Dr. Divakara. P
Internal Medicine
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Patient's Query
Hello doctor,
I have low libido problem. As a result of which I am suffering from ED since two years. I am 38 years old, married and having one daughter aged 6 years. I had some issue of erectile dysfunction at 32 years, but it got sorted by itself. I checked my testosterone and it was 295 ng/dL and 270 ng/dL (normal laboratory values above 300 ng/dL) tested at different laboratories a year back. My prolactin level is 4.36 (normal ranges between 1.61 and 18.77). Since two years I have tried ED drugs, but no significant results. I do have some symptoms like delayed ejaculation and baldness from the age of 22. I tried Testoviron depot 250 which gave very good results, but stopped as I was worried of side effects. Kindly advice whether I am a fit candidate for TRT. Are gel forms a better alternative and effective? I feel taking injection may become difficult. Kindly guide.
Hi,
Welcome to icliniq.com.
Yes, your symptoms are due to testosterone deficiency. And you do need testosterone supplement. Well, Depot injection was actually a good option. But, it comes with side effects. Still it is a good option as you need to take injection just once in one or two months. Testosterone gel is also a good option, but it should be applied daily and cost when compared to injection is high. But, the risk of side effect is less with gel. In addition, I recommend you to get tested for diabetes, serum vitamin D levels and get scrotal ultrasound scan done.
Patient's Query
Hello doctor,
Thanks for your immediate response. I am a non-diabetic. I will get the serum vitamin D and scrotal examination soon. Can you please give me a prescription for testosterone gel if the side effects are less? Also, let me know the routine test that I need to do, if I have to continue with TRT throughout my future. Also, let me know the dosage of the gel. Thank you.
Hi,
Welcome back to icliniq.com.
You can use Androgel (testosterone gel). It comes in a daily use sachet to be applied anywhere on the body. Within few minutes of application, the site should not come in contact with females or children. Side effects with injections are there will be increase in cholesterol levels, blood pressure and increased risk of heart problems. But, it will not happen in every one. So, get your blood pressure checked once in a month and blood cholesterol checked for every six months (lipid profile). If there is a symptom of chest pain then get 2D echo (two-dimensional echocardiogram) done. Otherwise, injections can also be continued.
Patient's Query
Thank you doctor.
Androgel is unvailable. Can Cernos be used instead? Also, please see if you can suggest a gel as well as injection that can be taken. Please guide.
Hi,
Welcome back to icliniq.com.
Yes, Cernos gel can be used. Ask for 1 % gel. I would suggest you to apply Cernos gel 1 % over thigh or back once daily. If you wish to opt for injection, take injection Testosterone cypionate 200 mg IM once a month.
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Internal Medicine
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