Erectile dysfunction affects approximately 5 percent of men 40 years of age, and up to 25 percent of men who are 65 years old. Unlike the normal, occasional erection challenges every man encounters from time-to-time, real erectile dysfunction, also known as ED, is an inability to get an erection or maintain an erection strong enough to have sex. Because there are so many cialis different causes of erectile dysfunction, diagnosing it's underlying causes is critical to ensuring it is treated properly.
First Steps in Diagnosing Erectile Dysfunction
The very first thing your doctor will do, when diagnosing your ED, is to review your medical history. This medical history will not only include your past medical problems and current medications you are on, but will also include questions about your lifestyle and sexual activity. Common questions include:
- What medications are you currently taking, including both prescription and over-the-counter drugs, as well as herbal supplements?
- Do you use drugs or alcohol? What and how frequently?
- Do you have more than one sex partner? If so, do you have ED with all of them?
- Do you experience evening or early morning erections?
- When did you first notice problems with getting or maintaining erections?
- How frequently do you currently get erections? What are the quality of these erections and how long do they last?
- Do you suffer from anxiety, depression or stress?
- Do you have current relationship problems?
Your doctor may want to also interview your sex partner, to help get further insight into the factors causing your erectile dysfunction. Your doctor will then perform a general exam.
What are the Specific Tests Used to Diagnose Erectile Dysfunction?
The types of tests your doctor will use to diagnose your erectile dysfunction will depend greatly on your medical history, his medical exam and which he feels is the most likely the cause of your ED. Following are the most common tests.
- CBC/Complete blood count – Anemia, a low red blood cell count, is often associated with fatigue and can lead to erectile dysfunction. A CBC will determine if you are anemic.
- Lipid profile – High levels of lipids/fats, including cholesterol, are known causes of atherosclerosis, also known as hardening of the arteries. This condition can prevent proper circulation to the penis needed to get and maintain a strong erection.
- Blood hormone profile – This test is used to determine your testosterone and prolactin levels. If either of these sex hormone levels are abnormal, it can result in erectile dysfunction.
- Kidney and liver function test – Improperly functioning kindeys or livers can lead to ED. This blood test will help ensure yours are healthy and working properly.
- Thyroid function test – The thyroid regulates the production of sex hormones. If your thyroid is not working properly, it could lead to erectile dysfunction.
- Urinalysis – A urinalysis can help diagnose diseases associated with erectile dysfunction, including diabetes, low testosterone, or kidney disease, if sugar, hormone, or protein levels in the urine are abnormal.
- Nocturnal penile tumescence/NPT – The NPT measures how many erections you have while you are asleep. On average, men have between five and six erections a night. If you are having less than this, this could mean there is nerve or circulation issues. To conduct this test, your doctor may use either the: snap gauge, strain gauge or RigiScan tests. The snap gauge uses three different plastic bands, of different strengths, to determine the strength of your erection at night by which band(s) breaks. Similarly, the strain gauge uses bands at the base and tip of the penis. However, instead of being designed to break, these bands stretch, which measures how much your penis girth changed at night. Lastly, the RigiScan device actually provides continual monitoring of your erections at night, giving both strength and frequency.
- Ultrasound – Ultrasound allows your doctor to see inside your body. For those suffering from erectile dysfunction, the ultrasound can show the strength of the blood flow in your penis, as well as identify atherosclerosis, venous leakage or scarring in the tissues that could be affecting your erections. Ultrasounds are usually conducted both while you're erect and while you're flaccid.
- Penile biothesiometry – Electromagnetic vibration is used to determine if your penile nerves are functioning properly. Nerve damage, or a decreased sensitivity, can lead to ED.
- Dynamic infusion cavernosometry – If you have a venous leak, chances are your doctor will use this test. Fluid is pumped into the penis in this test. By seeing what rate the fluid has to be pumped to maintain an erection, your doctor will be able to determine how serious your leak is.
- Cavernosography – A dye is injected into the penis, and is used with the dynamic infusion, then x-rayed to see where the venous leak is.
- Bulbocavernosus reflex – For this nerve function test, the doctor squeezes the head of your penis. This should result in your rectum contracting immediately, if your nerve function is normal.
- Arteriography – If your doctor feels vascular reconstruction surgery is appropriate, an arteriography will be used to x-ray the affected artery.