Erectile Dysfunction Tests

Doctors once believed that most erectile dysfunction (ED) was caused by psychological problems. That is no longer thought to be the case.

Some erection problems are psychological. However, doctors now recognize that many cases of ED are caused by underlying medical problems.

A physician’s initial evaluation for ED will typically involve taking a simple medical history and performing a physical examination. If this initial evaluation suggests a physical cause for your ED, diagnostic tests may be necessary to determine the underlying cause.

Tests for Erectile Dysfunction
A variety of different tests can be used to identify the cause of your ED.

Physical Exam
A detailed physical exam can help your doctor assess your overall health. Your doctor will likely check your blood pressure and ask about any recent injuries or illnesses. They will ask about your current medications or supplements. They will examine the penis and testicles for changes in sensitivity.

Psychological Testing
Your doctor may want to assess whether any psychological problems could be contributing to your ED. You will probably be checked for signs of stress, depression, and anxiety. Your doctor may ask about your relationship with your romantic partner. Detailed questions about your sex life may also be asked.

Nocturnal Erection Test
Men usually have erections at night as they sleep. Because there are so many different highly coordinated physiologic systems that are required to achieve an erection, the presence of nighttime erections can help determine whether your ED has a physical or mental cause.
A nocturnal erection test can determine if you have nighttime erections. This test involves placing a ring of special tape on the penis before sleep. If you have an erection, the tape will separate overnight. If there is genuine dysfunction of the muscles, blood vessels, hormones, or nerves required to produce an erection, then nocturnal erections will be absent.
This could be due to underlying medical conditions such as stroke, high blood pressure, diabetes, or multiple sclerosis. On the other hand, if all of the biologic systems needed for an erection are functional and the cause of ED is psychological, then nighttime erections will still be present during the deep slumber typical of the REM phase of sleep.

Blood and Urine Tests
Blood and urine tests can detect signs of diseases associated with erectile dysfunction. Such diseases include:
· diabetes
· heart disease
· kidney disease
These tests can also indicate if hormone levels might be playing a role in your ED.

Ultrasound
An ultrasound uses sound waves to see inside the body. It is a very effective way of examining blood flow. When a man has ED, an ultrasound can check blood flow in the penis. An ultrasound wand is simply moved over the blood vessels that supply the penis..
Sometimes, an injection may be used to stimulate an erection before this test. Then an ultrasound can check whether blood flow increases appropriately. Pain from the injection is rare. If you do have discomfort, it will likely be mild and go away quickly. However, if you are afraid of injections, talk to your doctor. It may be possible to use an erectile dysfunction drug, such as sildenafil, before the test instead.

Medication Erectile Disfunction

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 It is believed that 25% of cases of ED in some way connected with the intake of medicines. For example, the Massachusetts study on issues of aging men found that the frequency of ED was 28% among patients receiving treatment for diabetes, 39% among cardiac patients, and 15% among men - hypertensives receiving drug therapy. At present we know a large number of drugs that adversely affect the various links in a sexual act. Some of them have an effect on the central mechanisms of erection (antidepressants, antihypertensive medications central action), while others interact with the peripheral components of the arc at the level of the corpora cavernosa (blockers). Clinical signs of drug ED is relatively rapid onset, temporal association with drug intake, negatively affects the various links in a sexual act, and a decrease in severity of illness or its complete disappearance after discontinuation of the drug.
A special place in the pathogenesis of erectile dysfunction occupy such diseases as hypertension and diabetes. The main factor for the development of ED in this case becomes microangiopathy, which leads to a breach of circulation in cavernous bodies. The influx of arterial blood to the penis is carried out on the dorsal and cavernous arteries, originating from the internal pudendal artery. Further relaxation of smooth muscle elements of the cavernous tissue leads to filling of arterial blood lacunae. This, in turn, leads to compression of subtunikalnyh and emissarnyh venules and blocking the outflow of blood from the penis. This phenomenon is known as venookklyuzivny mechanism. Hypoxia, hypercholesterolemia, hyperglycemia leads to phenotypic changes in cavernous tissue - namely, to increase the synthesis and accumulation of collagen with the outcome in the cavernous fibrosis. Cavernous fibrosis is the main link in the pathogenesis of ED. At 48 h after the erection of the cavernous tissue develops, the degree of hypoxia, at which the induction of collagen synthesis in the cavernous tissue. Oxygenation cavernous tissue occurs during erection of the penis. In men with normal sexual function, not even sexually active, 4-8 episodes of spontaneous erections during the night to ensure adequate oxygenation cavernous tissue to prevent the changes leading to fibrosis. In diabetes the existing microcirculatory disorders aggravated by progressive autonomic neuropathy. There is a correlation between ED and coronary artery atherosclerosis. These diseases have common risk factors - hypertension, dyslipidemia, diabetes, smoking, sedentary lifestyle.

Erectile Dysfunction and Impotence in Different Age

Erectile dysfunction (impotence) in different age
Erectile dysfunction is age-appropriate. So at a young age is dominated by psychogenic and functional mechanisms of erectile dysfunction syndrome (compulsive expectations of failure, violation of the regulation of erection due to vascular dystonia), as well as the true venous insufficiency of the penis. In the older age of these reasons almost no one has to consider.
For erectile dysfunction in middle-aged men are more pressing challenges in a violation of the regulation of erection due to diabetes mellitus, metabolic disorders, alcohol and nicotine, contact with radiation, spinal diseases, endothelial dysfunction.
To existing problems in men older than 45 years joined circulatory disorders in atherosclerosis, hypertension, snoring, obesity. Accumulating and summed pathogenic factors lead to an irreversible process - the formation of cavernous fibrosis, most often in the early stages of exerting themselves pathological venous leakage - withhold an erection.
We consider any erectile dysfunction is not as a fait accompli, and as the stage of disease. In the early stages are formed predominantly psychogenic mechanisms, gradually shifting in the direction of functional disorders of regulation of erection. The process ends with persistent organic anatomical changes. This is a typical course. However, there are forms of erectile dysfunction of primarily organic. For example, cavernous fibrosis due to injury of the penis (including chronic), arterial insufficiency of the penis (also traumatic nature), venous outflow due to the presence of a pathological extension of the vessel, Peyronie's disease and some others.

What is Erectile Dysfunction?

The term "erectile dysfunction" has replaced the outdated term "impotence". The word "impotence" is no longer used, because it does not give a clear explanation of the problem. Moreover, the use of this term led to an incorrect understanding of this condition. Men suffering from erectile dysfunction, are not sterile and retain the ability to ejaculation and orgasm, as well as all other men. They also have all the normal male sex characteristics. Erectile dysfunction (ED) can be defined as "inability to achieve and (or) to maintain an erection sufficient for satisfactory sexual activity."
For most men at some time in their lives may be problems with achieving and maintaining an erection, possibly due to excessive stress, receiving large amounts of alcohol, or simply fatigue. However, if this problem persists, it most likely is associated with erectile dysfunction. ED affects 100 million men worldwide and 30 million men in the United States. The study of men's health showed the overall prevalence of ED, equal to 39% in the United Kingdom, Germany, France, Canada, Italy and Spain.

Study IMSM (Massachusetts study on issues of aging men) found that 52% of men aged ot40 to 70 years in varying degrees, suffered from erectile dysfunction. Many men with erectile dysfunction to suffer in silence because they believe it - artificial problem that they have to put up with her because they grow old or because there is still nothing to be done.

Why erectile dysfunction appears?

To understand why there is erectile dysfunction, it is useful to know how an erection appears. When a man is sexually excited, his brain sends signals to nerve endings in the tissues of the penis. This causes dilation of blood vessels in the penis and increases blood flow to it, which, in turn, leads to an erection. At the same time, those vessels, which usually occurs outflow of blood from the penis, are dwindling. This combination of increased blood flow to the penis and reduce its outflow leads to a full erection.

After the sexual act is the outflow of blood from the penis, and he returns to the relaxed state.