Erectile dysfunction, also known as ED or impotence, refers to a difficulty in achieving or sustaining an erection, which inhibits men from having sexual intercourse. According to the National Institutes of Health, around 5% of men aged 40 and up to 25% of men 65 years or older suffer from the condition on a regular basis.
Men suffering from impotence more than 20% of the time may require medical intervention. Men often feel embarrassed to share this information with a partner or a healthcare provider. However, when occurring on a regular basis, erectile dysfunction may be an initial symptom of more serious underlying conditions that include cardiovascular disorders or diabetes.
Consulting a Health Provider
Before ordering tests, prescribing medication or recommending treatment, physicians typically perform a physical examination and obtain a thorough medical history. Uncovering possible causes of impotence requires that men answer questions honestly. Some of the information needed by healthcare providers before testing include:
- A history of OTC, illegal or prescription drug use
- Alcohol consumption history
- Family medical history
- Whether the man is currently experiencing anxiety, depression or stress
- When ED symptoms began and circumstances of the event
- Normal duration, frequency and quality of erections
- History of erections in the morning or during the night
- Sexual techniques
- Current relationship problems
- Number of sexual partners
Following a physical examination and an extensive interview, physicians may order a combination of any of the following laboratory tests:
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Complete Blood Count or CBC: This test may reveal the possibility of having anemia or an infection.
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Lipid Profile: The blood test determines the levels of cholesterol or fats in the blood. Abnormally high levels may indicate hardening of the arteries, which can initially occur in the small and delicate vessels of the penis.
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Liver and Kidney Function: Malfunction of either organ may produce erectile dysfunction symptoms.
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Thyroid Function: The organ regulates sex hormone release and may contribute to ED if malfunctioning.
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Prolactin and Testosterone Levels: These are hormones that contribute to sexual function.
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Prostate Specific Antigen or PSA: When this protein appears in abnormally high levels, the test may indicate infection, inflammation, enlarged prostate or possible prostate cancer.
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Urinalysis: This test may indicate the presence of infection, diabetes, abnormal hormone levels or kidney malfunction.
From these basic tests, physicians then may proceed to tests that provide a better look at the actual anatomical structure and function of the penis and internal tissues.
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Duplex Ultrasound: Ultrasound images provide physicians with a glimpse of internal blood flow and tissue health.
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Nocturnal Penile Tumescence or NPT: The test measures erectile function while a man sleeps using a series of bands or loops placed around the head and base of the penis.
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Penile Biothesiometry: Using electromagnetic vibration, the test determines tactile sensitivity and nerve function.
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Vasoactive Injection: The test involves injecting medications into the penis, which encourages vessel dilation, increased blood flow and subsequent erection capability.
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Dynamic Infusion Cavernosometry: Physicians administer fluid into the penis at a predetermined rate, which evaluates the possibility of blood vessel leakage.
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Cavernosography: Administered in conjunction with the dynamic infusion test, the images determine if a vessel leakage has occurred.
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Arteriography: After injecting a dye into an artery, images of the blood vessel determine if vascular damage exists.
