Diagnosis of Erectile Dysfunction
The diagnosis of erectile dysfunction begins with a full assessment of sexual health, physical condition, and emotional wellbeing. Since erectile dysfunction may be caused by multiple factors, doctors take a broad approach to identify the underlying issue and recommend the most effective treatment.
Medical History and Sexual Health Review
Doctors will ask:
How often erection difficulties occur
Whether the issue is achieving or maintaining an erection
If there’s a drop in libido
The timing and progression of symptoms
Any underlying health conditions such as diabetes, heart disease, or hypertension
Lifestyle habits, including smoking, alcohol use, or drug intake
Emotional factors like stress, anxiety, or depression
These questions help determine whether the cause is more likely to be physical or psychological.
Physical Examination
A full examination may include:
Checking blood pressure and heart rate
Examining the penis and testicles
Assessing signs of hormone imbalance such as reduced muscle mass or breast enlargement
Looking for nerve-related issues such as reduced sensation
These observations help detect signs of systemic conditions like low testosterone or nerve damage.
Blood and Urine Tests
Doctors may order:
Blood sugar and HbA1c, to check for diabetes
Lipid profile, to assess cholesterol levels
Testosterone levels, especially if there are symptoms of low libido or fatigue
Thyroid function tests
Liver and kidney function tests
Prostate-specific antigen (PSA) in older men, to screen for prostate problems
Urine tests can also detect diabetes or infections that may contribute to ED.
Specialised Tests
If the cause remains unclear, further testing may be done:
Nocturnal penile tumescence (NPT) test – Checks if erections occur during sleep, suggesting a psychological cause
Doppler ultrasound – Measures blood flow in the penis to detect vascular issues
Neurological tests – Rule out nerve damage
Diagnosis of Erectile Dysfunction In South Africa
In South Africa, many clinics focus on symptom-based diagnosis due to limited access to advanced tests. Blood pressure screening and glucose monitoring are commonly available, while hormone tests and Doppler ultrasounds may only be accessible in private or urban facilities.
The diagnosis of erectile dysfunction is often straightforward. With a full understanding of the cause, most men can be successfully treated with medication, lifestyle changes, or counselling.
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