Question: 34 y/o male with 9 year hx of erectile dysfunction. Sx began summer of 2005, onset was sudden, ended a few relationships because of inability to perform sexually. Still managed to marry and have 1 child. Erections are weak, don't last long. In order to achieve erections that last long enough for successful sex I have to run and work out for several days in a row, eat healthy, get a lot of sleep and wait several days between ejaculations. Was seen by a urologist when I was 32, the encounter was brief and he told me it was all in my head. I use to watch porn often but have since stopped for about a year. Was refer'd to a psychologist and was told that they could not find any reasons for my dysfunction. Demanded referral to endocrinologist, labs revealed my pituitary gland was functioning properly, LFT's were WNL and my testosterone was "within normal limits" By normal limits I mean 1 point above the bare minimum of what is considered normal for men. My research has lead me to studies that conclude that my testosterone levels are more in line with 80 year old men than men my own age. I have low muscle mass, all of my fat is on my abdomen "skinny fat". I recently had gynocomastia surgery. I am active, I am in the military. Endocrinologist gave me viagra and basically told me to bugger off. My wife can no longer take the inability of me to perform and my marriage is on the verge of being ruined because she feels I don't want her. With this very limited information, what on earth do you think could be causing my weak erections and lack of sex drive? Do you think that at least trying testosterone supplementation is worth a shot? It's not normal for a 34 y/o man to have no sex drive and weak erections and it sure as heck wasn't normal when I was 25 either. I'm at my wits end.

I do not have the values with me, what I can tell you is that my FSH, TSH, prolactin, LH, LFT's, CBC, Chem panels were are well with normal limits. My wife says I snore on occasion but grind my teeth more than anything. A device I recently purchased shows my sleep is interrupted on average of 6 times a night. I am physically fit, I am in the military. I am 6 foot 2 inches, 206 lbs, I smoke on occasion, I had years during the 9 year hell where I used no tobacco at all. I haven't been much of a drinker for the last year. Never done a complete CMP nor a SHBG. My waist is about 36 inches. I have always held my fat on my abdomen. I have thin legs and thin arms. My father and brother were big hairy muscular men, I was not like that, no chance of kleinfelter's as I am not sterile. The whole thing began when I was in the best shape of my life as I was training in the Navy SEAL's pipeline. I have always been a good runner, just a hard gainer of muscle, almost impossible it seems, but if I stop working out the fat builds on me fast. Again, TSH well within normal limits. Can't really hold and really hard erection with masturbation. No hypertension, HDL and LDL always sit at about a 1:3 ratio, HDL usually in high 30's and LDL in high 90's to low 100's.