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Ken
Ken, Postgraduate doctor
Category: Medical
Satisfied Customers: 6558
Experience:  Working as a Doctor who Cares since 2001.
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Hi I am experiencing some sexual health problems. I am in

Customer Question

Hi
I am experiencing some sexual health problems. I am in my early 30's and I experience problems with premature ejaculation. I am then able to regain an erection. This is a self perpetuating problem as I become more tense about things which I don't feel helps. It is also having a negative impact on my mindset and inevitably makes me feel down.
I do experience pain in my right testicle - it is a sort of throbbing pain as if something may be twisted but have got nowhere with this despite visits to my GP.
I don't know whether I should go back again or try natural remedies etc.
Any help will be gratefully received.
Rob
Submitted: 3 years ago.
Category: Medical
Expert:  Ken replied 3 years ago.
Hello Rob,

I am Dr Ken and I will be helping you today. I am a bit worried for testicular pain. Do you have any associated symptoms like fever or swelling? Were any investigations done to see for the cause?
Customer: replied 3 years ago.

The testicular pain comes and goes and is noticeable in general day to day life (eg now for example). I also have lower abdomen pains which are akin to stomach cramps. I had scans of this area (ultrasound I think) of the area which showed up nothing. GP was then at a bit of a loss as what to do next.


I also have coeliac disease if that is of any relevance.

Expert:  Ken replied 3 years ago.
Rob,

I am happy that the ultrasound came negative. It rules out any testicular abnormality for sure. Abnormality at the ureter/ infection at the urinary bladder or abnormality at the bowel too may cause referred pain at the testis. Irritation of the nerve at the spine level also needs to be looked for. i would also check for varicocele {dilated veins at the supra-testicular region}.

Next - Few investigations like color doppler for testis {to look for dilated veins}/ ultrasound of abdomen/ x ray for lumbar spine/ stool analysis and scopy should give us more answers.

Associated premature ejaculation makes me think of neurological cause too { abnormality at the lumbar spine level}. Other causes for premature ejaculation are - psychological/ anxiety/ relationship problems/ other causes {hormonal imbalance/ thyroid abnormality/ abnormal chemicals in brain/ infections}. Detailed evaluation by a urologist should help.

Till than - you can try sexual therapy {masturbating an hour or two before intercourse/ avoiding intercourse for a period of time and focusing on other types of sexual play so that pressure is removed from your sexual encounters}/ squeeze technique may help too.

Wish you well.

Best
Customer: replied 3 years ago.


Hi


Can I ask what you mean by lumbar spine abnormality? I do have pain in the right side of my lower back (the same sided as the testicle which is painful). The pain in my back is right by the spine at about waist height if that makes any difference.


On squeeze technique the pain in my testicle is exacerbated by squeezing so I am not sure that would work.


Thanks


Rob

Expert:  Ken replied 3 years ago.
Rob,

The cord or bunch of nerves in simple word passes through the spinal canal {formed by vertebral body in front and ring like posterior part around}. Any bone spur of displacement or bulge of the disc cause pressure over the cord which results in symptoms like pain / numbness / tingling due to nerve irritation. It may also cause pain at the scrotum. The nerves leave the spinal canal through small rounded openings laterally. Pinching of these nerve roots can occur at this level too. X ray for the lumbar spine may give us a clue to diagnosis. MRI may be needed later.

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