Health History Helps Determine Impotence

With particular attention to sexual history, cardiovascular history, history of diabetes, smoking, medications and family history, a patient’s history is the main part to be considered for the evaluation of Erectile Dysfunction. A sexual history is often difficult for the inexperienced practitioner, but again, is extremely important in determining the cause of the condition.

The most common cause of Erectile Dysfunction is diabetes mellitus , but there are other endocrine-based causes including hyperprolactinemia, which is an elevated prolactin in the serum.

Any history of enfeebling diseases such as cancer should be noted, along with treatments such as chemotherapy or radiation. Neurologic diseases, including multiple sclerosis, strokes, cord damage or other cord problems should also be discussed. Vascular surgeries, neurologic spine or inguinal surgery should also be explored for evidence of damaged blood vessels, damaged innervations, or loss of the sympathetic nerve control.

The physician should ask about sleep disorders such as sleep apnea syndromes, and about psychological problems, and also the names of any drugs used to treat them. A marital or relationship history is important and should include the frequency of intercourse including the frequency of ejaculation.

Questions should focus on the frequency of nocturnal erections, whether a patient wakes up in the morning with an erection, and whether the erections are different when not having intercourse, during oral sex or masturbation, and how they compare to one another.

All medications including all over-the-counter products should be reviewed . Tobacco use, including the amount and length of time that the patient has smoked, are important to note. Any alcohol or recreational drug use, especially marijuana or cocaine, should also be documented.

Sexual dysfunction questions should also cover significant personal problems that may exist, such as a stressful job situation, impending divorce, separation, or sex with multiple partners.