instruction: hello doctor I am a 29 year old male and I am diagnosed with crohn disease before years and was taking immuran 150 my day and diagnosed with streptococcus after semen culture at the beginning of this year my main concern is ed and pe but the testosterone level is within the normal range I want to know whether my problem is urology or neurology
output: hello you have mentioned ed erectile dysfunction and pe premature ejaculation no details of medications tried so far can you elaborate on this testosterone only indicates sexual drive which you have not mentioned as a problem so that being normal rules out nothing there are no tests for ed and pe specifically history is key better to discuss in person immunosuppressive medications do not generally cause ed or pe you have not mentioned any reason or symptoms for checking semen culture in the absence of any such factors these semen tests can simply be a contaminant even if you have prostatitis it is not likely to cause ed or pe no need to treat semen culture unless you are symptomatic or in other words it will not help have you checked fasting glucose lipids and thyearoid function in the absence of any such symptoms this is likely to be psychogenic especially because of age please check the blood tests as above reassurance correct the factors if abnormal in the mentioned tests need a face to face audio conversation to understand the issues in more detail