Tests - Diagnosing Erectile Dysfunction: Mens Sexual Health

Content provided by the Faculty of the Harvard Medical School

Tests

Now that medication can successfully treat most men with erectile dysfunction, many once-routine diagnostic tests are used only when the doctor suspects the patient has an underlying problem requiring additional treatment.

Hormone tests. Checking testosterone levels used to be one of the first tests ordered for men with erectile difficulty, but that was before doctors realized that testosterone deficiency was rarely the source of the problem. Now, hormone testing is done for men whose medical exams suggest an endocrine problem and for those who have experienced a loss of sexual desire.

Your doctor also may want to check your blood levels of prolactin (a pituitary hormone that can block the action of testosterone) or thyroid-stimulating hormone (a good indicator of an underactive or overactive thyroid gland). These tests also used to be commonplace, but are now done only if your doctor thinks you might have a hormonal deficiency or imbalance.

Blood flow tests. A color duplex Doppler ultrasound, an imaging technique, can reveal problems with blood flow through the arteries or veins of the penis, such as venous leakage. A newer version, called penile Doppler, can be done in a physician's office. If you've tried pills for erectile dysfunction but haven't found them helpful, your doctor may inject prostaglandin, a fatty acid that widens blood vessels, into your penis to see if this causes an erection. If so, there's a good chance that you will respond to one or more of the injectable drugs used to treat erectile dysfunction (see "Injections").

Nocturnal tumescence tests. If it's unclear whether your erectile difficulties have a psychological or a physical cause, your doctor may suggest a nocturnal penile tumescence test. Psychological factors come into play when you're trying to achieve or maintain an erection. But the psyche doesn't affect nocturnal erections, which occur involuntarily during sleep. Physical causes affect both kinds of erections.

There are several ways to test for nocturnal erections. Medical devices may be attached to the penis to monitor its circumference or its rigidity throughout the night. A low-tech alternative is the postage stamp test. Simply paste a strip of postage stamps around your penis before going to bed. If the strip breaks by the morning, you've had at least one nocturnal erection. This confirms that erection is physically possible and indicates that the difficulty you've been having is probably due to psychological issues.

Last updated:	September 05, 2008