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re: twig and berries not ripe for the picking!
Mar 31, 2008

Dr. Bob,

Thanks so much for responding to my question regarding hypogonadism and HIV. i have had a potential exposure since my "negative" home access test; however, my female partner tested negative at the beginning of our relationship.

it actually isn't the erectile dysfunction that scares me....rather, it's the atrophy in my penis and testicles. my sack is much tighter and smaller than it once was, and my penis looks as though it has shrunk (almost like i wasn't ever circumsized).

recently i noticed that i have had some "splinter hemorrhages" in a couple of my fingers. my research has yielded that they can be a manifestation of HIV. i doubt i have endocarditis as splinter hemorrhages are a late symptom of endocarditis.

i just don't get it. hypogonadism in a 31 year old can only mean HIV.

thanks Dr. Bob...

Little Guy

Response from Dr. Frascino

Hello Little Guy,

Stop trying to self-diagnose! Your Internet research is not a substitute for a medical degree! Your statement that "hypogonadism in a 31-year-old can only mean HIV" is a prime example of just how woefully inadequate and misleading this type of Internet research can be! I can assure you HIV is far from the only cause of hypogonadism in 31-year-olds! Stop stressing and stop self-diagnosing! I urge you to follow my advice and get evaluated by a urologist or your primary care physician. Your twig will sprout into a tree limb and your berries will plump and ripen with the appropriate diagnosis and treatment.

Dr. Bob

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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