Dr Bob,

I have been taking an injectable called sustanon every two weeks for the last two years. It is the only testosterone supplement available here in Holland. My sex drive is non existant and I cannot even maintain an erection. It is causing problems with my life partner who is understandably getting more fristrated by the day. I must add that I am also severely depressed but my Psychiatrist will not prescribe anti depressants as I am Bi Polar and quite likely to get manic if I take them. I am on Kaletra and Truvada with good results.

Any suggestions?

Many Thanks

Paddy

Hey Paddy,

With a nonexistent sex drive, inability to sport a woody and an increasingly "fristrated" partner, the first thing to do is check your free testosterone level just prior to your next sustanon injection. This will determine if your testosterone-replacement therapy is adequate enough to bump your levels into the normal range. If you're low, you'll need to increase your replacement-therapy dose. If you're in the normal range, you'll need to investigate other potential causes for your unhappy Mr. Happy. Certainly severe depression can affect sexual drive and function. Being bipolar does not mean you cannot take all antidepressants. If necessary, you may need to get a second opinion.

Finally, have you tried Viagra or any of the related erectile dysfunction drugs? They might just give you the "lift" you need.

Good luck.

Dr. Bob