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Testosterone and nocturnal erections
Doctor, I'm 36 and had a bout with Peyronie's a few years ago that left me with some distal rigidity issues, that I treat with Viagra.   For the last 4-5 years, I've been concerned though about a lack of nocturnal erections or any spontaneous erections. I asked my Uro for a testosterone test.

I just had my Uro send me the copy of my testosterone report.  On the phone the doc told me "your free testosterone is fine ... don't worry about nocturnal erections."  I was less than pleased with that answer so I requested the copy myself to see the details.

My Total Testosterone was 235 (which he even wrote on the report was slightly low).  % Free is 1.71 ... Testosterone, Free 40.2pg/mL ... Prolactin 6.1ng/mL ...

I can give you other numbers if you'd like.  But judging by these numbers, am I incorrect in thinking my lack of nocturnal erections, spontaneous erections, etc., could be due to this low testosterone?  

I asked him about taking Trazedone at night (which is supposed to increase nocturnals) but he said he didn't prescribe this because of a risk of priapism.  He also said, "You don't want to try to correct your testosterone because you'll be doing it for the rest of your life."  He just didn't seem to care about nocturnals, but frankly, I feel like I need nocturnals for tissue health (in light of the Peyronie's) and also I might not need the Viagra if I got myself back in working oder, so to speak.

My question is am I write connecting the low testosterone number with my symptoms?  And is there a type of specialist I could consult on an issue such as this?

Thanks for your time.
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There is a possibility that the slightly low testosterone can affect the night-time erections.  However, it is not markedly low and typically much lower levels are needed to result in erection problems.  

I would also obtain blood tests to look for diabetes and the thyroid.  An ultrasound can determine if there are any vascular diseases that can lead to the symptoms.  

A urologist would be the appropriate specialist to discuss these issues.

Followup with your personal physician is essential.

This answer is not intended as and does not substitute for medical advice - the information presented is for patients education only. Please see your personal physician for further evaluation of your individual case.

Kevin, M.D.
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