Erectile dysfunction or impotence refers to the inability of a man to achieve an erection or maintain it for sexual intercourse. If the cases when a man can’t achieve and maintain erection are single, then there is nothing to worry about. The diagnosis is set with a stable poor erection, lasting for not less than for 3 months.
Severe impotence is rare in young people but the first alarming symptoms may appear early. Weak erectile dysfunction is found in 71.3%, moderate in 6.6%, severe in 12%. According to American data, there are 26 new cases per year per 1000 men (MMAS study). Among men between 30 and 80 years, the prevalence of erectile dysfunction increased from 2.3% to 53.4% with increasing age and the addition of concomitant pathologies. The exact answer, at what age this pathology develops, does not exist, but experts note that more and more young people face this unpleasant problem.
What Kind of Examination Can Be Prescribed
After a medical examination and a conversation, your doctor can refer you to the following examination methods:
- Clinical blood test (general blood test): This is a comprehensive blood test, which, among other things, can reveal anemia in a person. Anemia is caused by a low content of red blood cells in the blood and can contribute to an increased fatigue of the body, which in turn causes impotence.
- Functional tests of the liver and kidneys: These blood tests can determine whether impotence is a consequence of impaired liver or kidney function.
- Blood test for fats: This blood test measures the level of lipids (fats), for example, cholesterol. A high level of lipids may indicate an atherosclerosis (hardening of the arteries), which can disrupt the blood circulation of the penis.
- Functional Diagnosis of the Thyroid Gland: The function of one of the thyroid hormones is the regulation of the production of sex hormones, the deficiency of which leads to the development of impotence.
- Blood test for hormones: The level of testosterone and / or prolactin in the blood can be measured in order to detect abnormalities from the normal concentration of any of these hormones.
- Urinalysis: From the analysis of urine, you can find out a lot of different information, for example, the level of protein, sugar and testosterone. If the content of these substances in the blood differs from the norm, this can be a consequence of diabetes, kidney disease or a low content of testosterone. All this can lead to impotence.
- Duplex scanning: This test is one of the most effective for detecting impotence. At ultrasonic research high-frequency waves are used for reception of a visual estimation of tissues of an organism. For patients suffering from impotence, duplex scanning can be used to assess the state of the blood flow and identify signs of venous leakage and atherosclerosis, as well as to assess the state of the vascular walls. This test is carried out twice: the first time the penis is in the erect state (often after the injection of the drug that stimulates the erection) and the second time – in a relaxed state.
- Bulbocavernous reflex: This test verifies the sensitivity of the nerve endings of the penis. To do this, the doctor will compress the head of your penis, which should lead to contractions of the anal sphincter muscles. If the function of nerve endings is impaired, the response will be slow, or muscle contraction will not occur.
- Biotesiometry of the penis: This test uses electromagnetic vibration to assess the sensitivity of the penis and its innervation. Reduced sensitivity to these vibrations can indicate damage to the nerves.
- Injection of the vasoactive drug: During the test, an erection will be caused by the injection of a special solution that promotes the expansion (increase) of blood vessels and doses
Collection of Anamnesis with Erectile Dysfunction
Before sending you to do any tests, the doctor must examine your medical record and conduct a thorough medical examination. The doctor can also ask you questions about your personal and sexual life. Some of these questions may seem to you too intimate and even indecent. However, it is important that you answer them honestly. Among such questions can be the following:
- What medications are you taking right now? This includes prescription drugs, over-the-counter medicines, herbal supplements, dietary supplements (BAA), and illicit drugs or alcohol.
- Have you encountered any psychological problems, such as stress, fear or depression?
- When did you first notice symptoms of impotence?
- What is the frequency, quality and duration of your erections?
- What kind of sexual equipment do you use?
- Are there any problems in your current relationship with a partner?
- Do you maintain a relationship with several sexual partners?
- If you have more than one sexual partner, do you experience impotence with both of them?
The doctor may also want to talk with your sexual partner, as the latter can guess the reasons for your erectile dysfunction.
Examination of erectile dysfunction in men involves a number of instrumental studies. With their help, it is possible to identify ED-provoking diseases, if any, in the patient. In addition, the physical methods help to assess the condition of the blood vessels of the penis, reveal prostatic diseases, detect any neurogenic disorders. So, to set a diagnosis you need to go through:
- Ultrasound examination of the prostate;
- Dopplerographic examination of the vessels of the penis;
- Monitoring of nocturnal spontaneous erections;
- Examination of the adrenal glands, thyroid gland, testicles;
- Neurophysiological diagnostics;
- With its help, you can determine whether there are abnormalities in the operation of the spinal cord.