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I am a diabetic and for the past 7 days I have not been able to get an erection. I have increased urine output, my joints are really painful and stiff especially when I try and do something at work with them. They upped my citalepram from 20 mg to 40 mg. My girl tells me that she has smelled a strong medicinal smell on my breath. I also have increased insulin reactions. I have had 3 int eh last 3 weeks. My meds have not changed as I am on two different types of insulin, lipitor, lisinopril, citalapram, trazadone, and seroquel.   I am really worried about this and the soonest I was able to get an appointment is three weeks from now. Should I go to urgent care? Emergency, or stick with my appointment? I also have increased memory loss, I cannot remember what my girl friend said 10 minutes ago. Is it possible that my meds need to be changed? I am being overly medicate? Could loss of erectile function come from a combination of things? I need help, plese

Submitted: 735 days and 5 hours ago.
Category: Health
Value: $30
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Optional Information:
Male, Age: 34, Minnesota

Already Tried:
everything. Nothing works and I keep having severe mood swings

Posted by Dr. Eric 735 days and 5 hours ago.

Info Request

Hi! Greetings from a fellow Minnesotan. Can you answer a few questions for me? First of all, what type of diabetic are you? Type I or Type II? How long have you had diabetes? Is the medicinal smell she has noted a fruity smell? How much insulin do you take? Have you checked your sugars? Where have they been running? Has your weight changed? Do you know what your last hemoglobin A1c (or glycosylated hemoglobin) was? Regarding your erection problems - are you still waking up with an erection in the morning? Are you able to get an erection if you masturbate? Are you able to get an erection but just not keep it? Are you able to reach climax and ejaculate? Let me know the answers to these (many ;) questions and I will give you my best possible advice. Dr. Eric

735 days and 5 hours ago.

Reply

Reply to Dr. Eric's Post: Type I. Yes it is a fruity smell. Sliding scale, depending on blood sugar with humilog, with lantus it is 50 units once a day. I check my sugars regularly. 49, 188, 116, 128, 281, thn one that was 34 earlier today, 65, 52, 132, 92, 76. Weight has not changed in any dramatic manner. I believe that I have put on at least 5 pounds but then I flucuate. Hemoglobin over a year ago was in the mid 7's. No erection in the morning at all. I tried that tonight and it didn't work. We tried for a few hours actually. I had an soft erection but could not get harder. I did today after taking some male enhancement pills made of organics. Many times I cannot ejaculate. Thanks DOc.

735 days and 5 hours ago.

Reply

I also have a sinus infection. could that be casuing it as well? And my semen today was the consistancy of like a rubbery gel and really yellow.

Accepted Answer

I'm worried that your erection difficulties may be related to a more serious problem going on with your diabetes. The fruity smell that your girlfriend is probably smelling is likely ketones - usually these are related to very high sugars though it sounds like yours are quite brittle. Is there any chance that your meter may be broken? do you have urine ketone strips that you can check with?

Why has it been so long since you had a HgbA1C checked? The usual standard is every 3 months.

There is a condition called euglycemic ketoacidosis (see question 8 on this:

http://www.postgradmed.com/issues/2001/11_01/carroll.shtml )

Although this doesn't quite fit with what you've told me, I am still quite worried. I would recommend visiting a physician and asking them to check a urinalysis for ketones, and perhaps confirm that your meter is working. Ketoacidosis can be a reason why people can have erectile dysfunction.

Do you have a clinic that you can go to?

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Expert: Dr. Eric
Pos. Feedback: 98.5 %
Accepts: 230
Answered: 3/16/2008

Doctor (MD)

9 years of experience as board certified internist, pediatrician. Specialize in Adolescent Medicine.

Accepted Answer

The change in semen may also be caused by dehydration or changes in your normal blood salts and sugars. An STD would be a possibility, but I would expect a different spectrum of symptoms.

Are you taking any medications for the sinusitis?

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Expert: Dr. Eric
Pos. Feedback: 98.5 %
Accepts: 230
Answered: 3/16/2008

Doctor (MD)

9 years of experience as board certified internist, pediatrician. Specialize in Adolescent Medicine.

Posted by Dr. Eric 735 days and 5 hours ago.

Answer

Here is another article on euglycemic ketoacidosis. It was not something I was well versed on, so I've been reading up on it:

http://www3.interscience.wiley.com/cgi-bin/abstract/85514741/ABSTRACT?CRETRY=1&SRETRY=0

I would encourage you very strongly to have the urinalysis, and perhaps get the doctor to prescribe you ketone strips for your urine. Correcting the condition should fix the erection problems.

Let me know what you find out -- I'm a little curious now too.

Dr. Eric

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