Patient's question:
I am 35 years old and unmarried. In the past two years, I have noticed that my penis cannot erect well, and both the duration and hardness of the erection have significantly declined. I have been persistently running (sweating a lot), but it hasn't improved. What should I do? Does sweating a lot while running indicate anything? Is it related to difficulty in achieving an erection? Additionally, what are the concepts of "kidney yin deficiency" and "kidney yang deficiency" in traditional Chinese medicine? Thank you!Doctor's answer:
Hello, his condition may be erectile dysfunction. Below are several major therapies for this condition.(1) Medical Treatment
Treating systemic diseases: For early-stage diabetes patients, appropriate dietary control, insulin application, or oral hypoglycemic drugs can often rapidly improve sexual function.
Discontinuing drugs affecting sexual function: Many medications, such as antihypertensive drugs, antipsychotic drugs, diuretics, hormones, anticholinergic drugs, and cardiovascular system drugs, can cause erectile dysfunction. Discontinuing these drugs will be beneficial to the recovery of sexual function. However, before discontinuation, it is essential to weigh the patient's overall condition to decide whether to continue treating the primary disease, reduce the dosage, switch to other medications, or completely stop medication.
Endocrine Treatment: This includes the following aspects:
a) Application of sexual hormones or gonadotropins: For primary testicular dysfunction, testosterone can be used for replacement therapy; for hypothalamic or pituitary diseases, gonadotropins can be used, or luteinizing hormone-releasing hormone (LH-RH) can also be used. Testosterone propionate has a plasma half-life of 5–7 hours, so frequent medication is required, which can be troublesome. For long-term use, long-acting testosterone such as testosterone enanthate or testosterone cypionate can be chosen.
b) Adrenal cortex hormones or thyroid hormones: Suitable for adrenal cortex or thyroid hypofunction.
c) Dopamine agonists or dopamine-like drugs: Should be used for patients with hyperprolactinemia caused by hypothalamic or pituitary disorders. In about 5–19% of erectile dysfunction patients, hyperprolactinemia can be present, and bromocriptine (Brom