The diagnosis of erectile dysfunction (ED) comes from a medical doctor
or a specialist in the field of urology. The diagnosis is made after
clues are gathered from a medical history and questionnaire concerning
sexual function, a complete physical examination and laboratory
testing. An evaluation will also be done to access any medications
that you are taking by eliminating or replacing them one by one to see
if there is any improvement in the ED.

Specialized tests may help in making the diagnosis and may include
ultrasonography of the genital region. Usually the doctor will order
that an injection of medication be given and the ultrasound performed
both before and after the injection to see if there is any change in
the blood flow patterns.

As part of the diagnostic process, a neurological evaluation will be
done on the male to determine the penile vascular pressure. This
involves injecting a dye into the blood vessels which the doctor can
then view any possible abnormalities in the flow of blood to the
penis.

To determine if nonphysical factors are involved the doctor may ask
you about the occurrence of erections during masterbation, when you
are with a partner and also while you are sleeping. Usually men are
not aware of the erections during sleep, so a test can be performed
that will record the presence of these nocturnal erections. If
nocturnal erections are occuring than it is likely that the ED is
caused by nonphysical factors. This then, is an important test to take
in determining the risk factors and thus the cause of the ED.

Treatment for Erectile Dysfunction:

There are many treatment options available for men. The doctor or
specialist treating the man will offer the least invasive treatment
options first before graduating to the more invasive ones.

Treatment options include medications, mechanical devices, surgery and
psychological counseling. Both the cause and the severity of your ED
will be taken into consideration when designing the treatment plan.
You will be able to have input during this planning phase and your
input will be needed regarding the progress that is made during
treatment as well.

Insurance plans may cover the cost of treatment if the cause of your
erectile dysfunction is a medical one.

Medications:

The oral medications used to treat ED are: Sildenafil (Viagra),
Tadalafil (Cialis) and Vardenafil (Levitra). Viagra was the first pill
for ED and was approved in 1998 by the Food and Drug Administration
(FDA). Viagra is perhaps the most commercially advertised drug for ED.
These drugs must not be taken by men who are also on nitroglycerin for
heart problems as it can cause a drastic drop in blood pressure. These
three medications although similar vary in dosage, duration of
effectiveness and also for possible side effects. There are currently
no studies comparing these three medications with each other.

There is a needle-injection therapy, a self-administered intraurethral
therapy, hormonal replacement therapy, vacuum devices that can be
used, vascular surgery and penile implants.

Psychological counseling may also be beneficial for both physical and
nonphysical causes for ED. Psychological counseling may also benefit
the sexual partner as well.