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a lot of male problems...

I'm hoping someone can give me some advice, I have a lot of issues which have cause me a lot stress and embarrassment. Around four years ago, I began having problems with my erections and difficulty achieving an orgasm. Since that time things have gotten much worse, I experience hot flashes, heart palpitations, PVC's, no spontaneous or nocturnal erections, I can't sustain an erection without constant physical stimulation (even then it's very poor), my testicles have reduced in size by approximately 25%, I have aching pain in my prostate, very weak slow prostate contractions, a semen volume less than 2ml, semen has become a blend of very think globs mixed with thin watery parts, mild pain experienced with orgasm, and chronic constipation. I have seen my primary care physician but all she did was check my total testosterone which was 780 (reference range 348-1197), since it was normal she said it's was anxiety and depression; so she prescribed medication for that. Those medications do nothing for me but make me feel worse (five different anti depressants now, not one helped). She said the hot flashes were just anxiety attacks, but the xanax does nothing to help stop them or ease them when they occur. My insurance is terrible so I'd like to get some opinions on what's likely happening so I'd know what to talk to my Dr. about, I need a referral to see a urologist or my insurance won't cover the costs.
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Avatar universal
I forgot to mention I'm 28 years old and at a healthy weight.
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1711789 tn?1361308007
MEDICAL PROFESSIONAL
Hi there!

Erectile dysfunction can develop in young adults due to a variety of causes. Psychological stress, performance anxiety, depression, neurogenic disorders peyronie's disease, body image issues, medications, alcohol, smoking, drugs/medications, hormonal imbalance, radiation therapy, kidney failure, metabolic disorders, multiple sclerosis, hypertension, diabetes, prostatitis, urethritis etc. just to name a few. Anxiety and stress play an important role in the development of erectile dysfunction; and is the most common possible cause. At a primary level, I would suggest being a bit relaxed and working on the psychological factors. You could also see a psychotherapist/ behavioral therapist for the same. It might also be beneficial to get rid of factors like smoking/ alcohol/ drugs, if involved. In case this doesn’t work, I would suggest seeing a urologist for an evaluation of the above mentioned causes and appropriate specific treatment.
Hope this helps.

Take care!
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