Question 1

Hi Doctor, I took Saw Palmetto and Beta Sitosterol 500 mg to reduce my DHT. Since then, I have been experiencing sexual problems. I consulted a urologist who found my testicles are slightly small in size and volume by USG and Doppler. My testosterone level is 3.38 ng/ml. SHBG and diabetes levels are normal. I do not have anxiety. I can get an erection during masturbation, but the problem is that my testicles are small, I have no libido, and I do not ejaculate properly, it is just one drop. I have been facing this problem since I took Saw Palmetto. I stopped taking it, but the side effects are still the same. Should I go for hCG therapy or TRT? Whom should I consult, a urologist or an endocrinologist?

Question 2

I am a 35 year old man trying for a baby. I have been married for a year and tried for 2 to 3 months. My wife is 33 years old and has normal parameters for conceiving. My semen analysis report shows sperm count per ml is 32 million, total sperm per ejaculate is 128 million, rapid linear progression after half an hour is 20 percent and after 2 hours is 10 percent, and total abnormal spermatozoa is 66 percent. Kindly advise if this report is normal for my wife to conceive or should I start some medications?

Question 3

Hi Doctor, I recently had a blood test done and found that my androstenedione levels are low, and my other hormone levels are closer to the lower limit of normal. I have been experiencing several health issues including premature ejaculation, hair loss, weight gain, fatty liver, vitamin deficiencies, weakness, and infertility (low sperm count). Please advise me on what this could mean and what treatment options I should consider.

Do they check testosterone levels in routine blood work?

No.

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