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How is erectile dysfunction diagnosed?

To diagnosis erectile dysfunction (ED) I take a thorough medical history and ask the man a few questions such as:
  • How long have you had the problem?
  • Did it start after any recent medication changes, trauma or stress?
  • Do you ever have an erection?
  • How is your sex drive (libido)?
Tests to diagnose erectile dysfunction include:
  • Physical exam, including a penile and testicular exam
  • Prostate exam for men over 40
  • Laboratory test to check for sugar in the urine, which may be a sign of undiagnosed diabetes
  • Testosterone blood test
  • Prostate-specific antigen (PSA) blood test for men over 40
  • Ultrasound of the penis (penile Doppler) to show blood flow into the penis and how well the erect penis stores blood
You might wonder why you can't just buy the pills over the Internet and fix the problem. Because it's important not overlook the potentially serious causes of ED. Diabetes and hypertension (high blood pressure) can kill you. Hypogonadism (low testosterone level) can affect your entire body, not just your penis. Take erectile dysfunction seriously, and see a qualified doctor for a diagnosis.

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First, doctors usually perform a physical exam to help determine if underlying medical problems with the nervous or circulatory systems might be the cause of erectile dysfunction. Blood work, lab tests, and measurements of testosterone may help with the diagnosis. To determine if medication side effects could be the cause, your doctor will also want to know about any medications you are currently taking.

Your doctor might also ask questions about your emotional health and will want to know if there are any personal matters that might be affecting your sex drive. After determining the cause of your issues, your doctor may recommend any number of ways to treat the problem, depending on your circumstances.

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Jan L. Shifren, MD
Reproductive Endocrinology
To diagnose erectile dysfunction, the healthcare provider will ask about your symptoms and your health history, including any diseases and surgeries you've had and medications you're taking. Other queries may address feelings of depression, your stress level, and your relationship with your partner. Sometimes, having your partner come to your appointment can be helpful, although some men may prefer to go alone.

During an exam, the healthcare provider will check for conditions that can affect blood flow, such as high blood pressure or a heart murmur. He or she may test your blood to assess your risk for cardiovascular disease. The healthcare provider will also examine your testicles, penis, and chest (small testicles and enlarged breasts are signs of low testosterone). In addition, he or she will feel your prostate gland and test your reflexes. Now that medication can successfully treat most cases of erectile dysfunction, many once-routine diagnostic tests are rarely used. Still, if your healthcare provider suspects that you have another condition that requires treatment, he or she may order a specialized test.
Patients with erectile dysfunction report that they are unable to maintain an erection for the entire duration of a sexual activity. ED is diagnosed by patient’s symptoms. No special tests are required to make the diagnosis. A physician will do other tests (including urine analysis, check testosterone level and other metabolic levels) to evaluate for causes that may result in ED.
Dr. Mehmet Oz, MD
Cardiology (Cardiovascular Disease)
The first step to diagnosing erectile dysfunction (ED) is to make an appointment with your primary care physician. It's probably not going to be easy to talk about these things, but doctors know that most cases of ED are caused by physical problems, not emotional ones. He or she will take a medical and sexual history, do a physical exam, and do some lab tests to see if you have high cholesterol or high blood sugar, for example. ED is treatable at any age, but how it's treated depends on what's causing it, and your doctor can help you figure that out.

Diagnosing erectile dysfunction usually begins with a review of your symptoms and a physical exam. In some cases, this may be all a doctor needs to prescribe treatment. However, if a more serious underlying cause is suspected, there are other tests that may be performed. Doctors may run blood tests or urine tests to look for things like diabetes, hormone problems, and heart disease. Ultrasounds may be used to look for problems with blood flow to the penis. Some men may undergo overnight erection testing, which uses a simple test to see if erections occur during sleep. If it does, this suggests a psychological rather than physical problem.

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Important: This content reflects information from various individuals and organizations and may offer alternative or opposing points of view. It should not be used for medical advice, diagnosis or treatment. As always, you should consult with your healthcare provider about your specific health needs.