Brief Answer:
Your problem is due to multiple issues.
Detailed Answer:
Hello,
Thanks for your query.
I appreciate your efforts for medical consultation in so much distress.
Important aspects of your query are:
• 31 year old male
• Known case of obesity, low testosterone, anxiety, depression and
hypochondriasis.
• Currently on testosterone, Klonopin and wellbutrin
• Complaints of sexual problem.
In treatment sexual problem first step is to identify cause of the problem. It can be a result of a psychological or physical problem.
Psychological causes: Most common cause in young patients. These include performance anxiety, emotional weakness,
inferiority complex, stress, marital or relationship problems, low mood, and the effects of a past sexual and emotional trauma. Men with psychological problem usually have normal nocturnal erections and erections upon awakening, whereas men with physical problem often do not.
Physical causes: Include neurological disorders, alcoholism, smoking, hormonal imbalances, diabetes, hypertension, blood vessel disease and chronic diseases.
Structural problem: Deform penis and tight foreskin problem.
Your sexual problem is due to multiple problems. In your case following are the issue which need to deal with following steps:
-Low testosterone: You are already on treatment. Get your thyroid function test (T3/T4/TSH) done, as its imbalance also affect sexual life.
-Smoking: It is good that you have already stopped it.
-Weight: There is need to reduce weight further. Focus more on
aerobic exercise at-least 30-60 Minutes per day. Reduce fat intake. Do not reduce weight fast, just reduce 2-3 kg weight every month.
-Start some multivitamins daily.
-Treatment of anxiety, depression and hypochondriasis: Unexplained somatic symptoms (weird sensation/electric shock like feeling) and fear of different medical illness (like MS) are common in anxiety disorder. You do not need
neurologist opinion if your physician do not feel need for it. But you need
psychiatrist consultation to deal with these issues which take time to solve, so keep patience. Continue medicines (Klonopin and wellbutrin). Apart from that start some non drug treatment like cognitive
behaviour therapy (CBT) from nearby
psychologist to deal with anxiety, depression and hypochondriasis.
I hope this information has been both informative and helpful for you. In case of any doubt, I will be available for follow ups.
Wish you good health.
Regards,
http://bit.ly/Dr-Ashish-Mittal
Note: For further guidance on mental health,
Click here.