Sexual dysfunction and difficulty maintaining an erection require a doctor’s diagnosis before treatment can begin. Diagnosis of erectile dysfunction is a complex procedure: root causes may include inadequate testosterone levels, medical conditions, psychological factors or a lowered interest in intercourse. Both the cause and the nature of the sexual dysfunction must be identified.
Discussing erectile dysfunction is difficult for many men. Even some male doctors shy away from the topic. Maintaining an erection during intercourse is seen as an essential part of manhood and not being able to do so is not something most men want to admit to, even in the relatively safe confines of their doctor’s office. For this reason, only about ten percent of all men with erectile dysfunction seek medical help, and remain unaware of treatment options.
The Initial Examination
Besides undergoing a physical examination, you can expect to answer a lot of questions during your first doctor’s visit. Your doctor will develop medical, psychological, and sexual histories to help identify possible causes of your condition. Be as honest as you can: the more accurate your information, the more helpful it is to your doctor.
Erectile dysfunction was once considered primarily a psychological disorder, but recent research has revealed that physical disorders actually account for seventy percent of all cases. Report any existing medical condition. Both prescription and illegal drugs can prevent a man from maintaining an erection.
If your doctor suspects a physical cause, you will probably be sent for lab tests. Diagnosing erectile dysfunction often requires several tests, including measuring testosterone levels, blood tests and urine samples.
A number of specific tests may be used during the diagnosis. During the physical exam, the doctor may test the penis for normal responses to touch. Failure to respond could indicate nerve damage.
Most men have involuntary erections while they sleep. You may be monitored for nocturnal erections. While not one hundred percent consistent as a diagnostic, an absence of erections while asleep often points to a physical cause. If you have erections while asleep but not while awake, a psychological cause could be the problem.
A penile injection is one of the many tests that may be administered during a diagnostic workup for sexual dysfunction. Medications that cause the penile arteries to dilate are administered during a penile injection. This allows blood to flow into the penis, resulting in an erection. A penile injection allows the doctor to evaluate your capacity to achieve and maintain an erection.
Blood flow problems are often linked to erectile dysfunction. Your doctor may order an ultrasound to examine the penile arteries. The test allows the doctor to check for blood obstructions or irregularities in blood flow. The penis’s ability to trap blood for an erection is also observed. A cavernosography test may also be ordered. A dye is injected into the bloodstream so the doctor can view any problems with penile blood flow on the ultrasound.
Other forms of sexual dysfunction can easily be confused with erectile dysfunction. Erectile dysfunction has a very specific medical definition: the inability to maintain an erection long enough for intercourse, or the complete absence of an erection. Here are some conditions commonly mistaken for erectile dysfunction:
Premature ejaculation: This occurs when a man ejaculates before he intends to. Premature ejaculation rarely has a physical cause: anxiety and over-stimulation often cause the condition.
Delayed ejaculation: In this case, a man is either unable to ejaculate, or can only do so after prolonged intercourse. Like premature ejaculation, delayed ejaculation usually has psychological origins.
Prolonged refractory period: The refractory period is the time span after ejaculation when a second ejaculation is simply not possible. This period varies from one man to another. Age tends to lengthen the refractory period.
Lack of sexual desire: An absence of sexual desire may be physical or psychological in nature. Low testosterone levels may impair the level of arousal. Emotional problems may also lower sexual desire.