Erectile Dysfunction Impotence
Questions to Discuss with Your Doctor:
- Do you smoke cigarettes?
- Have you been screened for other medical problems such as high cholesterol, high blood pressure, heart disease, and diabetes?
- Do you have a neurologic disease or sickle-cell disease?
- Are you taking any medications (prescription or over-the-counter)?
- Has your erectile dysfunction worsened since starting any new medications?
- What effect is your erectile dysfunction having on your relationship? Your self-esteem?
- How long have you had erectile problems?
- Do you have erectile problems sometimes or all of the time?
- Have you ever had any psychologically stressful sexual experiences?
- Are you less interested in sex (diminished libido)?
- Are you having difficulty achieving an erection or sustaining it?
- Do you ever awaken with early morning or nocturnal erections?
- Do you have pain with erections?
- Penile bumps or lumps?
- History of penile trauma?
- History of pelvic surgery?
- What are your goals in receiving treatment?
- What therapies have you tried?
- Do you know how much benefit you can expect from medical therapies?
- Do you know the side effects and important drug interactions?
- Do you know the pros and cons of a penile prosthesis?
- Do you know the types of penile prosthesis and how they work?
Your Doctor Might Examine the Following Body Structures or Functions:
- Genital examination
- Rectal examination
- Neurologic examination
Your Doctor Might Order the Following Lab Tests or Studies:
- Blood tests (complete blood count or CBC, glucose, cholesterol panels, thyroid function tests, prolactin level)
- Blood testosterone level (if libido is decreased)
- Nocturnal penile tumescence (NPT) (see p. 1093)
- Neurologic testing (nerve condition studies)
- Psychological evaluation
- Your doctor may decide to do some vascular tests to establish whether the arteries that supply blood to the penis during erections are narrowed.
- Your doctor may do some tests to establish whether there is an abnormal blood flow out of the penis during erections leading to short-lived or partial erections.