Diagnosing erectile problems: When should I see a doctor?
See a doctor immediately if your erection lasts longer than three hours. Also, see a doctor immediately if you have taken type 5 phosphodiesterase, such as sildenafil (Viagra), tadalafil (Cialis) or vardenafil (Levitra) and you’re experiencing chest pains.
Tell your doctor that you took these medications. Don’t take medications containing nitroglycerin if you feel any chest pains and have already taken sildenafil (Viagra) or vardenafil (Levitra) in the last 24 hours, or tadalafil (Cialis) in the last 48 hours.
See a doctor if your erectile problems are accompanied with:
- any kind of injury of the back, legs, buttocks, groin, penis or testicles;
- loss of pubic or axillary hair and/or enlarging of the mammary glands.
Be sure to see a doctor in the next week or two if you have difficulties with erectile function more than 25 percent of the time, and if the problem:
- occurs alongside constant back pain;
- began after you started taking a new medication or changed the dose of a current medication;
- affects your self-esteem and prevents you from feeling like normal;
- doesn’t go away in spite of any action you’ve taken.
If your erectile dysfunction only occurs periodically, there’s no need to see a doctor. If an erectile problem occurs often but doesn’t really bother you or your partner, it’s up to you to decide whether to see a doctor or not.
Attentive waiting is taking a “let’s wait and see” approach. Some episodes of impotence are only temporary and easily solved. Don’t fear that it will happen every time. Forget about your failures. If possible, focus on having more success the next time. If you or your partner are worried about erection problems, then discuss the issue, speaking openly about your fears and concerns.
If all the measures you’ve undertaken don’t bring about the desired result after two weeks, and if you’re worried about having difficulty achieving or sustaining an erection, see a doctor who has the necessary qualifications and experience in treating such problems.
Who should I contact?
Some workers in the healthcare field (including doctors and psychiatrists) may feel uncomfortable discussing issues connected to sexuality and erection problems. Ask your doctor how competent they are in this area and whether they have experience in treating erectile dysfunction.
The following healthcare workers will be able to identify the symptoms of erectile dysfunction:
- Family doctor,
- A medical worker who sufficient credentials to run their own practice,
If there’s a possibility that your erectile dysfunction is being caused by a psychological problem, then your doctor may forward you to one of these specialists:
- Social worker with a diploma,
- A consultant who is qualified in the field of sexual and interpersonal problems.
Read the article “How to get the most out of your doctor’s appointment” to prepare yourself for your visit.
Analysis and Tests
As there are both organic and psychological factors in each and every case, sometimes it’s difficult to diagnose the exact cause of erectile problems.
Your doctor may do the following during the preliminary diagnosis:
- Define the risk factors that could be causing your erectile dysfunction (impotence). Please refer to the article “What increases the risk” in this section to find more information;
- Ask questions about your sexual function;
- Conduct a full medical examination of your belly, penis, prostate, rectum and testicles;
- Refer you for the following analyses:
- Testosterone: A low testosterone level can lower sexual attraction and cause erectile dysfunction;
- Prolactin: A high level of prolactin (hyperprolactinemia) can indicate the formation of small tumor in the hypophysis that can affect the levels of other hormones in the body. Erectile dysfunction, in this case, can occur due to changes in your hormonal state.
- Thyroid gland hormone: High or low levels of thyroid gland hormone can cause problems with sexual attraction and erectile dysfunction.
- Glucose: An increased glucose level in the blood indicates the possibility of diabetes mellitus, which can also cause erectile dysfunction.
Usually, oral medicines are recommended at this stage, such as sildenafil (Viagra), tadalafil (Cialis) or vardenafil (Levitra), unless an easy-to-identify cause of erectile dysfunction has been found (for example, a side effect from medication or a low testosterone level). If oral drugs won’t help or if your doctor feels you should undergo additional analyses, he/she may recommend you to:
- go for more tests to identify erection problems like, for instance, a test to determine nighttime erection (rigidity test) or a test involving intracavernous injection. Both of these tests help define whether the reasons for your erection problems are organic or psychological;
- visit a psychologist if there is reason to suspect a psychological cause.
An ultrasound test will be required if the doctor suspects you have problems with blood circulation (diseases of the peripheral arteries). Even if your arterial disease isn’t treatable, you’ll find it helpful to at least know of its existence, as it can indicate a risk of other diseases involving the blood vessels. In some cases, you might be appointed to undergo a radiography of the blood vessels to check blood flow through your arteries. This test is very rare since only a few men have benefited from treatment to restore blood vessels pumping blood into the penis.