Erection problems

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Male reproductive anatomy

Your doctor will perform a physical examination, which will likely include checking your circulation, a rectal exam, a neurological exam, and an exam of your penis.

To help diagnose the cause of the problem, your doctor will ask medical history questions, such as:

• Have you been able to achieve and maintain erections in the past?
• Is the difficulty in achieving erections or maintaining the erection?
• Do you have erections during sleep?
• How long have you had difficulty with erections?
• What medications are you taking (including prescription medications, over-the-counter medications, recreational drugs)?
• Do you smoke? How much each day?
• Do you use alcohol? How much?
• Have you recently had surgery?
• Have you ever had vascular surgery or other treatments for your blood vessels?
• Are you depressed?
• Are you afraid or worried about something?
• Are you experiencing a lot of stress?
• Has your energy level decreased?
• Are you sleeping well each night?
• Are you afraid of sexual activity because of physical problems?
• Have there been any recent changes in your life?
• What other symptoms do you have?
• Have you noticed changes in sensations in your penis?
• Do you have any problems with urination?

Tests that may be performed include:

• Urine analysis
• Blood tests, including CBC, metabolic panel, hormone profile, PSA
• Penile ultrasound (to evaluate for blood vessel or blood flow problems)
• Nocturnal penile tumescence (NPT) to test if you are having nighttime erections and rigidity monitoring (Rigiscan)
• Neurological testing
• Psychometric testing

TREATMENT

The treatment depends on the cause. For example, if the problem is caused by a hormonal imbalance, medication to treat the underlying endocrine disorder will be prescribed. Consult your health care provider for appropriate evaluation and management.

There are many treatment options today. These include medicines taken by mouth, injections into the penis, vacuum devices, and surgery. In order to treat erectile dysfunction effectively, you must be aware of and comfortable with the possible side-effects and complications that may occur with each therapy.