How Is Erectile Dysfunction Diagnosed?

Erectile dysfunction (ED) is a problem that causes distress both in the sufferer and their sexual partner.

However, relationship problems are not an unavoidable consequence of having ED. As Mark L. Held, Ph.D., a clinical psychologist, explains it1: “almost every man will experience ED at some point, but it is how he deals with it that counts.” 

Men who actively seek treatment are more likely to get better and keep their relationships healthy and happy. This is why it is so important to talk about ED as talking is the first step in finding treatment and saving your relationships.

To get a better grip on how ED could affect your relationships, continue reading.

What Is Erectile Dysfunction?

Erectile dysfunction, which is defined as an inability to achieve or maintain erections firm enough for sexual intercourse, affects anywhere between 5 and 35% of all men, according to a study2 published in the International Journal of Impotence Research. Despite ED being so common, men with ED will rarely seek medical help for this condition. 

This is a problem in itself as ED is often a symptom of a severe medical condition such as diabetes and cardiovascular disease, so not addressing ED may lead to these medical conditions going unnoticed until it is too late. 

Most men who experience ED for the first time instead choose to avoid addressing the issue altogether or try to treat their problem with drugs, supplements, or alternative remedies. Men will also rarely talk about ED with their partners, which can cause relationship strains. 

It is not uncommon for men to experience problems with erection, and although it is generally thought only older men are affected, a study from the Journal of Sexual Medicine3 discovered that younger men battle with erectile issues too. 

The research showed that one in four patients with erectile difficulties is a young man. Besides the treatment recommended by the doctor, one’s lifestyle choices such as nutrition matter as well.

Symptoms Of Erectile Dysfunction

Men should realize what symptoms may indicate erectile dysfunction. Having difficulty with an erection now and then is considered normal. This may be due to a stressful day.

Perhaps you are going through a tough time. There are, however, cases where you need to take action. This is important if the erectile difficulties are becoming more frequent.

The main symptoms of erectile dysfunction include:

  • You may not be able to get an erection when you are sexually stimulated. 

  • If you get an erection, it may not be rigid enough for sexual intercourse. 

  • When you have an erection, it may go away, and your penis becomes flaccid too quickly. 

There are other accompanying symptoms that some men tend to experience. If you have erectile dysfunction, you may find that your sexual desire is low too.

You may feel less interested in being involved in sexual activities with your partner. When your sex drive is low, it can worsen the existing erectile dysfunction symptoms you experience. 

What Causes Erectile Dysfunction?

There are many reasons why men develop erectile dysfunction. Some causes are linked to short-term erectile difficulties. When the cause resolves, the erectile function starts to improve again.

In other cases, you may find that erectile dysfunction affects you over a long period of time. In some men, there is even a complete inability to get an erection at all. 

Both physical and psychological causes need to be considered. Your physical health plays a role in the physiology behind erectile. At the same time, certain mental health problems can also contribute to poor erections. 

It is essential to understand how an erection works. The process does not start at your penis. Your brain first needs to be sexually stimulated for an erection to occur. When your brain receives sexual stimulation, it sends a signal to your penis. 

Upon receiving this signal, your penis relaxes the muscles at its base. This allows blood to start filling two of the chambers in your penis. As the blood enters these chambers, your penis starts to swell up. This causes you to achieve an erection.

The chambers are called corpora cavernosa. The penile arteries in these chambers fill with blood. The muscle at the base of your penis contracts once the chambers fill up with blood. This ensures the blood remains inside your penis.

In turn, your erection lasts during sexual intercourse. For the erection to go away, the muscles relax again, allowing the blood to flow out of your penile chambers. 

Physical Factors Linked To Erectile Dysfunction

Poor blood circulation is one of the most common reasons why men experience erectile dysfunction. If you have blood flow problems, it means not enough blood reaches your pelvic area.

In turn, there is not a sufficient amount of blood to flow into your penis when you experience sexual stimulation. Sometimes, blood does enter your penis, but it leaves your penis too soon. This means your erection goes away too soon. 

Some diseases that can affect blood flow to your penis include:

  • Atherosclerosis

Other conditions can affect your erectile function too. Men with diabetes are more likely to develop problems with their erectile function. This is because diabetes can cause damage to nerves. Some nerves help to send signals through the body. This may interfere with signaling to your penis. 

Other physical causes linked to erectile dysfunction include4:

  • Being obese or overweight increases your risk.

  • Multiple sclerosis.

  • Some prescription drugs can cause erectile dysfunction. 

  • The use of tobacco products also puts you at a higher risk for this condition. 

  • Alcoholism can increase the risk of erectile dysfunction. 

  • Men receiving treatment for prostate cancer are more likely to experience erectile difficulties. 
  • Parkinson’s disease is also a risk factor. 

Men with low testosterone may also develop sexual dysfunction. No direct link exists between testosterone and erectile function. It is known that this hormone regulates a man’s sex drive.

When a man has a low sex drive, his sexual performance is likely to suffer. Thus, by reducing the man’s libido, low testosterone may contribute to poor erectile function. An imbalance in testosterone is also linked to premature ejaculation

Psychological Factors Linked To Erectile Dysfunction

An erection starts at the brain. This means poor mental health is a big contributor to erectile dysfunction symptoms. Thus, it is important to consider mental conditions that may cause poor erectile function. 

Large amounts of stress can cause problems with your erectile abilities. This is often what causes short-term low libido. In turn, you may find that your erection is not as rigid as usual after a long day at the office. 

When stress becomes chronic, it can cause erectile dysfunction symptoms too. 

Depression and anxiety are also common psychological problems that lead to erectile dysfunction. Both of these conditions can cause problems with your libido. When your libido is low, you do not feel like having sex. In turn, you may find that your erection is also weak. 

If you have a relationship that is going through a tough time, then this may also cause erectile problems. Poor communication is a common reason for relationship troubles. 

How Is ED Diagnosed?

The diagnosis of erectile dysfunction can be somewhat tricky. An erectile dysfunction test can involve various procedures. There are many reasons why a man may experience these symptoms.

Doctors generally try to identify a specific cause. This will help the doctor offer more targeted treatment for their patient. By addressing the underlying cause of erectile dysfunction, symptoms may improve more effectively and faster. 

Medical And Sexual History

When a man has an erection problem, the doctor starts by taking a look at his medical history. Sexual history also needs to be taken into account. The doctor needs to understand if you have been diagnosed with any conditions.

Some medical conditions can cause you to experience erectile dysfunction symptoms. The doctor also needs to know if these conditions are being treated. If so, the doctor requires details of the drugs you are taking. 

The doctor will closely examine these factors. This allows them to determine if any existing factors may be contributing to your ED symptoms. The doctor might make suggestions based on their findings in your medical history.

If you have a history of sexual problems, the doctor wants to know about them too. This helps them determine if you had problems with your erections before a specific condition was diagnosed. 

Physical Exam

A doctor also needs to conduct a physical examination. There are a few things that a doctor will look for during a physical exam. The doctor may feel the abdomen area of your body. Your groin region may also be closely inspected. This helps the doctor identify problems like inflammation or an enlargement of certain organs. 

Depending on accompanying symptoms you have, additional factors may be considered during a physical exam. This may include a digital rectal exam. If this procedure is needed, the doctor will need to place a finger into your rectum. The doctor will use a glove during a digital rectal exam. A lubricant is also applied to the glove. This helps to reduce discomfort during the procedure.

The doctor will feel for abnormalities with your prostate during this exam. It can help in identifying problems like an enlarged prostate. Sometimes, signs of prostate cancer are also identified during a digital rectal exam. 

Blood And Urine Tests

A doctor may order certain urine and blood tests. This can help in determining specific potential causes behind erectile dysfunction. 

Blood tests are used to determine if the man has problems with their blood flow and heart5. A blood test can also help to detect the possibility of diabetes. A doctor may also test your testosterone levels with a blood sample. This helps the doctor determine if low testosterone might be behind your erectile dysfunction symptoms. It shows if there may be blood vessel problems too. 

A urinalysis can also look for a few diseases. A doctor may test for diabetes with a urinalysis. Other underlying medical problems can also be detected with a urine test. 

Overnight Erection Test

In some men, an overnight erection test may also be requested. This helps the doctor monitor the spontaneous erection you have while you sleep. You will get a device to take home. You need to place the device around the shaft of your penis before you get into bed.

The device will then count the number of erections you have during the night. It will also provide a measurement of how intense these erections are. This helps to determine if you have a nocturnal erection.

When positive results are found with the device, a doctor will look at your mental health. In such a case, depression and other mental disorders are considered to be potential underlying factors. The fact that you have erections while you sleep means your penis gets adequate blood flow. 

Injection Test

An injection test is sometimes used. This is also referred to as an intracavernosal test7. A specific substance is injected into your penis. The injection is made at the base of the penis. Once injection, you should get an erection. This helps the doctor determine if you may suffer from blood circulatory problems. 

If you do not get an erection once the injection was made, it means there may be an issue with your blood circulatory system. Insufficient blood is sent to your penis. In such a case, a doctor may request further tests. This will help the doctor identify the issues that are affecting your blood flow. 


An ultrasound may be ordered. This can be the case if the doctor identifies an abnormality with your prostate gland. A digital rectal exam is needed first. The ultrasound will provide a view of your prostate.

It helps the doctor see if there are any issues with this gland. This may include growths, which could indicate prostate cancer. The doctor can also detect benign prostatic hyperplasia, or an enlarged prostate, with an ultrasound. 

Mental Health Exam

If tests for physical causes fail, then the doctor will request a mental health exam. This will be conducted by a psychologist. The mental health professional needs to consider whether there may be any mental health problems that affect your libido. 

You may be tested for a variety of mental health problems. This includes depression and anxiety. 

The psychologist will ask about your personal life. Be sure to tell them if there is anything that stresses you out. If you feel depressed, note this to the mental health professional. It will help them make a more accurate conclusion. When a psychological cause is identified, it will be treated with the appropriate medication. 

Treatment Options For ED

Treatment for erectile dysfunction depends on the diagnosis. A doctor will base the treatment on the findings during the testing procedure when you were diagnosed with the condition. By addressing an underlying cause, the treatment may yield more successful results. 


Some drugs can help to provide a more immediate effect when treating ED. The most popular drug would be Viagra. Viagra is a PDE5 inhibitor. This drug helps to increase erectile rigidity and quality. It takes only about an hour to start working. A few side-effects can happen when you take Viagra. Several alternative medications exist too. These all work in similar ways. 

If a doctor identifies an underlying cause, they will target it with a treatment plan. If you have hypertension, the doctor will give you medicine to lower your blood pressure levels. When mental conditions are affecting your sexual performance, a psychologist may provide you with the appropriate medication. 

Testosterone replacement therapy may be suggested if the patient has low testosterone. This might improve signs of the impotence of libido is low. 


In rare cases, surgery may be used to improve erectile function. This is the last resort. Other treatments are usually tried first. An implant can be made into your penis. The penile prosthesis may help to make your penis more rigid during sexual intercourse. If there are problems with the structure of your penis, they may be corrected through a surgical procedure too. 

Natural Alternatives

A few natural supplements seem to be helpful for men with erectile dysfunction symptoms. You need to consider the drugs you take at the moment. This will help you identify potential interactions.

If there is no concern about interactions, then these natural supplements might be a way to improve your erectile function. 

A few supplements that you can try out include:

  • Rhodiola Rosea.

Lifestyle Changes

A couple of lifestyle changes can also make a big difference. You will need to take a closer look at your current lifestyle to determine what changes should be made. 

If you are obese, then try to lose weight. Obesity significantly increases your risk of erectile dysfunction. By losing weight, you also improve your heart health and reduce your risk of diabetes.

If you live a sedentary life, then try to become more active. Even simple activities like taking a walk may help to boost your blood flow and get more oxygen into your body. This also helps you shed excess pounds. 


Although widespread, problems with erection have a major impact on men’s confidence and emotional wellbeing. Fortunately, it is possible to manage ED and improve sex life with some lifestyle modifications and, of course, adhering to the doctor’s instructions.


  1.  Everyday Health. (2011) Erectile Dysfunction and Your Relationship. [online] Available at:
  2. Nature Journal. (2002) Prevalence of erectile dysfunction: a systematic review of population-based studies. [online] Available at:
  3. Journal of Sexual Medicine. (2013) One Patient Out of Four with Newly Diagnosed Erectile Dysfunction Is a Young Man – Worrisome Picture from the Everyday Clinical Practice. [online] Available at:
  4. 5 HHS Public Access. (2014) Screening Strategies for Cardiovascular Disease in Asymptomatic Adults. [online] Available at:

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