Hi Dr. I was recently notified by my neurologist that I have disk herniations on my lumbar spine (I had an MRI). I don't think they're severe but I've been having more minor pain recently in my lumbar spine. I have also been having PE recently. My next appointment with my neurologist in on April 10th but I'm concerned now that the PE is somehow related to the disk herniations and some nerve issues. I decided to go to a sports medicine orthopedist and to the neurologist because I was getting a numb right leg after about 1 mile of running. After running a mile my leg would feel sort of dead; this would wear off after about five minutes of not running. Anyway I have no history of PE. I've always been able to last a while and have good about my performance. In fact I'm on Lamictal the mood stabilizer and on Emsam. Emsam my doctor says actually delays orgasm which has been my experience. So now I don't really know what's going on. Any ideas as to what might be happening?
2015-02-05 11:28:36
Hi! I appreciate your worries regarding your symptoms. First let us consider the pain/numbness in your leg after running which subsides a few minutes after you stop running. This can be due to a pinched nerve caused by a disc herniation. However it can also be due to intermittent claudication. The diseased and thrombosed arteries go in spasm while walking or exercising due to increased blood demand there is reduced oxygen in muscles and hence pain. A neurogenic variant of this is most likely in your case which happens due to vertebral canal stenosis. The hallmark of diagnosis is that the pain disappears with a little rest and person can start walking again. Betablockers aspirin ACE inhibitors etc are the mainstay of treatment. An EMG/NCV test may help diagnose the neurogenic variant while a dopplar study of blood vessels of leg may help diagnose thrombosed blood vessels. Since you are also experiencing premature ejaculation various causes should be looked into and investigated. Premature ejaculation could be a side effect of Lamictal so please ask your doctor about it. The other possibility is that the penile blood vessels are either thrombosed or have a clot or their blood supply is compromised. This can be diagnosed through a dopplar study. Pinched nerves in lower spine and/or pinched pudendal nerve is another possibility which should be looked into (through EMG/NCV and other specialized tests). If your symptoms are related to blood vessels then it would be important to get liver function tests lipid profile tests for thyroid and diabetes done as all these conditions affect the blood vessels. You need to discuss all these possibilities with your doctor and undergo investigations as suggested. Hope your problems are sorted out soon! Good Luck and take care!
2015-02-05 11:29:06
