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How is Impotence diagnosed or evaluated?

If you suspect you may be suffering from impotence, or erectile dysfunction, your physician can conduct a series of exams and tests to determine if that is the cause of your erection difficulties. 


The physician will begin by reviewing both your medical and sexual history. It is important to be honest with your physician, no matter how embarrassed you feel talking about the subject. Your physician is there to help you, so make sure you give all of the facts. 



For example, you may have problems associated with your sexual desires, your ability to maintain an erection, ejaculation or orgasm. Your physician will also review any other medical conditions that you may have that might be the cause of your male impotence, or erectile dysfunction. Drug interference with a man's ability to have an erection accounts for one-fourth of all male impotence cases.

Your physician will also conduct a physical exam. It is possible that your penis is not responding to touching, which could indicate a problem in the nervous system. In other cases, abnormal secondary sex characteristics, such as hair pattern or breast enlargement, can point to hormonal problems. If this is the case, your physician may suspect that your endocrine system is involved.

If your penis has a slight curve or bends to one side, your erection dysfunction could be the result of Peyronie's disease.

If your physician suspects other causes, lab tests will be ordered to help confirm the diagnosis of erectile dysfunction, or male impotence. Tests for systemic diseases include blood counts, urinalysis, lipid profile, and measurements of creatinine and liver enzymes. If your physician suspects there may be a problem with your prostate, he may collect a sample after massaging the prostate, in addition to a routine urine sample. This special sample will contain secretions from the prostate -- and, perhaps, a few clues to the condition. Among patients with chronic bacterial prostatitis, cultures from the post-massage urine sample may be positive for bacteria. If a patient has chronic nonbacterial prostatitis, the sample will usually have high levels of white blood cells, which are a sign of inflammation.

And finally, if your physician suspects that your erectile dysfunction problem may be psychological, a test, which includes an interview and a questionnaire, will reveal certain psychological factors to help uncover the reason for the problem. In addition, the man's sexual partner may also be interviewed, to help determine sexual expectations and perceptions during intercourse.

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