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Diagnosis of Erectile Dysfunction (Impotence)
You will be asked about your symptoms and medical history. A physical exam will be done. Be prepared to identify every medication you are taking. As many as 25% of erectile dysfunction cases are due to medications. Expect questions about the frequency, quality, and duration of your erections. Your answers may help determine if primarily psychological and/or physiological factors are causing your impotence.
Your penis, testes, and rectum will be examined. If a physical cause is suspected, laboratory tests may be ordered. The following factors will be evaluated:
- Laboratory tests —Blood glucose, lipids (cholesterol), and thyroid function tests are likely to be advised.
- Testosterone —If you are over 50 years old or if your doctor suspects hypogonadism (small testes and reduced bodily hair), a blood test for testosterone will be ordered.
- Endocrine tests —Other endocrine tests may be ordered, such as thyroid stimulating hormone (TSH), prolactin, and fasting blood sugar.
- Nocturnal erections —Potent men have spontaneous erections at night. If you do not remember them because you were asleep, there are devices that can measure and record them.
- Psychology —There are always psychological factors associated with sexual functioning, whether they are the cause or just a result. You and possibly your partner may be given a questionnaire to help determine what emotional and psychological factors may be contributing to your condition.
- Cardiac function tests—These tests may be considered by your doctor. Poor cardiovascular function is associated with erectile dysfunction.
Guay AT, Spark RF, et al. American Association of Clinical Endocrinologists medical guidelines for clinical practice for the evaluation and treatment of male sexual dysfunction: a couple’s problem. 2003 update. Endocr Pract. 2003;9:77-95.
Heidelbaugh J. Management of erectile dysfunction. Am Fam Physician. 2010 Feb 1;81(3):305-312. Available at: http://www.aafp.org/afp/2010/0201/p305.html. Accessed March 8, 2016.
National Institute of Diabetes, Digestive, and Kidney Diseases. Erectile dysfunction. National Institute of Diabetes, Digestive, and Kidney Diseases website. Available at: http://kidney.niddk.nih.gov/kudiseases/pubs/ED. Updated November 2015. Accessed March 8, 2016.
Sivalingam S, Hashim H, et al. An overview of the diagnosis and treatment of erectile dysfunction. Drugs. 2006;66:2339-2355.
Webber R. Erectile dysfunction. Clinical Evidence. 2005;13:1120-1127.
- Reviewer: Adrienne Carmack, MD
- Review Date: 03/2016
- Update Date: 03/15/2015