Dr. Ankush Jairath
Urology
The following is an actual conversation between an iCliniq user and a doctor that has been reviewed and published as a Premium Q&A.
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Patient's Query
Hi doctor,
I am a 21-year-old male and have noticed dramatic changes in my energy levels and with my everyday life. It is hard for me to go to sleep or stay asleep. I cannot perform my job at 100 percent because my body is just so exhausted. I have had erectile dysfunction, which is affecting my marriage which is causing me to overthink because I just have no energy at all for anything which is affecting my personal life. I have checked my testosterone levels twice, tried working out hard, and eating even healthier but noticed it went down from 357 to 355 in two weeks. According to my doctor's opinion, it is not low enough to do testosterone treatment, but I feel like it is so low that it affects me, and I do not know what to do. I really want my testosterone to be at a natural level for my age. I can only imagine where my levels will be at age 30 and 40.
Hi,
Welcome to icliniq.com.
Please answer few questions. What kind of erectile dysfunction are you suffering from? Do you have total erectile dysfunction? Is it that you can have an erection but not enough to have penetration into the vagina? Or if erection is there enough to have penetration, but there is a problem in sustaining erection? Is there any premature ejaculation (ejaculation within 30 sec of starting intercourse)? Any habits of smoking? What is your sleep pattern? Why have you started on Amitriptyline, and for how long?
Revert back with the answers. Thank you.
Patient's Query
Hello doctor,
I have trouble getting erected. The blood flow going to the penis is low. And sometimes, it is enough to go into the vagina but not enough to stimulate my wife. I take Amitriptyline for fibromyalgia that I was diagnosed with. I only take it on days when I cannot tolerate my nerve pain. So maybe 4 to 8 times a month. I mainly take Duloxetine since it helps me more with nerve pain. I do actually have trouble finishing. It takes me about 10 to 20 minutes to finish.
Hi,
Welcome back to icliniq.com.
I like to start you on medication that increases blood flow to the penis by dilating the blood vessels. I will put you on a very low dose and will increase gradually in case of suboptimal response. Start taking tablet Tadalafil 2.5 mg once a day for two weeks. We will discuss the results after two weeks and plan out further treatment accordingly.
Thanks.
Regards.
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Urology
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