HOW TO DIAGNOSE IMPOTENCE?

The inability of a male to sustain an erection for intercourse is termed as Erectile Dysfunction (ED) or male impotence. It affects one out of every ten men in America. As 30 million of men are affected due to ED and men in the age group 40 and above are more prone to it. Its Signs and symptoms are characterized by the inability to maintain erection. Normal erections during sleep and in the early morning suggest a psychogenic cause, while loss of these erections may signify underlying disease, often cardiovascular in origin. Other causes leading to erectile dysfunction are diabetes mellitus (causing neuropathy) or hypogonadism (decreased testosterone levels due to disease affecting the testicles or the pituitary gland). Impotence is treatable at all age groups, and awareness of this fact has been growing. More men have been seeking help and returning to near- normal sexual activity because of improved, successful treatments for impotence. Impotence is diagnosed by finding the problem, and it is done as: Patient History Medical and sexual histories help define the degree and nature of impotence. A medical history can disclose diseases that lead to impotence. A simple recounting of sexual activity might distinguish between problems with erection, ejaculation, orgasm, or sexual desire. A history of using certain prescription drugs or illegal drugs can suggest a chemical cause. Drug effects account for 25 percent of cases of impotence. Physical Examinations A physical examination can give clues for systemic problems. If the penis does not respond as expected to certain touching, a problem in the nervous system may be a cause. Abnormal secondary sex characteristics, such as hair pattern, can point to hormonal problems, which would mean the endocrine system is involved. A circulatory problem might be indicated. Laboratory tests Several laboratory tests can help diagnose impotence. Tests for systemic diseases include blood counts, urinalysis, lipid profile, and measurements of creatinine and liver enzymes. For cases of low sexual desire, measurement of testosterone in the blood can yield information about problems with the endocrine system. Other tests Monitoring erections that occur during sleep can help rule out certain psychological causes of impotence. Healthy men have involuntary erections during sleep. If nocturnal erections do not occur, then the cause of impotence is likely to be physical rather than psychological. Tests for this are not completely reliable. Psychosocial Examinations A psychosocial examination, using an interview and questionnaire, reveals psychological factors. The man