26/M Married

Erectile dysfunction Chief Complaints Unable to perform sexual activity. Erection is very poor. History H/o- hair loss, IBS, Excessive sleep pattern, TSH raised 3 years back took eltroxin 50 (now Tsh norml stopped medicine) Vitals Everything norml Physical Examination General appearance good. Weight 78 kg Height 5ft 10inch Management On rx kamini vidravan ras+makardwaj vati. Took penagra (only for incourse then he feels better)

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History of hypothyroidism And drop out needs to consider Pt is overweight and likely obese ERECTILE DYSFUNCTION Needs to r/o diabetes and hypertension Adv sr testestrone and usg scrotum Sos angiography testes Plan the treatment as per workout Adv penile compression and vibrator therapy

DD Hypothyroidism, uncontrolled Metabolic syndrome Pickwickian syndrome, pituitary dysfunction Obstructive sleep apnoea Suggest, assay of testosterone, prolactin, ENT opinion, sleep lab studies to rule out OSA

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