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Q. I am suffering from thyroid problem. I have been suffering from erectile dysfunction. I have fear of not performing.


Image: I am suffering from thyroid problem.  I have been suffering from erectile dysfunction.  I have fear of not performing.

Hello doctor,

I am suffering from a thyroid problem. My TSH level is on the higher side. At present, I am taking 50 mg Thyroxine. For the last 4 or 5 months, I have been suffering from erectile dysfunction. Please give me a proper solution.


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Dr. Ashok Kumar Choudhary
M.B.B.S., M.D. PSYCHIATRY
Andrology, Geriatrics, Psychiatry, Psychologist/ Counsellor, Psychotherapy, Sexology

Hi,

Welcome to icliniq.com.

Unfortunately, the information provided at this stage is very limited, and it is difficult to interpret and make conclusions.I request you to post the following details:

  1. Your age.
  2. How the problem started, whether it was of acute (sudden) onset or on and off initially?
  3. How has been the progress of the problem in the last six months?
  4. Duration of sexual activity and any concern about duration?
  5. The frequency of the problem in a week or a month.
  6. What are the factors that increase the problem in the bedroom?
  7. Factors that relieve the problem, like thoughts, situations, partner, place, etc.
  8. Do you get early morning or night erections? If yes, how frequent?
  9. Your marital status and partner details.
  10. Effect on your marriage or relationship so far.
  11. Details of medical illnesses other than thyroid issue.
  12. Medications you are receiving currently.
  13. Medications you tried till date and their results.
  14. Any investigations so far carried out and if yes, details of the investigations.

At this stage, I would like to inform you that thyroid is mostly not responsible for erectile dysfunction, and we need to explore additional reasons for same. I am not sure about your age, but if you are above 50 years, you are requested to get the following blood reports if not acquired already.

  1. Serum testosterone.
  2. Serum LH, FSH, Prolactin.
  3. Serum TSH, T3, T4.
  4. Lipid profile.
  5. Complete Blood count (CBC).
  6. Penile Doppler study.
  7. Semen analysis.

Erectile dysfunction is a complex disorder and needs a thorough evaluation for treatment. I look forward to seeing more details.

 

Thanks doctor,

My age is 45 years. The problem started in a few months back. Sometimes the problem does not bother me, but sometimes it does. Regarding the progress of the erectile dysfunction, it has increased. The duration of sexual activity is about 5 to 10 minutes. The frequency of the problem is about once a week. The factors that contribute to increasing the problem of erectile dysfunction is a little bit of fear of not performing. Factors that relieve the problem are thoughts other than sexual intercourse. I get morning erection. The frequency of erection is maybe three or four times. I am married and have two children. My wife's age is 38 years. I suffered from digestive disorder last year. Thyroxine 50 mg is the only medication which I am taking. I have not yet tried any medication for my problem. Thank you in advance.

 

Dr. Ashok Kumar Choudhary
M.B.B.S., M.D. PSYCHIATRY
Andrology, Geriatrics, Psychiatry, Psychologist/ Counsellor, Psychotherapy, Sexology

Hi,

Welcome back to icliniq.com.

Thanks for reverting. After reviewing the information provided, I feel that psychogenic components are more important for your erectile dysfunction and need to be evaluated. Presence of night and morning time erection (when no fear of performance) indicates that fear is one of the main contributors to your problem. I like to stress out that it does not mean other factors are not present. To rule out the possibility of other factors, I had requested few investigations which need to be carried out.

Regarding psychological causes, I would like to inform you that this is the most common cause of erectile dysfunction. It means that our thinking is the main reason for not getting a full erection. Many people develop it following an occasional failure in the bedroom. Once there is a failure due to one or another reason, so much significance is attached by the concerned person to the failure that hurts one's ego. Once the problem has started, there is no relief till the person introspects or gets help. I recommend the following:

  1. Trying not to think about performance is of paramount importance.
  2. The understanding of the partner is also important as criticism from partner increases the fear and hence erectile dysfunction.
  3. Use relaxation techniques to relieve yourself and avoid excessive stress at work as well as home.
  4. Go for regular physical exercise.
  5. Drink at least three liters of water a day.
  6. Increase the amount of garlic in the diet.
  7. Spend time with family members and friends.
 
 
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