctor. I sincerely hope that helps. Take care and please do keep me posted on how you are doing.