Getting Help for Erectile Dysfunction - What to Expect at the Doctor's Office: Diagnosing and Evaluating Erectile Dysfunction
Remember, your doctor or healthcare provider is the single best source of information regarding you and your health. Please consult your doctor if you have any questions about your health, your symptoms, or your medication.
Introduction
If you think you have erectile dysfunction (ED) and you are thinking about going to see your doctor, you might be wondering what would happen at the doctor's office. It might be a little uncomfortable to talk about sex and your erections, but your health care professional will be as professional about this issue as any other health concerns you have. Go get some help-you won't regret it.
How is an erectile dysfunction diagnosis made?
In order to make a diagnosis (needs to be put into the glossary) of erectile dysfunction, your health care professional will want to take a history, do a physical exam and maybe some blood tests.
- The History: this will include questions about your medical, social and sexual background. You should answer these questions as honestly as possible, even if it feels uncomfortable or embarrassing.
- The Physical Exam: In the physical exam your doctor will look for signs of several health concerns that might contribute to erectile dysfunction, like high blood pressure, liver or kidney disease, heart disease, thyroid or neurological problems.
- The Blood Tests: Your doctor may want to check on some of your other health concerns, but sometimes it is also helpful to test your testosterone level (this will need to be in the glossary as well)
What will the doctor ask me?
Here are some of the important questions that your doctor might ask you:
- How long have you been having trouble with your erections?
- Has this happened suddenly or slowly, over time?
- Can you name an event that started the problem?
- Do you have trouble with your erections all the time, or only some of the time?
- Does this happen with all your partners I if there are multiple partners) or only with one partner?
- Do you wake up n the night or early morning with an erection?
- Do you get hard with stimulation?
- When you get an erection, are you able to penetrate your partner?
- Does your erection last long enough for successful completion of intercourse?
- Do you have any pain or have any curvature of your penis?
- Do you smoke?
- Do you drink alcohol? If so, how much?
- Have you had surgery?
- What medical conditions do you have?
- Do you feel stressed or depressed?
- Is your trouble with erections causing you to feel stressed?
- Is your partner interested in restoring your erectile function?
Your doctor may ask you to complete a questionnaire. The questionnaire may be helpful in assessing your problem further.
What is the doctor looking for in the physical exam?
Most likely you will get a head to toe exam and your health care professional will look at the following:
- Your blood pressure and heart rate to see if you have any vascular problem
- Your head and neck to check your thyroid, lymph nodes and eyes
- Your chest to see how your lungs and heart are working
- Your abdomen to check your liver and kidneys
- Your genitalia (another glossary term) to look for any physical problems with your penis or testes and to check other sex characteristics, like pubic hair
- Your pulses
- Your penile sensation, reflexes and rectal tone.
Why is my doctor checking my testosterone level?
Sometimes low testosterone levels can cause erectile dysfunction, so the doctor will check your testosterone level to see if you might be helped by testosterone replacement. Low testosterone can cause poor libido and supplement might help improve your libido. Testosterone supplement alone won't treat your erectile dysfunction, but it might make you more sensitive to ED treatment. It is important that you talk to your health care professional about your testosterone level and what it means.
What happens next?
Once the history and physical have been done, your health care professional will talk to you about lifestyle changes and possible therapies. It is important to identify the possible causes of erectile dysfunction so you get the most appropriate treatment. It is often helpful for your partner to go along with you for this discussion with your health care professional. Let's be honest, your treatment will be more effective if you and your partner understand the problem and work on the solutions together.
Do I need "special" tests?
In some cases, more evaluation may be necessary. Here is a little information about tests that might be ordered.
Nocturnal Penile Tumescence (NTP) - this test is to see if you have erections in the night and if you do, how often and how hard they are
Doppler Ultrasound-this test is to see about the blood flow in the penis
Resources:
The Process of Care Consensus Panel. Int J Impot Res. 1999;11:59-70.
100 Questions and Answers about Erectile Dysfunction
