How to Test for Erectile Dysfunction
Erectile dysfunction (otherwise known as E.D.) is an increasingly more common problem among men these days. E.D. can be caused for numerous reasons. These can be summed into two factors: physical problems and psychological problems. In order to rule out what is causing the problem, there are tests that can be administered by your doctor to determine the root of your ED.
There are many physical conditions that can be causing your erectile dysfunction. For example:
- Nerve problems within the penis that can be caused by many things. Many illnesses such as diabetes or MS can cause damage to the nerves and thus affect a man’s ability to properly perform in bed. Surgery near the pelvic area or any other type of pelvic injury can also be a culprit for nerve damage in the penis. Also, a man who has undergone radiation treatment for prostate cancer, colon cancer or any other pelvic related area radiation can also suffer nerve damage to that area.
- Trouble with the blood supply to the penis. There are certain conditions that can cause the arteries in the penis to harden (this is called atherosclerosis). Blood flow can also be affected with certain activities such as professional cycling, which causes the blood flow to that area of the man to be constricted for an extended period of time.
- Low thyroid or testosterone levels.
- Taking certain medications that can cause impotence as a side effect. Medications that have been known to have these negative side effects in certain cases have been depression meds and hypertension (high blood pressure) meds.
- Using illicit drugs (i.e. heroin, etc.), alcohol or tobacco has also been known to affect a man’s ability to get an erection at times.
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Initial Testing
The first tests that will be administered in a doctor’s office to determine the cause of your erectile dysfunction are general physical exams and lab work.
For the physical, you can expect the doctor to examine the regular things such as:
- blood pressure, etc
- and also do a tactual examination of the penis and testicles to check for any irregularities.
- Lab work will include blood tests to determine different hormone levels (for example: prolactin, testosterone, thyroid, etc.), complete blood count, cholesterol and triglyceride levels, as well as glucose levels to rule out undetected diabetes. A urine sample may also be administered.
When taking blood tests or giving urine samples, there isn’t any special preparation that needs to be done. Giving a blood sample may hurt a little and might cause some bruising at the site where the needle was inserted but there are really no major risks with getting blood work done. To avoid bruising you can apply pressure to the area for a few minutes after the needle is retrieved.
If tests appear to be normal, your doctor may put you on a trial course of some type of ED medication such as Viagra, Cialis or Levitra to see how you react.
Other tests that can be administered to determine whether an erection problem is physical, psychological or a combination of both include:
- Nocturnal Penile Tumescence (NPT) (Also known as the rigidity test or stamp test)
- Intracavernosal injection test
Nocturnal penile tumescence (NPT) test
It isn’t common knowledge, but the majority of men (there are some exceptions where sleeping disorders or serious depression is concerned) have between 3 to 5 complete erections while they are in deep sleep or REM (rapid eye movement as it is known). When a man can’t obtain an erection do to a psychological problem, they still manage to have full erections while they sleep.
This test is designed to determine whether a man’s erectile dysfunction is based on physical or psychological factors. If the man has a physical condition that is causing his ED then he will be unable to have a normal, full erection. On the other hand, if he does present a normal and full erection then psychological factors may be the culprit underlying the ED problem.
Tests can (and usually are) self administered at home. In some cases, they may also be administered in special sleeping labs. There are two ways to administer the test:
- A snap gauge. This is a plain ring like tool that consists of plastic films that wrap the penis. These films snap after they reach a certain pressure. This is the easiest and cheapest way of administering the NPT. It isn’t the most sophisticated but it can inform you of whether or not an erection has been obtained and also how firm the penis got when it obtained the erection.
- An electronic monitoring gadget. Unless you are looking to spend a lot more money than you should or your problem is that serious that only a very sophisticated test that gives you more accurate and detailed information that can tell you wants wrong with you, I wouldn’t do this. This gadget measures the width of the penis and is connected to a small monitor that is recording the changes in the loops the gadget has. As the penis starts to harden, the loops stretch and results are recorded. It can record every single erection you’ve had during the night with full description. Since this method is a bit more sophisticated, it usually requires the patient to stay over night at a sleep lab.
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If the gauge snaps or you have at least one monitor reading then you are presenting normal erections during sleep and your problem may very well not be physical. To make sure that the tests are accurate, it is good to repeat them at least two to three nights in a row.
Before you take the test, make sure you don’t take any type of ED medication such as Viagra beforehand. It is also recommended to stop the consumption of alcohol and/or sleeping pills at least two days before taking the test. Sometimes alcohol and sleeping pills can affect your REM and therefore affect the accuracy of the test. Once you are ready, it is recommended for you to use brief type underwear with a fly (not boxers). To administer the test, simply take out your penis through the fly as to avoid pubic hair from getting in the way and attach the device and then place the penis back into the briefs.
If none of the films break or no reading was able to be recorded then your problem is physical and more tests need to be administered to determine cause.
There is no pain or discomfort associated with the NPT and no risk in doing the test. The only thing a man might feel is a bit of embarrassment, which should be disregarded. Remember that you are doing something that is going to help you get to the root of your problem and there is nothing to be ashamed or embarrassed about. Besides, you are not alone in your struggle. There are many men that are going through the same thing everyday.
Intracavernosal Injection Test
This is the most uncomfortable test that can be administered to test for erectile dysfunction problems. In this test a specialized urologist injects a special medication into the base of the penis with a small needle. The medication that is used is usually prostaglandin E1 and allows the penis to obtain an erection.
The urologist can also choose to place a comparable medication into the urethra, which is called an intraurethral medication. Once the medication is in the penis, the doctor may massage the penis to spread the medication or apply a band around the base of the penis to avoid the medication from escaping the penis area. An erection should occur somewhere between 5-10 minutes after the injection. Once you’ve obtained an erection, the erection is then measured for fullness, stiffness and duration.
There is no need to worry if you need to take this exam. Anxiety about the test can affect the results so just try to stay calm. The test is really easy and is done right in the doctor’s office or in an outpatient clinic. It is a very simple procedure and requires minimal preparation. All you do have to make sure is that you advise your doctor of any allergies you may have to any medications so that he/she may plan accordingly. Also, inform whether or not you have any type of unusual bleeding problems or are taking any type of blood-thinning meds such as warfarin or aspirin. If you suffer from priapism (having an erection for more than 4 hours) or have ever suffered from this disorder, make sure to also comment this to your doctor.
You can expect to be asked to remove all your clothes and use a cloth to cover yourself. A nurse will then come in and clean the penis with an antiseptic. While the doctor is injecting the medication into the penis, you may feel a sudden sharp, stinging sensation at the base of the penis but it doesn’t last very long. If, however, you feel burning or actual pain then inform your doctor right away.
After the medication is administered and the doctor has done his thing, you might be asked to watch sexually stimulating movies or be asked to stimulate yourself to facilitate the erection process.
The results are usually measured on a scale of one to four with four being a full erection. If your test results show a 0-2 then your problem lies within a physical factor, however, if your results show a 3 or a 4 then your problems are most likely psychological.
After all is said and done, the doctor may administer another medication that will counteract with the first medication and cause the erection to subside if it hasn’t done so already. After this then you’re free to go.
There really isn’t any major risk with this test. There is a slim chance that you may present some bleeding or some bruising and swelling in the area where you were injected but nothing major.
If after taking all these physical exams nothing works and no physical cause can be pinpointed as the culprit of the ED problem, a psychological test may be recommended to determine other psychological factors that may be causing this ailment. Such problems may include:
- Grief / Depression
- Problems in your relationship
- Stress
- Anxiety in your ability to perform sexually
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