Dr. Joel Nathan
04-12-2009, 11:32 AM
What if you're a young guy with a normal testosterone level and you have ED?
Usually ED is found in andropause in guys over 50 and can be due to low T.
Sometimes ED happens in younger men.
Perhaps even if your self made testosterone is normal, your free testosterone is low. I'd get a total and free testosterone level as well as an estradiol level.
Drugs that sometimes cause impotence include:
* Older anti-ulcer medications (cimetidine)
* Anticholinergic drugs (including some antihistamines)
* Antinausea drugs, particularly metoclopramide (Reglan)
* Antifungal drugs (especially ketoconazole)
* Nonsteroidal anti-inflammatory drugs (NSAIDs), when used on a daily basis
Peripheral autonomic polyneuropathy, as may be seen in alcoholism or amyloidosis, may cause erectile dysfunction but generally spares libido.
Diabetic polyneuropathy is a very common cause; however, as noted below, the erectile dysfunction in diabetes may also be caused by vascular lesions.
Genital herpes may be associated with erectile dysfunction, possibly due to a herpetic infection of the nervi erigentes.
There can be psychological issues too.
Wow, that's a lot of info, I don't want to overwhelm anyone, but I'm thorough!
Check to see if you are on any of the drugs that can cause ED that are listed above and check with your doc to see if there is an alternative.
The take home lesson is: See an endocrinologist first and then a urologist. Sometimes primary care docs need to refer you.
The information above is for educational purposes only and you need to check with your health care provider before instituting any changes.
Regards,
Joel
Usually ED is found in andropause in guys over 50 and can be due to low T.
Sometimes ED happens in younger men.
Perhaps even if your self made testosterone is normal, your free testosterone is low. I'd get a total and free testosterone level as well as an estradiol level.
Drugs that sometimes cause impotence include:
* Older anti-ulcer medications (cimetidine)
* Anticholinergic drugs (including some antihistamines)
* Antinausea drugs, particularly metoclopramide (Reglan)
* Antifungal drugs (especially ketoconazole)
* Nonsteroidal anti-inflammatory drugs (NSAIDs), when used on a daily basis
Peripheral autonomic polyneuropathy, as may be seen in alcoholism or amyloidosis, may cause erectile dysfunction but generally spares libido.
Diabetic polyneuropathy is a very common cause; however, as noted below, the erectile dysfunction in diabetes may also be caused by vascular lesions.
Genital herpes may be associated with erectile dysfunction, possibly due to a herpetic infection of the nervi erigentes.
There can be psychological issues too.
Wow, that's a lot of info, I don't want to overwhelm anyone, but I'm thorough!
Check to see if you are on any of the drugs that can cause ED that are listed above and check with your doc to see if there is an alternative.
The take home lesson is: See an endocrinologist first and then a urologist. Sometimes primary care docs need to refer you.
The information above is for educational purposes only and you need to check with your health care provider before instituting any changes.
Regards,
Joel