Erectile Dysfunction (Impotence)
Medical and sexual histories help define the degree and nature of ED. A medical history and recounting of sexual activity may help disclose diseases leading to ED and to distinguish these from other problems related to sexual desire, erection, ejaculation or orgasm. Drug effects account for 25% of ED cases: using certain prescription or recreational drugs can be a chemical cause.
A physical examination can differentiate between nervous system, endocrine system or circulatory system problems, and can identify unusual characteristics of the penis itself.
Several laboratory tests can help diagnose ED and can be used to test for systemic and endocrine problems. It is quite clear that ED may be an early marker of cardiovascular disease and diabetes. Men are advised to be screened for these diseases, in addition to the so called metabolic syndrome.
Healthy men have involuntary erections during sleep. If nocturnal erections do not occur, then it is likely to be a physical rather than a psychological cause. Monitoring erections that occur during sleep by nocturnal penile tumescence can help to rule out certain psychological causes but this method is not completely reliable. Scientists have not standardised these tests, nor have they determined when they should be applied for best results.
A psychosocial examination, using an interview and a questionnaire and involving the man’s sexual partner if he so wishes, can reveal psychological factors. Expectations and perceptions during sexual intercourse can be determined in order to work towards a resolution. We have a dedicated psychosexual therapist.