A doctor will ask about your symptoms and medical history and perform a physical exam. Be prepared to identify every medication you are taking. As many as 25% of erectile dysfunction cases are attributed to medications. Be prepared to answer questions about the frequency, quality, and duration of your erections. Your answers may help determine if primarily psychological and/or physiological factors are causing your impotence.

Because penile erection is a complex interaction of both halves of your autonomic (automatic) nervous system, your blood circulation, and your emotions, some symptoms may suggest a psychological issue. These can include problems as depression, and/or a medical problem such as diabetes.

Symptoms of these issues include:

• A less firm penis
• Fewer erections
• Fewer spontaneous nighttime erections

The doctor will examine your penis, testes, and rectum. If a physical cause is suspected, laboratory tests may be ordered. The following factors will be evaluated:

• Routine laboratory tests: Blood count, urinalysis, and a battery of blood chemistry tests will evaluate your general health.
• Testosterone: If you are over 50 years old or if your doctor suspects hypogonadism (small testes and reduced bodily hair), a blood test for testosterone will be ordered.
• Endocrine tests: Other endocrine tests may be ordered, such as TSH, prolactin, and fasting blood sugar.
• Nocturnal erections: Potent men have spontaneous erections at night. If you do not remember them because you were asleep, there are devices that can measure and record them.
• Psychology: There are always psychological factors associated with sexual functioning, whether they are the cause or just a result. You and possibly your partner may be given a questionnaire to help determine what emotional and psychological factors may be contributing to your condition.

Treatment involves the following:

• Lifestyles modifications
• Medications
• Surgery
• Counseling
• Alternative and complementary therapies