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Impotence (Erectile dysfunction) - Diagnosis

Description

An in-depth report on the causes, diagnosis, treatment, and prevention of erectile dysfunction.

Alternative Names

Diagnosis:

The doctor typically interviews the patient about many physical and psychological factors and performs a physical exam.

Medical History

The doctor should take a medical and personal history and may ask about the following:

Past and present medical conditions, surgeries, and medications
Any history of psychological problems, including stress, anxiety, or depression
Lifestyle factors such as alcohol, drug, and dietary supplement use

In addition the doctor will ask about the patient's sexual history, which may include:

When problems with sexual function began
The frequency, quality, and duration of any erections, and whether they occur at night or in the morning
The specific circumstances when erectile dysfunction occurs
Details of technique
Whether problems exist in the current relationship

If appropriate, the doctor may also interview the sexual partner.

Physical Examination

The doctor will perform a physical exam, including examination of the genital area and a digital rectal examination (the doctor inserts a gloved and lubricated finger into the patient's rectum) to check for prostate abnormalities. It is important to check the blood pressure and to evaluate the circulation by checking pulses in the legs.

Laboratory Tests

Blood tests may be used to measure testosterone levels to determine if there are hormone problems. The doctor may also screen for thyroid and adrenal gland dysfunction. In addition, the doctor may order tests for blood sugar (glucose) levels to check if diabetes is a factor. For more sophisticated tests, the doctor may refer the patient to a urologist. Because erectile dysfunction and atherosclerosis are often linked, it is important to check cholesterol levels.

Resources

www.niddk.nih.gov -- National Kidney and Urologic Diseases Information
www.auanet.org -- American Urologic Association
www.urologyhealth.org -- Urology Health

References

Babaei AR, Safarinejad MR, Kolahi AA. Penile revascularization for erectile dysfunction: a systematic review and meta-analysis of effectiveness and complications. Urol J. 2009 Winter;6(1):1-7

Bhasin S, Cunningham GR, Hayes FJ, Matsumoto AM, Snyder PJ, Swerdloff RS, et al. Testosterone therapy in adult men with androgen deficiency syndromes: an Endocrine Society clinical practice guideline. J Clin Endocrinol Metab. 2006 Jun;91(6):1995-2010. Epub 2006 May 23.

Boloña ER, Uraga MV, Haddad RM, Tracz MJ, Sideras K, Kennedy CC, et al. Testosterone use in men with sexual dysfunction: a systematic review and meta-analysis of randomized placebo-controlled trials. Mayo Clin Proc. 2007 Jan;82(1):20-8.

Lindau ST, Schumm LP, Laumann EO, Levinson W, O'Muircheartaigh CA, Waite LJ. A study of sexuality and health among older adults in the United States. N Engl J Med. 2007 Aug 23;357(8):762-74.

McVary, K. T.. Clinical practice. Erectile dysfunction. N Engl J Med. 2007 Dec; 357(24): 2472-81.

Melnik T, Soares BG, Nasselo AG. Psychosocial interventions for erectile dysfunction. Cochrane Database Syst Rev. 2007 Jul 18;(3):CD004825.

Miles CL, Candy B, Jones L, Williams R, Tookman A, King M. Interventions for sexual dysfunction following treatments for cancer. Cochrane Database Syst Rev. 2007 Oct 17;(4):CD005540.

Müller A, Mulhall JP. Cardiovascular disease, metabolic syndrome and erectile dysfunction. Curr Opin Urol. 2006 Nov;16(6):435-43.

Nehra A. Erectile dysfunction and cardiovascular disease: efficacy and safety ofphosphodiesterase type 5 inhibitors in men with both conditions. Mayo Clin Proc. 2009 Feb;84(2):139-48.

Saad F, Grahl AS, Aversa A, Yassin AA, Kadioglu A, Moncada I, et al. Effects of testosterone on erectile function: implications for the therapy of erectile dysfunction. BJU Int. 2007 May;99(5):988-92. Epub 2007 Feb 19.

Selvin E, Burnett AL, Platz EA. Prevalence and risk factors for erectile dysfunction in the US. Am J Med. 2007 Feb;120(2):151-7.

Vardi M, Nini A. Phosphodiesterase inhibitors for erectile dysfunction in patients with diabetes mellitus. Cochrane Database Syst Rev. 2007 Jan 24(1):CD002187.

Reviewed last on: 7/8/2009
Harvey Simon, MD, Editor-in-Chief, Associate Professor of Medicine, Harvard Medical School; Physician, Massachusetts General Hospital. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

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