dr i'm a healthy guy 32 with no medical problems except i'm very mildly overweight. i have sex only two times in three months as i live far from my home. For a month i'm not getting regular nocturnal erections, the last week when i had sex i had good erection but the second day it was mild. is there possibility that i'm having hormonal imbalance or low t, actually from few months i noticed some new hair growths on my shoulders and upper arms. and i have also decreased ejaculation volume. please help is it hormonal or any other physical cause?


Its not possible to determine the cause of your problem from the information presented.  The fact that the nocturnal erections are diminished does suggest a possible problem but this is not definitive and the fact that things worked well once and not the next day is suggestive of a psychological component.  Talk to your physician if this continues and have the testosterone level checked.  If that's normal, then there could be other causes of your problem.


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Stephen W. Leslie, MD


Questions concerning erectile dysfunction, kidney stones and prostate disorders including prostate cancer. I have a special interest in kidney stone disease prevention.


Full time practicing urologist with 30 years experience. Associate Professor of Surgery and Chief of Urology at Creighton University Medical Center. Editor in Chief of eMedicine Urology internet textbook. Author of only NIH approved book written for patients by a urologist on the subject of kidney stones "The Kidney Stones Handbook". Inventor of the "Parachute" and "Escape" kidney stone baskets and the "Calculus" stone prevention analysis computer program.

American Urological Association, Ohio State Medical Association, Sexual Medicine Society

Men's Health, Journal of Urology, Urology, Healthwatch Magazine, Emergency Medicine Monthly, eMedicine, "The Kidney Stones Handbook", and numerous articles in various newspapers. He is also the editor of the Urology Board Review by McGraw-Hill used by urologists to study for their Board Certification Examinations.

Graduate of New York Medical College with residencies completed at Metropolitan Hospital New York, Albany Medical Center and University of Wisconsin-Madison.

Awards and Honors
Thirlby Award of the American Urological Association. Rated as one the country's Best Urologists by the Independent Consumer's Research Institute

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