Diagnose erectile dysfunction by assessing patient’s history, through physical examination and finally, some lab tests.
While a simple, recounting of sexual activity might distinguish among problems with sexual desire, erection, ejaculation, or orgasm.
ED diagnosis by Physical Exam
- If the penis is not sensitive to touch - then it is a nervous system problem.
- Problems of secondary sex (sexual maturity distinguishes one gender to other) hair growth, breast enlargement, etc. - hormonal problems (endocrine system)
- Circulatory problem - decreased pulses in the wrist or ankles.
- Physical (penis) - that bends or curves when erect (Peyronie's disease).
- If nocturnal erections (involuntary erections during sleep) do not occur, then ED is likely to have a physical rather than psychological cause.
Lab ED tests
Blood counts, urinalysis, lipid profile, and measurements of creatinine and liver enzymes. Measuring the amount of free testosterone in the blood can yield information about problems with the endocrine system and is indicated especially in patients with decreased sexual desire.
- Blood tests measure hormone levels, cholesterol, blood sugar, liver and kidney function, thyroid function and levels of other sex hormones.
- CBC–Complete blood count (CBC) of red cells and white cells is useful to examine anemia; it causes fatigue and general malaise. The level of blood lipids (fats) may indicate arteriosclerosis, which can reduce blood flow to the penis causing erection problems.
- Liver and kidney function tests help to find any Liver or kidney disease can contribute to hormonal imbalances, which may results in ED.
- Thyroid function tests to find any thyroid hormonal abnormality, which regulate metabolism and sex hormone production; a deficiency may result in impotence.
- Urinalysis to measure levels of protein (albumin), glucose (sugar), and hormone testosterone. High levels of protein indicated kidney disease; high level of glucose indicates diabetes and low level of testosterone may cause ED.
- Erectile function tests to asses erectile by examining the blood vessels, nerves, muscles, and tissues of the penis.
- Duplex ultrasound is useful to diagnose blood flow, venous leak, atherosclerosis, and calcification of erectile tissue. This test is by inducing erection by injecting prostaglandin (hormone-like stimulator).
- Nocturnal penile tumescence (NPT), it is normal for a man to have five to sex erections each lost for 30 minutes with an in-between gap of 90 minutes during sleep, particularly during rapid eye movement (REM). Their absence may be due to nerve function or blood supply problems in the penis.
- Bulbocavernosus reflex test is to access nerve sensation in the penis. The physician presses the glans (head) of the penis, which immediately causes the anus to contract if nerve function is normal. If there is any abnormality suspected, then your doctor suggests specific nerve tests for further evaluation.