Erectile Dysfunction
- Diagnosis
How is erectile dysfunction diagnosed?
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. Measuring the amount of available testosterone in the blood can yield information on problems with the endocrine system and may explain decreased sexual desire. Low testosterone level can be treated with testosterone replacement therapy in selected cases.
Psychosocial examination, using an interview, can reveal psychological factors contributing to ED. Sometimes, 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. Doppler ultrasound can help determine if the blood circulation to the penis is sufficient for an erection. Neurological tests, including a physical examination to check for nerve damage, are important, especially in cases of spinal cord injury. These comprehensive screenings and tests are helpful in diagnosing and understanding the underlying causes of erectile dysfunction.
