Erectile Dysfunction and Multiple Sclerosis

Patient

Q: Hello, I am 27 Male.. Suffering from Multiple Sclerosis from past 5 years. The major symptom which is persistent is Erectile Dysfunction.
My early morning (8 AM) testosterone levels are 320ng/dl which I feel is low but no doctor is treating that.
Also, I feel that testosterone drops during the day and at night they might be much lower than that range which might cause ED.
Also, PDE5 inhibitors like Viagra, Cialis aren't working anymore.
Please suggest... Are Testosterone supplements the way to got? Are they safe for MS? Would it help in ED? Also, I want to maintain fertility, that's one main thing.

Symptoms:  Erectile Dysfunction
Doctor

A:   Erectile dysfunction, sometimes called impotence or ED, is the inability to achieve or maintain an erection. It is estimated that nearly one in five men in the general population is affected at some point, either every now and again or more consistently over a prolonged period of time. Erectile dysfunction is thought to be more prevalent amongst men with MS and research suggests anything from one quarter to two thirds of men with MS are affected. There are a number of possible causes for erectile dysfunction in MS, of which nerve damage is the main cause.

Sexual problems are often experienced by people with MS, but they are very common in the general population as well. Sexual arousal begins in the central nervous system, as the brain sends messages to the sexual organs along nerves running through the spinal cord. If MS damages these nerve pathways, sexual response — including arousal and orgasm — can be directly affected. Sexual problems also stem from MS symptoms such as fatigue or spasticity, as well as from psychological factors relating to self-esteem and mood changes. In a recent study, 63 percent of people with MS reported that their sexual activity had declined since their diagnosis. Other surveys of persons with MS suggest that as many as 91 percent of men and 72 percent of women may be affected by sexual problems. Ignoring these problems can lead to major losses in quality of life.
MS does not affect the basic fertility of either men or women, although sexual problems may interfere with the ability of a man with MS to father a baby. "Dry orgasms" that impair fertility, have been reported by men with MS in several studies. These problems have been successfully treated with medication or through techniques to harvest sperm for insemination. Men who are concerned about fertility issues should consult a urologist experienced in this area. Please consult the issues with your treating physician.

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