Hi there, it’s really good to hear from you again after a few months. I’m glad you checked in, though it’s unfortunate to hear you’re dealing with so many complex layers of MG.

I can’t give medical advice, but what you’re describing makes sense as something to bring back to your doctors. Muscle cramps can be a known side effect of pyridostigmine (Mestinon), and some MG folks in our community also report cramping not associated with treatments, especially in the calves and feet. Here’s a discussion I think you’ll be interested in: https://forumsstg.myastheniagravisnews.com/forums/forums/topic/pain-and-myasthenia-gravis-2/.

For erectile dysfunction, there are several possible pieces in the mix. Type 2 diabetes on its own is a major risk factor for ED. Long-term opioid use can affect hormones and is also linked with sexual dysfunction, including ED. Antidepressants such as duloxetine are another potential factor.

Because there are so many possible contributors in your case, the safest path is to talk directly with your primary doctor, MG specialist, endocrinologist, and possibly a urologist. They’re the ones who can look at all of your medications together, check hormones if needed, and decide what is safe to adjust or investigate further.

Please keep looping your doctors in about both the cramping and the ED, and update us any time you want to talk through how it’s going! -Jodi, Patient Advocate