Hello , I'm married 32 yrs old & have 4

Patient

Q: Hello , I'm married 32 yrs old & have 4 kids. I'm a very active sportsman & also run around 8k daily. Also I'm very active in sex & normally i have it almost daily. For the last few days I'm not able to maintain my erection. It never happened in my life. During sex i get erection & then it goes down or sometime i don't get erection. But I'm able to feel orgasm with stimulation from hand. My blood pressure is low these days around 110/70 or 100/70 which used to be 120/80. I'm feeling little lazy & lack of interest is for everything not just sex. I'm not feeling to go for sports like i used to. Everything is boring & slow these days. I never felt this way all my life. Before this problem started i used to feel pain in bottom of my legs & back pain. I don't think stress is the issue as life is same as it used to be. I was never like this.
I have no issue with my wife & im not worried after this problem as well but i just want to understand & solve it. What i should do to overcome it ? My food intake is excellent . Fruits , vegetables & meat everything is there in my diet. I don't have any other issue and also not using any drug or medicine. I don't drink alchohol & also dont smoke.
Please advise some treatmemt & also should i try yohimbe as one of my friend is very satisfied with it.
Thanks.

Doctor

A:   Hello,
Thanks for the query to ATD for an opinion,

The fact that your blood pressure has dropped and your body feels sluggish and lethargic most of the time, indicates a possibility of hypothyroidism which can be ruled out with a thyroid profile.
If deficiency then thyroxine supplementation can help. But considering that your lifestyle activities have not changed much, the most likely reason for occasional erectile dysfunction and maintenance issues could be distraction during sex or pre-occupancy with thoughts before or during performance of sex.

So try spending more time on foreplay before getting into the act of intercourse, this should help.
I hope i have answered your query in detail,
Wishing you good health,
Regards

Comments / Follow Ups

Patient: Hello , I got my thyroid test. Test results are
T3: 100.94
TSH: 1.108
T4: 7.87
Problem is not less interest in sex but lack of interest is for everything i used to enjoy. These days I'm ready to fall asleep anytime. I'm not willing or ready to do my routine activities. General desire & zest are lacking. I'm slow these days. Everything else in life is great. No stress or any other issue. Let me know if i should start some supplements or vitamins that will help me enjoy activities that i used to enjoy. My ED is not a permanent issue. I get morning erections daily & during sex as well. But sometime i don't get hard & it started to happen just couple of days before. My main focus is not just getting erection , I'm actually trying to find the desire for activities that i used to have. Online i read about dopamime deficiency & symptoms really match my conditions. I hope i have given maximam detail. Please advise accordingly.
Thanks
Doctor: Hello,
Your thyroid levels are normal and rules it out completely. Dopamine deficiency per se cannot be diagnosed just based on symptoms as these symptoms overlap with innate depression, at present i would suggest that lethargy and disinterest with low zeal can be controlled with multivitamins and low dose antidepressants like tricyclic antidepressants , daily dosage, available only on prescription. Hence suggested that you should visit a neurophysician or a psychologist for an evaluation and further prescription of drugs.
Patient: Hello, this is my last free follow up & let me know how to contact u again in future because you know my history now.
Lets not make things complicated , is there any safe supplement that can make me crave sex & give me energy for sports. I don't have any depression. Life is great. I don't want to get any formal treatment at this point of time. Everything is great except few episodes of ED & low energy. Please advise simple ways to get out of it. What multivitamin & non-prescription remedy is available for me. Thanks & Regards.
Doctor: I would like you to start on CAP BECOZINC , which is a multivitamin capsule to be taken twice a day for first 15 days and then once a day for next 15 days. This should be available as an otc. This shall deal with lethargy and shall bring proactiveness in your health. Decreased interest to work and lethargy can also be countered by increasing your daily water intake to 4-5 litres which shall help maintain a better circulation.
Patient: Hello , i got my serum Testestorene test 334. Is that normal for my age? Can i safely improve my Testestorene Level as it will help me in sex drive & in sports as well.
Thanks
Doctor: Hello,
Your testosterone levels are fine and you really do not need any supplementation either. Just continue on multivitamins for at least 2 months and you should experience difference.

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