Erectile dysfunction - Diagnosing erectile dysfunction

Erectile dysfunction (ED) can often be diagnosed by your GP. They will talk to you about your situation and may carry out a physical examination.

Your GP may ask you about:

your symptoms
your overall physical and mental health
your alcohol consumption
whether you take drugs
whether you are currently taking any medication

If you do not want to talk to your GP about erectile dysfunction, you can visit a genitourinary medicine (GUM) clinic. You can find your nearest GUM clinic on the British Association for Sexual Health and HIV (BASHH) website.

Sexual history

You'll also be asked about your sexual history. Try not to be embarrassed because erectile dysfunction is a common problem. You can request a male GP at your surgery if you prefer.

You may be asked about:

your previous and current sexual relationships
what your sexual orientation is
how long you have been experiencing erectile dysfunction
whether you can get any degree of erection with your partner, on your own or when you wake up in the morning
whether you have been able to ejaculate or orgasm
your libido (your level of sexual desire)

Erectile dysfunction that happens all the time may suggest an underlying physical cause.

Erectile dysfunction that only occurs when you are attempting to have sex may suggest an underlying psychological (mental) cause.

Assessing your cardiovascular health

Your GP may assess your cardiovascular health. Narrowed blood vessels are a common cause of erectile dysfunction and linked with cardiovascular disease (conditions that affect the heart and blood flow).

Your GP may:

measure your blood pressure to see if you have high blood pressure (hypertension)
listen to your heart rate to check for any abnormalities
measure your height, weight and waist circumference to see if you are a healthy weight for your height
ask you about your diet and lifestyle, for example, how much exercise you do
test a sample of your blood for glucose (sugar) and lipids (fatty substances), as high levels can indicate conditions affecting your heart or blood vessels

Physical examinations and tests

A physical examination of your penis may be carried out to rule out anatomical causes (conditions that affect the physical structure of your penis).

If you have symptoms of an enlarged prostate, such as weak or irregular urination, a digital rectal examination (DRE) may be suggested.

Blood tests can also check for underlying health conditions. For example, measuring the levels of hormones such as testosterone can rule out hormonal conditions, such as hypogonadism (an abnormally low level of testosterone).

Further testing

In some cases you may be referred to a specialist for further testing. This might be the case if you are unusually young to be experiencing erectile dysfunction as it's rare in men under 40 years of age.

Intracavernous injection test

An intracavernous injection test involves injecting a man-made (synthetic) hormone into your penis to increase the blood flow. This helps assess any abnormalities in your penis and plan surgery.

If the injection doesn't result in an erection it may indicate a problem with the blood supply to your penis. In some cases, you may also need an ultrasound scan.

Arteriography and dynamic infusion cavernosometry or cavernosography

These specialised tests involve injecting dye into the blood vessels of your penis and studying the dye on a scanner. These are likely to be used if you are being considered for surgery or if a problem has been detected with your blood vessels.

Psychological assessment

If the cause of your erectile dysfunction is thought to be psychological, you may be reffered for a psychological assessment.