Erectile Dysfunction

Patient history, including medical and sexual histories, is crucial in defining the degree and nature of erectile dysfunction (ED). It can disclose diseases leading to ED, and a simple recounting of sexual activity may identify problems with sexual desire, erection, ejaculation, or orgasm. Additionally, the use of certain drugs can suggest a chemical cause, as drug effects are a frequent cause of ED.

A physical examination can provide valuable clues to systemic problems. For example, if the penis is not sensitive to physical touch, a problem in the nervous system may be the cause. Abnormal secondary sex characteristics, such as unusual hair patterns or breast enlargement, can point to hormonal problems, implicating the endocrine system. The doctor may also discover a circulatory problem by observing a decreased pulse rate in the wrist or ankles. Furthermore, unusual characteristics of the penis itself could suggest the source of the problem, such as Peyronie’s disease.

Laboratory tests, including blood tests to check the level of male hormones and to identify other medical problems causing ED, are essential. Additionally, tests for systemic diseases, such as blood counts, urinalysis, lipid profile, and measurements of creatinine and liver enzymes, can provide valuable insights. Measuring the amount of available testosterone in the blood can yield information on problems with the endocrine system and may explain decreased sexual desire.

Psychosocial examination, using an interview and a questionnaire, can reveal psychological factors contributing to ED. Furthermore, a man’s sexual partner may also be interviewed to determine expectations and perceptions during sexual intercourse.

In addition to the above, specific tests may be performed to further evaluate the condition. Ultrasonography can help determine if the blood circulation to the genitals is sufficient for an erection. Neurological tests, including a physical examination to check for nerve damage, are also important. Blood pressure tests, involving the injection of a dye in the blood vessels, can help determine any abnormalities in the flow of blood through the penis. These comprehensive screenings and tests are essential in diagnosing and understanding the underlying causes of erectile dysfunction.