believed that most erectile dysfunction (ED) was caused by psychological
problems. That is no longer thought to be the case.
problems are psychological. However, doctors now recognize that many cases of
ED are caused by underlying medical problems. A physician’s initial evaluation
for ED will typically involve taking a simple medical history and performing a
physical examination. If this initial evaluation suggests a physical cause for
your ED, diagnostic tests may be necessary to determine the underlying cause.
A variety of different tests can be
used to identify the cause of your ED.
A detailed physical exam can help your doctor assess
your overall health. Your doctor will likely check your blood pressure and ask
about any recent injuries or illnesses. They will ask about your current medications
or supplements. They will examine the penis and testicles for changes in sensitivity.
Your doctor may want to assess whether any psychological
problems could be contributing to your ED. You will probably be checked for
signs of stress, depression, and anxiety. Your doctor may ask about your
relationship with your romantic partner. Detailed questions about your sex life
may also be asked.
Nocturnal Erection Test
Men usually have erections at night
as they sleep. Because there are so many
different highly coordinated physiologic systems that are required to achieve
an erection, the presence of nighttime erections can help determine whether
your ED has a physical or mental cause.
A nocturnal erection test can
determine if you have nighttime erections. According to the Mayo
Clinic, this test involves placing a ring of special tape on the penis
before sleep. If you have an erection, the tape will separate overnight. If
there is genuine dysfunction of the muscles, blood vessels, hormones, or nerves
required to produce an erection, then nocturnal erections will be absent.
This could be due to underlying
medical conditions such as stroke, high blood pressure, diabetes, or multiple
sclerosis. On the other hand, if all of the biologic systems needed for an
erection are functional and the cause of ED is psychological, then nighttime
erections will still be present during the deep slumber typical of the REM
phase of sleep.
Blood and Urine Tests
Blood and urine tests can detect signs of diseases
associated with erectile dysfunction. Such diseases include:
- heart disease
- kidney disease
These tests can also indicate if hormone levels might be
playing a role in your ED.
An ultrasound uses sound waves to see inside the body.
It is a very effective way of examining blood flow. When a man has ED, an
ultrasound can check blood flow in the penis. An ultrasound wand is simply
moved over the blood vessels that supply the penis..
Sometimes, an injection may be used to stimulate an
erection before this test. Then an ultrasound can check whether blood flow
increases appropriately. Pain from the injection is rare. If you do have
discomfort, it will likely be mild and go away quickly. However, if you are afraid
of injections, talk to your doctor. It may be possible to use an erectile
dysfunction drug, such as sildenafil (Viagra), before the test instead.