Erectile dysfunction indicates the inability to gain and maintain the erection that is adequate for having sexual intercourse. Many men face this problem occasionally, in fact, it is estimated that almost every man will have erectile dysfunction at least once in life. On the other hand, erectile dysfunction can be a serious chronic problem, indicating that there is an underlying cause that needs to be solved.
Treatment for erectile dysfunction depends largely on its underlying cause. Different causes call for different options in treatment, which is why it is necessary to diagnose it properly.
When seeing a doctor for erectile dysfunction, it is advised to be prepared honest, because some parts of the exam can be very personal and feel intrusive, but they are necessary for obtaining a proper diagnosis.
The process for diagnosing erectile dysfunction usually consists of general physical exam, an interview and a set of specialized tests.
Diagnosing erectile dysfunction
Some of the questions doctors usually ask when a person comes in complaining of erectile dysfunction regard the sexual and emotional life of the patient, possible sources of stress, depression and anxiety, the time, situation, circumstances and extents of the symptoms when they first started, and such. The doctor may also ask about the sexual habits of the patient, for example what sexual techniques he uses and whether he has morning erections, how often he masturbates and how many partners does he have.
Doctors also need to know if the patient is taking any over-the-counter prescription medications, herbal supplements, alcohol or street drugs.
After the interview and the physical exam, doctors may order tests such as complete blood count, liver and kidney function tests, tests for lipid levels in blood, thyroid function tests, blood hormone analysis and analysis of urine.
Specific tests done for erectile dysfunction include duplex ultrasound, which is probably the best and the most efficient test for erectile dysfunction, nocturnal penile tumescence, penile biothesiometry, vasoactive injection, dynamic infusion cavernosometry, cavernosography, arteriography and bulbocavernous reflex.
The most important tests are duplex ultrasound and nocturnal penile tumescence. In duplex ultrasound, high-frequency sound waves are used to provide images of tissues, which may show poor blood flow, leakage, scarring or artherosclerosis.
Nocturnal penile tumescence is performed to see if the patient is having erections in his sleep. Normally, a man has six or seven erections during the night. In this test, several elastic bands are placed around the penis. When the penis is erect, the bands will stretch and measure the changes in circumference of the penis. If they stay in place, without stretching, it means the nocturnal erections are not happening, and it usually indicates a problem with nerve function or circulation.