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  • Shawn Kocab

How is Erectile Dysfunction Diagnosed?

Diagnosing erectile dysfunction may require physical and mental exams as well as a comprehensive assessment of your sexual and medical history. Hard as it is to open up about it, it is important to talk to a professional if ED is affecting the quality of your life. A healthy sex life is part of a healthy life, so don't hold back any information when talking to your doctor about your condition.

Medical and Sexual History

Diagnosing erectile dysfunction may require insight from your medical and sexual history. The first thing your doctor or urologist will probably ask you to do is talk about your sex life and any medical conditions in the past that could be tied to erectile dysfunction.

Some of the questions you may need to answer include:

  • How confident are you of your ability to get and sustain an erection?

  • Does your penis get firm enough for intercourse when you're sexually stimulated? If not consistently, how often does it happen?

  • How often do you maintain an erection throughout intercourse?

  • Do you achieve sexual satisfaction from intercourse?

  • Do you wake up with an erection every morning? If not, how often do you get erections when you wake up in the morning?

  • How would you rate your sex drive/libido?

  • How often do you achieve climax/ejaculation from sexual intercourse?

  • Have you had penile surgery that may have damaged nerves or blood vessels in your penis?

  • Are you on any prescription medication or over-the-counter drugs?

  • Do you drink alcohol, smoke, or use any hard drugs?

Your sexual and medical history are important for pinpointing the cause of your erectile dysfunction. Divulging your medical history is important as it reveals previous diseases or invasive medical procedures that could lead to erectile dysfunction. Your sexual history, on the other hand, attests to your sexual desire, problems with ejaculation, and any difficulties you may have maintaining an erection and achieving climax during intercourse.

Physical and Mental Health Exam

Mental health exams typically come in the form of questionnaires that you fill. Depending on how you answer the questions, a health professional will be able to detect symptoms of mental issues that could be causing ED. Illnesses like depression and anxiety and low self-esteem issues are strongly linked to erectile dysfunction.

A physical exam is a standard procedure for diagnosing erectile dysfunction. It typically involves five tests:

Physical touch - Touching the penis establishes if it is sensitive to touch. A lack of sensitivity indicates problems with the nervous system.

Observation - The penis' appearance can indicate an underlying problem, particularly if it is curved. When a penis bends or curves when erect, it's a symptom of Peyronie's disease.

Body exam - Enlarged breasts and extra hair suggest a problem with your hormones.

Blood pressure and pulse - Problems with circulation can lead to ED. Poor circulation may be the reason why the penis is not getting enough blood to erect.

Other tests may include:

Lab Tests: Part of the physical examination may require lab testing. It is possible to detect the causes of ED in the blood. For instance, conditions like diabetes, atherosclerosis, hormonal imbalance, and chronic kidney disease can be detected by a blood test.

Imaging tests: The doctor might recommend a Doppler ultrasound test to establish erectile dysfunction's causative factors like poor blood flow through the penis. The test is conducted by a technician, who passes a handheld device over your penis. The device measures blood flow, then displays the results in color images on a computer screen.

Details like the speed and direction of blood flow are obtained after a urologist or radiologist studies and interprets them. It's highly likely that you may get an injection to induce erection.

Nocturnal Erection Tests: Nocturnal erection tests help doctors determine whether the cause of ED is physical or psychological. A healthy male typically has three to five erections in his sleep. If the test confirms that you're unable to get erections even in your sleep, it indicates a psychological or emotional issue.

A nocturnal erection test requires you to wear a plastic ring around your penis overnight. The device measures the frequency and firmness of erections you get while asleep. The test can occur at home or at a special sleep lab where electronic monitoring devices can be used to measure the number of erections, the firmness of your erections, and how long each erection lasts.

Injection Test: During this test, an intra-cavernosal injection is administered to induce an erection. Sometimes, the health professional will insert the medicine directly into the urethra. The reason for inducing an erection is to establish how firm your penis gets when erect, and how long you can sustain an erection.

All these tests typically take place in your doctor's office.

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