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Conditions: Erectile Dysfunction

Identifying ED - Erectile Dysfunction

What tests can help identify the causes of ED?

The diagnosis of ED is easy. Determining why ED is occurring, on the other hand, can be more difficult. Identifying the cause of ED usually begins with a structured interview, followed by a physical examination, and possibly laboratory testing.

Determining whether a person suffers from ED rather than other sexual problems of ejaculation, orgasm, or sexual desire is an essential first step. Once ED is established, a doctor will determine the nature of ED. Finding the cause begins by asking many of the previous questions in order to obtain a medical, sexual and psychological history. These questions can be helpful in determining the severity of ED and revealing possible medical conditions or diseases that may be causing, or merely complicating, a man's ED. Sometimes a doctor may also ask their patient to complete a questionnaire regarding their sexual function which can confirm the presence of ED.

  • After this structured interview, a physical examination is performed in order to help identify physical problems that may be causing ED. A simple physical examination often includes a check for abnormalities in the penis and testicles.
  • Pulse examination - including lower extremity pulses that may indicate circulatory problems.
  • Neurological examination - including gait and postural instability, testing sensations of touch, and reflexes.
  • Rectal exam - checking sphincter tone and evaluating the prostate.
  • Abdominal examination - looking for signs of liver or kidney disease.

Some simple laboratory tests may be performed. These tests include:

  • Blood tests
    • Testosterone: Deficiency in this sex hormone can be linked to sexual dysfunction
    • Blood sugar levels - screening for diabetes.
    • Lipid profiles - determines cholesterol and triglyceride levels, possibly indicating arteriosclerosis (which can reduce blood flow to the penis).
    • Liver and kidney function - disease to either the liver or kidney can create hormonal imbalances. Enzyme and serum creatinine level analysis for liver function are indicators of kidney efficiency.
    • Thyroid function - production of sex hormones and regulation of metabolism is done by thyroid hormones.
  • Urinalysis - also analyzes sugar and hormone levels that may indicate diabetes, as well as kidney dysfunction and testosterone deficiency. In some men, further tests may be required in order to help identify the cause of ED. These include erectile function tests, such as:
    • Vascular testing: the most commonly performed tests
    • Injection testing - Agents that cause increased blood flow are injected into the erectile chamber of the penis to cause an erection. The response to the medication may aid the physician in defining the cause of the problem.
    • Duplex ultrasound - Also called Doppler color-flow mapping or Doppler ultrasound - It is a form of ultrasound that allows physicians to see the structure and blood flow through blood vessels.
    • Dynamic infusion cavernosometry/cavernosography (DICC) - A sophisticated penile blood flow test conducted in some men with ED and penile abnormalities, Usually done at major medical centers or by ED experts.
  • Neurological testing: these tests are rarely done these days.
    • Penile biothesiometry - Electromagnetic vibration is used to evaluate penile sensitivity and nerve function.
    • Somatosensory evoked potentials - Electrical, tactile or another type of stimulation of the nerves to determine nerve damage and function.
    • Pudendal electromyography - The pudendal nerve is the main nerve supplying the pelvis, bladder and urethra. Damage to this nerve can cause ED. Electromyography is a test that doctors use to detect nerve function and measure the electrical activity generated by muscles. Therefore this test can determine if damage to the pudendal nerve is the cause of ED.
  • Nocturnal penile tumescence - Men normally have erections when asleep at night, if not, this may be indicative of a problem with nerve function, hormones or blood supply to the penis.

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