NBME 21 Answers ↦
Idk about this. My thoughts:
-libido is a product of testosterone and emotions (psychogenic)
-tumescence is a product of pelvic splanchnics S2-S4 (parasympathetic)
-patient's issues are 1 month old (aka recent) and his wife died 2 years ago & testosterone is normal (therefore libido normal)
-patient can jack off, therefore penile stimulation reflex arc is intact and pelvic splanchnics are working (nocturnal tumescence normal)
Couldnt a psychogenic cause reduce libido?
"Testosterone concentration is within the reference range" and the fact that he has no difficulty masturbating = normal libido.
Low testosterone would contribute to low libido
And if he had low libido he would have difficulty masturbating
whoops meant to comment on the other comment
perhaps it's more to do with the fact that he can get erections when masturbating, outside of nocturnal erections which are not mediated by sexual desire. So his libido must be intact since he has sexual desire evident in being able to masturbate.
At least, that's the way I saw it.
"Testosterone concentration is within the reference range" and the fact that he has no difficulty masturbating = normal libido. Low testosterone would contribute to low libido And if he had low libido he would have difficulty masturbating
The way I made the decision about normal vs. decreased libido is also that he presented to his doctor due to difficulty maintaining an erection while trying to have sex - meaning he has the libido to try to have sex. Does that make sense?
It also says there are no signs of depression, which would cause the low libido after his wife died.
two years is a enough time to mourn...just saying
thisisfine, it makes absolute sense. That is the same way i saw it
He misses his wife man, isn't ready for other women. Psychogenic ED. physically hes fine (can crank his meat)