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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.

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