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My 28 year old son has just told me that he has never, been…

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My 28 year old son...
My 28 year old son has just told me that he has never, been able to ejaculate, his testicles are drawn up against his body, and they "don't work". He has extreme psychosocial issues over this and has never told a doctor. He also has no health insurance. Can you please aadvise me on this.
Submitted: 7 months ago.Category: Urology
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Answered in 36 minutes by:
11/22/2017
Urologist: Dr. Mo, Board Certified MD replied 7 months ago
Dr. Mo
Dr. Mo, Board Certified MD
Category: Urology
Satisfied Customers: 2,011
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Hi, Dr. Mo here with JA. Please let me review the information and I'll reply shortly.

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Urologist: Dr. Mo, Board Certified MD replied 7 months ago

Has he ever tried masturbation or intercourse?

Does he have normal morning erections when he awakes?

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Customer reply replied 7 months ago
he has masturbated and had intercourse, but he says he never ejaculated. He was once diagnosed with low testosterone, but his insurance at the time would not pay for the supplements, so he stopped taking them. He has congenital spinal abnormalities and had many X - rays of his low back as a child. He has very low muscle mass and very little body hair. He won't discuss morning erections with me, but I have gone in the room and seen him a it at least a partial erection.
Urologist: Dr. Mo, Board Certified MD replied 7 months ago

The low testosterone might explain the inability to ejaculate.

It's unlikely to be something neurologic or the inability to ejaculate otherwise he wouldn't be able to get an erection at all.

Does his genitalia appear smaller than normal or is he concerned that it might be less developed?

Also, has he had any other hormone tests besides testosterone done that you are aware of?

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Customer reply replied 7 months ago
I don't know. I haven't seen his genitals naked since he was 10. I am going to try to get him to call, but he is too upset right now. He has not had other hormone tests, but had genetic testing as a child due to the congenital defects. He also has a high palate, has adducted thumbs, UP obstruction, multiple abnormal ribs with two too many on one side and one too many on the other. The genetic testing showed nothing and the paperwork they gave said the only thing close was some kind of dwarfism. He is 6' 2" or 3", so that is not the issue.
Urologist: Dr. Mo, Board Certified MD replied 7 months ago

So most likely it's not anything more serious or problematic than the hormone issues.

With testosterone supplementation he might have a chance at full normal ejaculation.

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Urologist: Dr. Mo, Board Certified MD replied 7 months ago

Was he upset that he wasn't able to ejaculate?

Or was he able to at least climax?

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Customer reply replied 7 months ago
He thinks he us some kind of asexual freak. He thinks there is no reason to make an effort at making a life for himself because no woman would ever want him. Him revealing this tonight is a culmination of years of growing psychosocial issues and withdrawal from society. I suspect this explains why he has pulled back from external relationships so drastically.
Customer reply replied 7 months ago
I just don't know how to make him get help for aby if it. He has held on to this for so long and never told his doctor. He feels shame instead of wanting help.
Urologist: Dr. Mo, Board Certified MD replied 7 months ago

It might be that he doesn't feel connected to his doctor.

A psychologist or therapist might be a better fit for him. Someone he can see regularly and confide in.

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Customer reply replied 7 months ago
He won't go. It's just a really bad situation. I've tried.
Urologist: Dr. Mo, Board Certified MD replied 7 months ago

I see. That can be difficult because of course with therapy and such personal matters the patient is the one who has the final say in what they are willing to share.

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Urologist: Dr. Mo, Board Certified MD replied 7 months ago

Maybe if he had the testosterone therapy and was able to ejaculate normally he would feel more normal and less embarrassed by the situation.

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Customer reply replied 7 months ago
I need to figure out a way to get him in to someone now and how to pay for it without insurance!
Customer reply replied 7 months ago
I appreciate your help.
Urologist: Dr. Mo, Board Certified MD replied 7 months ago

There are organization and resources to help with therapy and there are hotlines you can call based on the resources available in your city. They can then also tell you what assistance is available to pay for such services when insurance isn't available.

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Customer reply replied 7 months ago
Can you give referrals or links? We live on a small town.
Urologist: Dr. Mo, Board Certified MD replied 7 months ago

I wouldn't be able to give referrals or links because each city is different.

You can go on your state website and look for the health authority or do a search for mental health resources and your state. That then should take you to some locations based on the city you live in.

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Urologist: Dr. Mo, Board Certified MD replied 7 months ago

Please let me know if I can clarify anything.

Otherwise I hope I provided you with a 5-star service.

Please click on the rating button when ready.

Dr. Mo

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Urologist: Dr. Mo, Board Certified MD replied 7 months ago

Please let me know if you have any other questions.

Otherwise I hope I provided you with a 5-star service.

Dr. Mo

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