HomeAnswersEndocrinologyerectile dysfunctionI am facing erectile dysfunction for a year. How to get treated?

What are the treatment options for erectile dysfunction?

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The following is an actual conversation between an iCliniq user and a doctor that has been reviewed and published as a Premium Q&A.

Answered by

Dr. Deep Dutta

Medically reviewed by

iCliniq medical review team

Published At December 25, 2016
Reviewed AtOctober 3, 2023

Patient's Query

Hello doctor,

I am 33 years old. My height is 5.9 feet and weight is 198 lbs. I do not have the habit of smoking, but I drink. Please go through my blood reports. I have been facing erectile dysfunction for the last one year. I have tried Megalis (Tadalafil) and Manforce (Sildenafil citrate). When I am using the medicines, it gives me erection, but leads to anejaculation (no discharge). One of the doctors advised me to get my testosterone checked and when I got it checked it was low. The doctor prescribed me tablet Unidep SR 150 mg, two tablets in the morning and injection Cernos 1 g deep intramuscular. I think my doctor is leading me to a testosterone replacement therapy. Is there any other medicine that I have to try instead of testosterone replacement therapy? I am afraid of testosterone replacement therapy due to its side effects. The doctor has prescribed me Cernos 0.04 oz, which I think is too much after having researched on the internet. I got to know that 400 mg bi-monthly is a good dose. Cernos come in a 0.1 fl oz vial. So, can I take about 0.07 fl oz every fortnightly? Is that a correct calculation for about 400 mg? What does Unidep do and why this was prescribed to me? I heard while taking testosterone my estrogen can increase and it will not resolve my erectile dysfunction. So, how to control that?

Answered by Dr. Deep Dutta

Hi,

Welcome to icliniq.com.

Your testosterone level of 132 ng/dL is suggestive of hypogonadism (attachment removed to protect patient identity). Your HbA1c (glycosylated hemoglobin) of 6.2% is suggestive of prediabetes. Have you had diabetes ever? Have you taken any medications for diabetes? Diabetes is well known to be associated with erectile dysfunction and hypogonadism. Please get your fasting and 2 hour post meal glucose tested. Cernos 40 mg (Testosterone) per day is usually enough. But, before starting testosterone for symptomatic relief, we need to find out the cause for your hypogonadism. Please consult an endocrinologist immediately. You need to get yourself examined by him. Also, you need to be evaluated for diabetes and dyslipidemia. You also need to lose body weight by 15 to 22 lbs.

Patient's Query

Thank you doctor,

I neither had diabetes nor have taken any medicines for that. Still, I will get my glucose tested. I live in a small town and so no good doctors are here. I will soon find an endocrinologist and get myself examined. Did you mean Cernos 40 mg per day daily injection or 600 mg fortnightly?

Answered by Dr. Deep Dutta

Hi,

Welcome back to icliniq.com.

Please get your fasting and 2 hours post 75 g anhydrous glucose blood glucose checked. 75 g of anhydrous glucose is equal to 84 g of Glucon-D, which is easily available. After getting the tests done, I suggest you start with tablet Glycomet (Metformin) 500 mg, one tablet after dinner daily. Consult a specialist doctor, discuss with him or her and take the medicine with consent. Before starting testosterone supplementation, you need to get a few baseline tests done. Get yourself tested for hemoglobin, prostate specific antigen titer, ultrasound scan for prostate volume and liver function tests. Do not worry. Ask your general physician for a referral to an endocrinologist.

Patient's Query

Thanks doc for the advice

I am not sure whether I would be able get these test done in my town specially USG for prostate volume.

Thank you.

Answered by Dr. Deep Dutta

Hello!

Please get the tests done first. Lets not start androgen replacement before the tests. A bit delay in androgen replacement will not do you any harm

Same symptoms don't mean you have the same problem. Consult a doctor now!

Dr. Deep Dutta
Dr. Deep Dutta

Endocrinology

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