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Men’s Health - How is Erectile Dysfunction diagnosed?

Patient History

First of all, a look at your medical and sexual history will help to define the degree and nature of the problem. A medical history can disclose diseases that lead to erectile dysfunction while a simple recounting of sexual activity might distinguish among problems with sexual desire, erection, ejaculation, or orgasm. A history of using certain prescription or other drugs can suggest a chemical cause, since drug effects account for 25 percent of cases. Cutting back on or substituting certain medications can often alleviate the problem.

Physical Examination

A physical examination can give clues to systemic problems. For example, if the penis is not sensitive to touching, a problem in the nervous system may be the cause. Abnormal secondary sex characteristics, such as hair pattern or breast enlargement, can point to hormonal problems, which would mean that the endocrine system is involved. The doctor might discover a circulatory problem by observing decreased pulses in the wrist or ankles. And unusual characteristics of the penis itself could suggest the source of the problem for example, a penis that bends or curves when erect could be the result of Peyronie's disease.

Laboratory Tests

Laboratory tests are not always required but can be helpful in certain circumstances. Tests for systemic diseases are carried out where appropriate and include blood counts, urinalysis, lipid profile, and measurements of creatinine and liver enzymes. Measuring the amount of free testosterone in the blood can yield information about problems with the endocrine system and is indicated especially in patients with decreased sexual desire.

Other Tests

Monitoring erections that occur during sleep (nocturnal penile tumescence) can help rule out certain psychological causes of erectile dysfunction. Healthy men have involuntary erections during sleep. If nocturnal erections do not occur, then erectile dysfunction is likely to have a physical rather than psychological cause.

Psychosocial Examination

A psychosocial examination, using an interview and a questionnaire, reveals psychological factors. A man's sexual partner may also be interviewed (but only if the patient agrees) to determine expectations and perceptions during sexual intercourse.