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Suggest Treatment For Erectile Dysfunction And Azoospermia

Posted on Fri, 20 Nov 2015

Question: hi! my husband is 32 yrs old recently diagnosed with diabetes. he is having erectile dysfunction. his serum fsh is 21.31, his sperm count is nil. his penis and testicles are small. he is not mentally stable. plz help me.

Answered by Dr. Chintan Solanki (3 hours later)

Brief Answer:
go for serum testosterone level and other investiagtions

Detailed Answer:
Hello XXXXXXX

Thanks for writing to us.

I can understand your concern.

Diabetes at age of 32, not mentally stable, nil sperm count with small penis and testicles are the factors must be evaluated with some investigations.

His FSH level if mentioned in mIU/ml unit it is high.

From basic history it seems that he has some hormonal problem.

I need more information from your side.

- Upload reports of him until done now.

- He needs to go for serum testosterone (total and free) and Sex hormone-binding globulin (SHBG) level .

- I need to know his size of penis and scrotum. Preferably he should undergo ultrasound of scrotum.

- What is duration of marriage life? Since when he has erectile dysfunction?

- Do you have nay child?

- What type of psychological problems/symptoms he has?

-
I will be happy to help further after your response.

Regards,

Dr.Chintan Solanki.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Chintan Solanki (3 hours later)

Thank you so much for the answer Dr. He is taking Tab. Dionil once for diabetes. His penis size is 3 inch when it gets some erection and testicles size is half inch. I got married in the month of may 2015. From my first night my husband used to tell me a story before coming close. That story is his friend's wife divorced his friend in a month reason stating she is not sexually satisfied by her husband. He gets angry on small things like: 1) why you made poha for breakfast, 2) why i went out with his mother, 3) Why grandpa is watching tv serials, 40 Why im sitting a bedroom alone.
His whole family knows that his attitude that is why the ignore him saying that he is like that only.
When i told him lets go and consult with the doctor he refused saying that im satisfied, if you are not that is your problem. He is using bad word to me like i know you are not satisfied physically from me so you will sleep with other person or you would have slept already. We went to psychiatrists. Doctor said that if he couldn't control his anger he might harm himself or others. Dr has also given few medicines to him like: tab. BUSPIN-5, Tab. clonil-10, Tab. pxe-cr-12.5, each tabklet half at night and for erection Tab. Tadalip-20. these medicines did not helped him. so many times he tried to insert his penis but due to lack of erection it never happened naturally. i never felt his penis inside. Dr said he can not perform physical activities without medicines and in our case natural pregnancy is next to impossible. He has to take medicines for his psychological condition for long time. Dr didn't specified the time period. I am attaching his few reports.

Regard, XXXXXXX

Answered by Dr. Chintan Solanki (41 minutes later)

Brief Answer:
Some long term psychiatric problem may be there

Detailed Answer:
Dear XXXXXXX

Thanks for information.

I want to give my opinion from clinical experience. Whatever I am going to explain is possibility, confirmation can only be done after your in-laws true information. I may be wrong.

You married just before 5 months. You have noticed some of abnormal behavior since you married. His family is aware about his problem and they just do not care or give attention. I think he might be suffering some king of psychiatric problem since before your marriage. Doctor has also told that he has to take medicines for long means there should be some psychological problem. Otherwise for erectile dysfunction it is not like that.
Buspin is an anti-anxiety drug, clonil and pexep both are used for premature ejaculation and pexep is for depression/anxiety disorder as well.

3 inches erect penis is somewhat small, it should be 4 inches at least. Half inches testicle is absolutely abnormal. No sperm means his testicles are not working I guess. Testosterone is the hormone required for erection and it is produced form testicles mostly.He has probably testosterone deficiency. In that case he needs testosterone supplement. And sperm count is confirmed nil, I am sorry to say that he cannot be father at all.

I didn't get any reports. Please upload his semen analysis and other reports if you have.

- Have you met him before your marriage? If yes did you find any abnormality in behavior at that time?

- Does he have any friends? if yes did you meet anyone of them and get any information about his personality?

- What is his education and work?

- What diagnosis was made by psychiatrist about his problem?

- What do you feel about your in law's opinion about your husband? Are they telling truth and hiding something?

- Please upload reports.

I will be happy to help further.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Chintan Solanki (51 minutes later)

Hi, I have provided some attachments. Please review them.

Answered by Dr. Chintan Solanki (36 minutes later)

Brief Answer:
reports suggest he has abnormality with testicles and testosterone

Detailed Answer:
Hi,

Thanks for reports. You have mentioned the same in your narration also.

He seems to have testicular failure. Reduced testicles size, high FSH and nil sperms favor testicular failure. And this problem should not happen suddenly in five months. It should be there before. It is possible that it can be there since childhood.
Go for his testosterone level also. It will be likely low or absent.

Feel free to discuss further.

Note: For further guidance on mental health, Click here.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar