Dr. Saurabh Subhash Pandya
Urology
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Patient's Query
Hi doctor,
I am a 60 year old male with type 2 diabetes (HbA1c 6.2). Recently, I have lost the ability to ejaculate. Erections are not the problem, just no orgasm or ejaculate. Everything feels right during stimulation but stops short of actually going over the top. I went to a urologist, but he did not seem to be of any help. He could only offer Viagra. He did say my prostate was only slightly enlarged. Over the last couple of years, the ejaculation quantity has diminished. Now, it seems to be dry. Please offer me something here.
Hi,
Welcome to icliniq.com.
Poor or absent ejaculation occurs due to medicines for prostate or due to diabetes. In some diabetic patients, there is retrograde ejaculation (into the bladder) or sometimes no ejaculation. This can be confirmed by post ejaculation urine test for sperms.However, this should not prevent you from enjoying sexual activity. You will simply be shooting blanks or having a dry orgasm. If there are issues with reaching orgasm or regarding decreased libido, then probably see another urologist or an andrologist. He may suggest checking your serum testosterone levels.
Patient's Query
Thank you doctor,
I wish I could shoot blanks and still experience the orgasm. That is not happening. I have been on a testosterone regimen for nearly a year (1 mL for every two weeks). My recent laboratory result was 716 ng/dL. Before year also, my libido has almost disappeared and the current lack of orgasm has developed.
Hi,
Welcome back to icliniq.com.
I suggest three monthly Depot testosterone injections or daily testosterone patch or gel. This will give better results. I also suggest Tadalafil or Sildenafil on demand after consulting your doctor. A combination of testosterone and Tadalafil or Sildenafil works better than either alone.
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