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Help! Twig and berries not ripe for the picking!
Mar 30, 2008

Greeting Dr. Robert-

I have made a donation to the Foundation; thanks so much for the work you do assisting people and your efforts towards raising awareness. You are an angel!

I am a 31 yr old hetero male. A few years ago I started noticing that it was becoming increasingly difficult for me to achieve an erection. Sometimes I'd be successful, sometimes not. I did become a father 4 years ago. However, in the past 10 months it has gotten to the point where it is impossible. I have no morning erections. I feel as though I have no libido. And most distressingly, my testicles and penis seem to have atrophied. My own symptom surfing led me to "hypogonadism". The symptoms seem to fit me to a "T". The scary part is that more or less everything I read points to HIV/AIDS as a leading cause of hypogonadism.

I had a Home Access test about a year ago and it was negative, but now I am freaking out. All the research I have done makes it seem like the only way for an otherwise healthy (I don't even get colds frequently!) 31 year old to experience low testosterone is from uncontrolled HIV infection. I have had 2 hernia surgeries, but those were both 10 years ago (had many erections and became a father in the meantime). The gradual increase in erectile dysfunction has gone on over the past 4 years; the testicular and penile atrophy is a very recent phenomenon.

Despite my negative home Access test result, I am starting to worry that I have HIV as this just doesn't seem right for a 31 year old. I have an appt scheduled with my PCP next week, but I am freaking out.

Would it be common/normal for hypogonadism to be my first symptom of HIV infection?

Thanks-

little guy

Response from Dr. Frascino

Hey Little Guy,

The only reason to be worried about possible HIV infection would be if you've had a possible HIV exposure. Have you? You didn't mention any HIV risks in your post. If you've had no risks since your last negative Home Access test, HIV is not your problem!

Certainly hypogonadism is one cause of erectile dysfunction. However there are a number of other causes as well. Similarly HIV disease can cause hypogonadism; however, there are a wide variety of other causes as well. Should you freak out? No, of course not. See your PCP (primary care physician). He may well begin the evaluation or send you to a urologist. Ultimately I'm quite confident your unhappy Mr. Happy will soon be up and cuming once again.

Thanks for your kind comments and your donation to the Robert James Frascino AIDS Foundation (www.concertedeffort.org).

Be well.

Dr. Bob



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