Struggling with ED and Low Libido for Years—Feeling Overlooked by Doctors
As a 26-year-old man, I've been grappling with erectile dysfunction and a diminished sex drive for the last three to four years. Despite consulting with various medical professionals—including my primary care physician, a urologist, a nurse practitioner, and an endocrinologist—no one has pinpointed a definitive reason for my symptoms. A plethora of blood tests has consistently shown normal levels of prolactin, SHBG, testosterone, free testosterone, PSA, FSH, TSH, among others. There were instances when my prolactin levels soared—recorded at 20 and then at 55—but both episodes occurred shortly after ejaculation. An MRI revealed a minuscule Rathke’s cleft cyst measuring just 2mm by 3mm; however, the specialists dismissed it as a probable cause for my problems. I also attempted treatment to reduce my prolactin levels on two occasions, each spanning three months, but saw no improvement. Years prior, I underwent surgery for an inguinal hernia, although my difficulties appeared even before that procedure. Furthermore, I've had extensive check-ups, including physical assessments, sleep evaluations, an EKG, and an echocardiogram, and everything looks normal—there are no warning signs. For the past two or three years, I've been engaging in therapy in hopes of breaking free from this cycle, yet progress has been minimal. I attend therapy weekly, switching between my regular therapist and an EMDR specialist, in addition to meeting with a psychiatrist. Across the years, I've experimented with various medications; currently, I'm taking 200 mg of Lamictal along with 300 mg of Wellbutrin each day. This situation has severely impacted my self-esteem and general wellness. My libido has hit rock bottom; I rarely experience spontaneous erections, and morning wood is almost non-existent. When it does occur, it feels weak and far from a robust erection. I find myself feeling lost and uncertain about the future. Standing at 6'3" and weighing 185 lbs, I'm aware I'm on the leaner side for my height and exercise two to three times weekly for about an hour. Are my healthcare providers possibly overlooking something? Could these issues purely be psychological? I feel an overwhelming sense of despair, as though no matter the approach we take, nothing seems to change. I am reaching out for guidance—any assistance would be appreciated.
Answers (1)
3/19/2025, 2:50:50 PM
OpenHealth AI
It's understandable to feel overwhelmed and discouraged when facing persistent issues with erectile dysfunction (ED) and low libido, especially after extensive consultations and normal test results. Your feelings are valid, and it’s important to recognize that you're not alone in this struggle. Let’s break down the potential factors contributing to your experience and prioritize steps you can take.
Key Points:
- Possible Psychological Component: Your ongoing therapy suggests that emotional and psychological factors may be influencing your symptoms.
- Hormonal Balance: Despite normal blood tests for hormones, fluctuations can still impact sexual function.
- Lifestyle Considerations: Your overall health and stress management play crucial roles.
Explanation:
Erectile dysfunction and low libido can be caused by various factors including hormonal imbalances, psychological stress (such as anxiety or depression), and lifestyle habits. Since your hormonal tests have come back normal, it's worthwhile to consider that psychological factors might be significantly affecting your sexual health. Chronic stress, anxiety related to performance, or emotional distress can create a cycle that further diminishes libido and erectile function.
Additionally, medications like Lamictal and Wellbutrin can potentially influence sexual desire and performance. Thus, it might be insightful to review your current medication regimen with your healthcare provider to assess their impact.
Next Steps:
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Review Medications: Schedule an appointment with your prescribing doctor to discuss how your current medications might be affecting your libido and erectile function. Sometimes, adjusting the dose or changing the medication can lead to improvements.
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Focus on Mental Health: Continue with your therapy, as working through psychological aspects is essential. Consider discussing specific techniques for dealing with performance anxiety or self-esteem issues with your therapist.
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Optimize Lifestyle Choices: Ensure you maintain a healthy diet, avoid excess alcohol and recreational drugs, and practice regular physical activity, which can support hormonal balance and improve mood. Aim for adequate sleep, as it is crucial for overall health and hormonal function.
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Sexual Health Communication: If you’re comfortable, you could explore couple's therapy or communicate openly with a partner about your feelings and concerns, which can alleviate some stress regarding performance.
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Tracking Symptoms: Keeping a journal of your symptoms, alongside variations in mood and lifestyle factors, might help identify patterns or triggers that you can address or discuss with your healthcare team.
Lastly, remember that recovery and improvement can take time; be patient with yourself through this process. Each small step you take contributes to your overall well-being. If you feel comfortable doing so, consider seeking a second opinion from a specialist who focuses on sexual health, as they may bring a fresh perspective to your situation.
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