Q: We have been married since two years and my husband has erectile dysfunction. He is 27 years old. We consulted a doctor who, after tests and examinations, told us that he had a testosterone level of 157 ng/dl, FSH, LH, Prolactin within the normal range. His seminal analysis show sperm count 20 million, 5% grade 4 sperms motility, pus cell 12-15 Volume 3.5 ml. The doctor gave him Sustenon injections for 4 months. After this, he performed successfully and his sex desire too improved but his sperm count has decreased significantly. Can you recommend any medicine that will stimulate his testicles to produce testosterone and normal sperms? We want to conceive naturally.

A:Reduction in the sperm count after testosterone therapy is very much expected as a rebound phenomenon and is likely to return to normal soon. However, Erectile dysfunction is a very complex issue which involves matching the satisfaction of both the partners. Invariably as it is likely to be in the case of your husband, it is expected to be psychogenic and could have problems ranging from sexual desire to satisfactory orgasm. You should be careful in meddling with the testosterone (hormonal therapy) as it could be counter productive. In fact what he requires is a detailed consultation with the qualified sexual medicine specialist and/or qualified sex therapist and life style changes and psychotherapy in addition to PDE 5 inhibitors, which could take care of the problem and obviate the need for hormones.