Concerns about erectile dysfunction and health issues

Question #25858

45 days ago

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Concerns about erectile dysfunction and health issues - #25858

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عمري ٣٦ متزوج ليا ٣ اطفال وزن ٦٢ عم بأخذ دوا جينسينغ زياده وزن فقط عمعاني من الضعف انتصاب وجع ضهر ومعي دوالي درجه ثانيه باليسار واليمين تمام تحاليل اوجوجو عليها والتعديل المناسب لكل نسخه وشكرا هذي التحاليلEndocrinology Result Unit Reference Range Pre-Res TSH (CLIA) 4.812 ȝIU/mL 0.35 - 5.50 Prolactin (CLIA) 448.461 * ȝIU/ml 42.50 - 414.00 TestosteroneTotal (CLIA, Serum) 5.554 ng/ml 2.30 - 8.58 Vitamine B12 253.111 pg/ml 183-822 25-(OH) vit D 8.859 * ng/mL Deficient:<12 Insufficient:12-20 sufficient:20-150 toxicity:>150 Biochemistry Result Unit Reference Range Pre-Res Glucose 78 mg/dl 75.00 - 110.00 Lipid panel Cholesterol 222 mg/dl Desirable: <200 Borderline: 200-239 High Risk: > 240 HDL Cholesterol 62 mg/dl Desirable > 45 Borderline 40-45 high risk < 40 LDL Cholesterol 140.22 mg/dl Optimal :<100 <70 if CHD present Near Optimal:100-129 Bordeline :130-159 High risk :160-189 Very High :>190 CT/HDL 3.5 < 4.97 Triglyceride 98.9 mg/dl Optimal : <150 Borderline : 150-199 High risk : 200-499 very high : >500 Spermocytogram Morphologically Normal 15.00 % Morphologically Abnormal 85.00 % Head Anormalies 43.00 % Microcephalic 9.00 % Macrocephalic 4.00 % Multiple 4.00 % Elongated 3.00 % Amorphous 11.00 % IsolatedTail 12.00 % Vacuolated 0.00 % Midpiece And Neck Anomalies 22.00 % Cytoplasmic Droplet 9.00 % Bent 13.00 % Tail Anormalies 20.00 % Absent 3.00 % Short 5.00 % Coiled 10.00 % Multiple 2.00 %

How long have you been experiencing erectile dysfunction?:

- Less than 1 month

How severe is your back pain?:

- Mild, occasional discomfort

Have you made any lifestyle changes recently?:

- No, same as before

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Doctors' responses

Dr. Bharat Joshi

I’m a periodontist and academician with a strong clinical and teaching background. Over the last 4 years and 8 months, I’ve been actively involved in dental education, guiding students at multiple levels including dental hygienist, BDS, and MDS programs. Currently, I serve as a Reader at MMCDSR in Ambala, Haryana—a role that allows me to merge my academic passion with hands-on experience. Clinically, I’ve been practicing dentistry for the past 12 years. From routine procedures like scaling and root planing to more advanced cases involving grafts, biopsies, and implant surgeries. Honestly, I still find joy in doing a simple RCT when it’s needed. It’s not just about the procedure but making sure the patient feels comfortable and safe. Academically, I have 26 research publications to my credit. I’m on the editorial boards of the Archives of Dental Research and Journal of Dental Research and Oral Health, and I’ve spent a lot of time reviewing manuscripts—from case reports to meta-analyses and even book reviews. I was honored to receive the “Best Editor” award by Innovative Publications, and Athena Publications recognized me as an “excellent reviewer,” which honestly came as a bit of a surprise! In 2025, I had the opportunity to present a guest lecture in Italy on traumatic oral lesions. Sharing my work and learning from peers globally has been incredibly fulfilling. Outside academics and clinics, I’ve also worked in the pharmaceutical sector as a Drug Safety Associate for about 3 years, focusing on pharmacovigilance. That role really sharpened my attention to detail and deepened my understanding of drug interactions and adverse effects. My goal is to keep learning, and give every patient and student my absolute best.

45 days ago

Hello dear
See pain can be due to minor trauma or discomfort
Iam suggesting some precautions for improvement.
Please follow them for atleast two weeks
Diclofenac sodium gel topical application twice a day for 1 week
Voveron xr 50 mg twice a day for 5 days
Mild physiotherapy exercises atleast half an hour daily
Crave bandage if applicable
Hot fomentation application twice daily
For erectile function problem follow below precautions
Avoid heavy meals and alcohol
Take ashwagandha or triphala once a day for 2 months
Do meditation
Do physical exercises atleast for half an hour
Especially kegel exercises
Take shilajeet for 1 month once a day
In case of no improvement in 1 month, kindly consult gynaecologist and orthopedic surgeon for further clarification
Hopefully you recover soon
Regards

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Dr. Arsha K Isac

I am a general dentist with 3+ years of working in real-world setups, and lemme say—every single patient teaches me something diff. It’s not just teeth honestly, it’s people… and how they feel walking into the chair. I try really hard to not make it just a “procedure thing.” I explain stuff in plain words—no confusing dental jargon, just straight talk—coz I feel like when ppl *get* what's going on, they feel safer n that makes all the difference. Worked with all ages—like, little kids who need that gentle nudge about brushing, to older folks who come in with long histories and sometimes just need someone to really sit n listen. It’s weirdly rewarding to see someone walk out lighter, not just 'coz their toothache's gone but coz they felt seen during the whole thing. A lot of ppl come in scared or just unsure, and I honestly take that seriously. I keep the vibe calm. Try to read their mood, don’t rush. I always tell myself—every smile’s got a story, even the broken ones. My thing is: comfort first, then precision. I want the outcome to last, not just look good for a week. Not tryna claim perfection or magic solutions—just consistent, clear, hands-on care where patients feel heard. I think dentistry should *fit* the person, not push them into a box. That's kinda been my philosophy from day one. And yeah, maybe sometimes I overexplain or spend a bit too long checking alignment again but hey, if it means someone eats pain-free or finally smiles wide in pics again? Worth it. Every time.

44 days ago

Hello
Your results point to several treatable causes that may explain the erectile dysfunction:
Key findings
Vitamin D is very low (8.8) → can cause fatigue, general weakness, and may affect erections
Prolactin is mildly elevated → can reduce libido and erection quality
Testosterone is within the normal range
B12 is relatively low (near the lower limit)
Total cholesterol and LDL are elevated
Grade 2 varicocele may contribute in some cases
Recommended steps
1.	Treat vitamin D deficiency with a medical dosing plan
2.	Repeat prolactin test in the morning, avoiding stress and sexual activity beforehand
3.	Improve lifestyle: regular exercise, good sleep, reduce saturated fats
4.	Stay well hydrated and stop any unreliable weight-gain supplements
5.	See a urologist to evaluate the varicocele if the problem persists
Seek medical review sooner if erectile dysfunction lasts more than 3 months or worsens.
I trust this helps
Thank you
Take care

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Dr. Nikhil Chauhan

I am currently working as a urologist and kidney transplant surgeon at Graphic Era Medical College & Hospital, Dehradun. It's a role that keeps me on my toes, honestly. I handle a pretty wide range of urology cases—stones, prostate issues, urinary tract obstructions, infections, you name it. Some are straightforward, others way more complex than you expect at first glance. Every patient walks in with a different story and that’s what keeps the work real for me. Kidney transplant surgery, though, that’s a whole different zone. You’re not just working on anatomy—you’re dealing with timelines, matching, medications, family dynamics, emotional pressure... and yeah, very precise coordination. I’m part of a team that manages the entire transplant process—from evaluation to surgery to post-op care. Not gonna lie, it’s intense. But seeing someone who’s been on dialysis for years finally get a new shot at life—there’s nothing really like that feeling. In the OR, I’m detail-focused. Outside of it, I try to stay accessible—patients don’t always need answers right away, sometimes they just need to feel heard. I believe in walking them through what’s going on rather than just giving reports and instructions. Especially in transplant cases, trust matters. And clear, honest conversation helps build that. Urology itself is such a misunderstood field sometimes. People ignore symptoms for years because it feels “awkward” or they think it’s not serious until it becomes unmanageable. I’ve had patients who came in late just because they were embarassed to talk about urine flow or testicular pain. That’s why I also try to make the space judgment-free—like whatever it is, we’ll figure it out. At the end of the day, whether I’m scrubbing in for surgery or doing OPD rounds, I just want to make sure what I do *actually* helps. That the effort’s not wasted. And yeah, some days are frustrating—some procedures don’t go clean, some recoveries take longer than they should—but I keep showing up, cause the work’s worth doing. Always is.

43 days ago

Hi, thank you for sharing your detailed reports and history.
Here is a breakdown of your health concerns and the next steps based on your results:
1. The Main Cause of Erectile Dysfunction
· High Prolactin (448.46): This is the most likely cause of your weak erections. High prolactin lowers libido and causes ED.
· Plan: This needs medication (like Cabergoline) to bring it down.
2. The Cause of Back Pain & Fatigue
· Very Low Vitamin D (8.86): This is a severe deficiency. It directly causes bone pain (back pain), muscle weakness, and fatigue.
· Plan: You need high-dose Vitamin D supplements immediately (e.g., 50,000 IU weekly).
3. Hormonal & Metabolic Issues
· Thyroid (TSH 4.8): This is on the high end of normal. Combined with high prolactin, it should be monitored.
· High Cholesterol (222): This affects blood flow to the penis. You need to watch your diet.
4. Varicocele & Fertility
· The varicocele (grade 2 on both sides) is affecting your sperm quality (85% abnormal forms). This impacts fertility but is not the cause of your ED.
Summary & Action Plan:
1. Stop Ginseng: It is not helping your specific hormonal issues.
2. Repeat Prolactin Test: Do it tomorrow morning, 2 hours after waking up, well-rested.
3. Start Vitamin D: Begin high-dose supplements as advised by your doctor.
-Dr. Nikhil Chauhan
Urologist

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Dr. Prasannajeet Singh Shekhawat

I am a 2023 batch passout and working as a general physician right now, based in Hanumangarh, Rajasthan. Still kinda new in the bigger picture maybe, but honestly—every single day in this line teaches you more than textbooks ever could. I’ve had the chance to work under some pretty respected doctors during and after my graduation, not just for the clinical part but also to see how they handle people, real people, in pain, in panic, and sometimes just confused about their own health. General medicine covers a lot, right? Like from the smallest complaints to those random, vague symptoms that no one really understands at first—those are kinda my zone now. I don’t really rush to label things, I try to spend time actually listening. Feels weird to say it but ya, I do take that part seriously. Some patients just need someone to hear the whole story instead of jumping to prescription pads after 30 seconds. Right now, my practice includes everything from managing common infections, blood pressure issues, sugar problems to more layered cases where symptoms overlap and you gotta just... piece things together. It's not glamorous all the time, but it's real. I’ve handled a bunch of seasonal disease waves too, like dengue surges and viral fevers that hit rural belts hard—Hanumangarh doesn’t get much spotlight but there’s plenty happening out here. Also, I do rely on basics—thorough history, solid clinical exam and yeah when needed, investigations. But not over-prescribing things just cz they’re there. One thing I picked up from the senior consultants I worked with—they used to say “don’t chase labs, chase the patient’s story”... stuck with me till now. Anyway, still learning every single day tbh. But I like that. Keeps me grounded and kind of obsessed with trying to get better.

44 days ago

Hello
I understand infertility is a significant concern. However, before I can guide you properly, I need more information about your situation.
Important questions:
1. How long have you been trying to conceive? (Months or years?)
2. Are you married/in a relationship? And has your partner been evaluated by a gynecologist?
3. Looking at your lab results—your sperm morphology is abnormal (85% abnormal forms). Have you seen a urologist or fertility specialist about this, or is this the first time you’re seeing these results?
4. Your prolactin is elevated (448.461)—did a doctor discuss this with you? High prolactin can affect fertility and sexual function.
5. Your Vitamin D is severely deficient (8.859)—have you been treated for this? Low vitamin D affects sperm quality and fertility.
6. Are you experiencing any symptoms like low libido, erectile dysfunction, or ejaculation issues?
These details matter because infertility has many causes, and your lab results suggest specific issues that need proper specialist evaluation and treatment.
You need to see a fertility specialist (andrologist/urologist) who can:
- Repeat semen analysis
- Investigate the prolactin elevation
- Check other hormones
- Create a treatment plan
Thank you

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Dr. Shayeque Reza

I completed my medical degree in 2023, but honestly, my journey in healthcare started way before that. Since 2018, I’ve been actively involved in clinical practice—getting hands-on exposure across multiple departments like ENT, pediatrics, dermatology, ophthalmology, medicine, and emergency care. One of the most intense and defining phases of my training was working at a District Government Hospital for a full year during the COVID pandemic. It was chaotic, unpredictable, and exhausting—but it also grounded me in real-world medicine like no textbook ever could. Over time, I’ve worked in both OPD and IPD setups, handling everything from mild viral fevers to more stubborn, long-term conditions. These day-to-day experiences really built my base and taught me how to stay calm when things get hectic—and how to adjust fast when plans don’t go as expected. What I’ve learned most is that care isn't only about writing the right medicine. It’s about being fully there, listening properly, and making sure the person feels seen—not just treated. Alongside clinical work, I’ve also been exposed to preventive health, health education, and community outreach. These areas really matter to me because I believe real impact begins outside the hospital, with awareness and early intervention. My approach is always centered around clarity, empathy, and clinical logic—I like to make sure every patient knows exactly what’s going on and why we’re doing what we’re doing. I’ve always felt a pull towards general medicine and internal care, and honestly, I’m still learning every single day—each patient brings a new lesson. Medicine never really sits still, it keeps shifting, and I try to shift with it. Not just in terms of what I know, but also in how I listen and respond. For me, it’s always been about giving real care. Genuine, respectful, and the kind that actually helps a person heal—inside and out.

44 days ago

It’s better to visit a physician in person for better evaluation.

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Dr. Aarav Deshmukh

I am a general physician with 8 years of practice, mostly in urban clinics and semi-rural setups. I began working right after MBBS in a govt hospital in Kerala, and wow — first few months were chaotic, not gonna lie. Since then, I’ve seen 1000s of patients with all kinds of cases — fevers, uncontrolled diabetes, asthma, infections, you name it. I usually work with working-class patients, and that changed how I treat — people don’t always have time or money for fancy tests, so I focus on smart clinical diagnosis and practical treatment. Over time, I’ve developed an interest in preventive care — like helping young adults with early metabolic issues. I also counsel a lot on diet, sleep, and stress — more than half the problems start there anyway. I did a certification in evidence-based practice last year, and I keep learning stuff online. I’m not perfect (nobody is), but I care. I show up, I listen, I adjust when I’m wrong. Every patient needs something slightly different. That’s what keeps this work alive for me.

43 days ago

أنت تعاني من عدد من القضايا الصحية التي يمكن أن تكون مرتبطة أو تساهم في مشكلة ضعف الانتصاب وآلام الظهر التي تشعر بها. بناءً على تحاليلك، هناك بعض الأمور التي تحتاج إلى الانتباه لها. أولاً، مستوى هرمون البرولاكتين لديك مرتفع، وقد يكون له دور في ضعف الانتصاب. من المهم متابعة ذلك مع طبيب مختص في الغدد الصماء لعمل التقييم المناسب وضبط العلاج إذا لزم الأمر. أيضًا، مستوى فيتامين د لديك منخفض جدًا، مما قد يؤثر على صحتك العامة والعظام، لذا يجب التفكير في تناول مكملات فيتامين د بناءً على نصيحة طبية لضبطه ضمن الحدود الطبيعية. بالنسبة لمستوى الكوليسترول الكلي والـ LDL العاليين، قد تحتاج إلى التفكير في تحسين نظامك الغذائي وزيادة النشاط البدني لتحسين هذه القيم وتقليل خطر المشاكل القلبية، وربما تحتاج أيضاً لأدوية خاصة بتحسين دهون الدم إذا لم تتحسن بممارسات نمط الحياة. بالإضافة إلى ذلك، نتيجة تحليل السائل المنوي تظهر زيادة في معدل الشذوذ الشكلي للحيوانات المنوية، ومن المفيد متابعة ذلك مع أخصائي العقم أو طبيب المسالك البولية لمعرفة ما إذا كان هناك حاجة إلى مزيد من التقييم. بخصوص الدوالي، إن كانت تسبب ألماً أو انزعاجًا، يمكن التفكير في التقييم العلاجي الجراحي أو التدخلي. من المهم جدولة زيارة لطبيب مختص يقوم بمراجعة جميع هذه العوامل معًا لمزيد من الفهم الشامل لحالتك واعطاء النصائح المناسبة.

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Dr. Alan Reji

I'm Dr. Alan Reji, a general dentist with a deep-rooted passion for helping people achieve lasting oral health while making dental visits feel less intimidating. I graduated from Pushpagiri College of Dental Sciences (batch of 2018), and ever since, I've been committed to offering high-quality care that balances both advanced clinical knowledge and genuine compassion for my patients. Starting Dent To Smile here in Palakkad wasn’t just about opening a clinic—it was really about creating a space where people feel relaxed the moment they walk in. Dental care can feel cold or overly clinical, and I’ve always wanted to change that. So I focused on making it warm, easygoing, and centered completely around you. I mix new-age tech with some good old-fashioned values—really listening, explaining stuff without jargon, and making sure you feel involved, not just treated. From regular cleanings to fillings or even cosmetic work, I try my best to keep things smooth and stress-free. No hidden steps. No last-minute surprises. I have a strong interest in patient education and preventive dentistry. I genuinely believe most dental issues can be caught early—or even avoided—when patients are given the right information at the right time. That’s why I take time to talk, not just treat. Helping people understand why something’s happening is as important to me as treating what’s happening. At my practice, I’ve made it a point to stay current with the latest innovations—digital diagnostics, minimally invasive techniques, and smart scheduling that respects people’s time. I also try to make my services accessible and affordable, because good dental care shouldn’t be out of reach for anyone.

42 days ago

ضعف الانتصاب لديك غالبًا مرتبط بنقص فيتامين د الشديد، وارتفاع بسيط في هرمون الحليب، مع تأثير دوالي الخصية، بينما التستوستيرون طبيعي ولا يحتاج علاج. يُنصح بعلاج نقص فيتامين د، إعادة فحص هرمون الحليب صباحًا، تحسين نمط الحياة، ومراجعة مستوى فيتامين B12. راجع طبيب غدد صماء وطبيب مسالك بولية لتقييم السبب بدقة ووضع العلاج المناسب خاصة إذا استمرت الأعراض.

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Dr. Alan Reji

42 days ago

نتائج التحاليل تظهر أن فيتامين D منخفض جدًا، وفيتامين B12 منخفض نسبيًا، وهرمون البرولاكتين مرتفع قليلًا — وهذه العوامل قد تسبب ضعف الانتصاب، التعب، وآلام الظهر، بينما التستوستيرون طبيعي تقريبًا. تحتاج علاج نقص فيتامين D وب12، وإعادة تقييم ارتفاع البرولاكتين، إضافة إلى علاج دوالي الخصية إذا كانت تسبب أعراض، لذلك يُنصح بمراجعة Urology وEndocrinology لتعديل العلاج والمتابعة. مؤقتًا توقف عن الاعتماد على الجينسنغ فقط، واهتم بالتغذية الجيدة، التعرض للشمس، الرياضة، وخفض الكوليسترول لأن LDL مرتفع قليلًا.

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Dr. Alan Reji

42 days ago

تحاليلك تُظهر نقص شديد جدًا في فيتامين D، ونقص نسبي في فيتامين B12، وارتفاع بسيط في هرمون البرولاكتين — وهذه الأسباب قد تسبب ضعف الانتصاب، التعب، وآلام الظهر، بينما التستوستيرون طبيعي تقريبًا. تحتاج علاج لنقص فيتامين D وب12، وإعادة فحص البرولاكتين، ومتابعة دوالي الخصية إذا كانت تسبب أعراض، لذلك يُنصح بمراجعة Urology وEndocrinology لتعديل العلاج والمتابعة. مؤقتًا اهتم بالتغذية الجيدة، التعرض للشمس، الرياضة، وخفض الكوليسترول لأن LDL مرتفع قليلًا، ولا تعتمد على الجينسنغ وحده.

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