The diagnosis of erectile dysfunction

If you're having trouble with erectile dysfunction, this checklist may sort out the origin of the problems and clarify your thoughts and feelings about the matter.

Question 1: Do you have any of the following problems with sex?

  • Low libido in general

  • Low libido towards my partner

  • Not getting aroused (turned on)

  • Not keeping an erection sufficient for intercourse

  • Not having an erection in the first place

  • Not reaching orgasm, even though I feel turned on

  • Coming too quickly

  • My orgasm that lacks any real intensity

  • I have an orgasm but not I do not ejaculate

  • I feel pain while having sex

This question should identify your problem. As you can see there are many possible problems, but if you can pick a clear one from the above, then you are much closer to identifying the real issue.


Other pages of information on the diagnosis of erectile dysfunction

Home ] [ ED checklist ] The symptoms of ED ] Psychogenic or organic ED? ] Guidelines for the treatment of Erectile Dysfunction (1) ] Revised guidelines for the treatment of ED (2) ] Primary and secondary ED or erectile dysfunction ]
[ Treating, curing and preventing erectile dysfunction ]

Question 2: When did you last have a normal erection and a normal ejaculation?

This helps to identify how long you have had a problem with erectile dysfunction (ED), and that make indicate the origin: a short time means there may be some psychological issue behind the erection difficulties. Erectile dysfunction that's lasted for longer and has developed slowly but gradually may have a physical cause - for example, poor blood flow.

Question 3: When you masturbate do you get an erection? If so, is it a full erection?

Being able to get a full erection when you masturbate, or your partner masturbates you, means you have a normal blood supply and normally working nerve system in your penis. If you can't get erect for intercourse, then you probably have an emotional issue that is stopping you getting erect.

Question 4: Do you have a morning or nocturnal erection, and if so, what percentage of a normal erection is it?

Nocturnal erections (or nocturnal penile tumescence) is a sign of a healthy penis, and means the problem is not physical. A healthy penis will become erect between three and five times each night. You may not be aware of this (though your partner may); the presence of a more obvious erection in the morning when you awaken probably means your ED has a psychological cause.

Question 5: If you read porn or see a porn film, do you become erect?

An erection caused by erotic stimulation is a good sign that the function of the nervous system and blood supply to the penis are normal, which again suggests a psychological cause of your ED.

Question 6: Do you sometimes get an erection but not at other times?

Having an erection sometimes but not at other times is a good sign that your ED is psychologically based. If there were a physical cause, you might never get an erection.

Question 7: Does erectile difficulty occur only with a certain partner?

Obviously if you find that you only have erectile dysfunction with one partner, and not others, this is a clear indication that it's unlikely to be a physically based problem of impotence. It also suggest that psychosexual therapy or counseling might be useful.


Question 8: Is your female partner aware you are asking for help?

Clearly a man who is impotent but has told his partner what he is doing about it is has good communication with her and this means that treatment is more likely to be a success.

Question 9: Does your partner support your actions?

In essence, a man who has support from his partner is more likely to be able to recover his potency and get over erectile dysfunction quickly. Men whose partners do not offer support tend to be angry and resentful, and this slows down or prevents recovery of potency.

Question 10: Is your partner sexually attractive to you?

You may well imagine that if you do not find your partner sexually attractive, you may not feel sexual desire and you may not get aroused. This is what we might term situational impotence or erectile dysfunction.

Question 11: Has erectile dysfunction caused any of the following problems?

  • Cool atmosphere at home

  • Less communication and talking

  • Avoidance of discussion of sex

  • More arguments and disagreements

  • Withdrawal and isolation

  • Less trust between the two of you

  • Spending less time together

Erectile dysfunction may affect a couple's relationship in many ways: arguing, depression, avoidance, discouragement, distrust, frustration are just some of the ways this can manifest.

Question 12: Do you initiate sexual activity, or does your partner?

If you or your partner tend to initiate sex unequally, this may mean you have very different interests in sex or in the relationship. Certainly it would be more equal for both partners to initiate sex when they wanted to be satisfied or to satisfy their partner.

Question 13: Do you like your partner to come every time you have sex?

Many men with erectile dysfunction often resent the commitment they feel they must make to sex - especially when they feel they have to "give" their partner an orgasm every time they have sex. Also, another unrealistic expectation is that all sessions of sex must end in intercourse and thrusting. Such preconceptions can cause anger, resentment and eventually erectile dysfunction.


Question 14: Have any of these medical conditions ever affected you?

  • High blood pressure

  • Heart disease

  • Heart attack

  • Diabetes

  • Thyroid gland disease

  • Testicular disease

  • Multiple sclerosis

  • Parkinson's disease

  • Other neurological disease

  • Stroke

  • Kidney disease

  • Cancer

Any illness like these can cause erectile dysfunction, and if you have any of them, or have ever had any of them, please make sure that your doctor or therapist knows about them. The same is true of the following surgeries:

Question 15: Have you had any of the following surgical procedures?

  • Removal of the prostate

  • Removal of the bladder

  • Rectal or colon surgery

  • Cardiac bypass

  • Disk surgery

  • Vascular surgery of the legs or major blood vessels

All of these conditions can cause impotence because of their effect on blood flow to the penis or possible damage to nerves.

Question 16: Do you take prescription medications?

Medicines such as antidepressants, sedatives, drugs for stomach acidity, hormones, blood pressure pills, and some cold medications can play a part in erectile dysfunction.

Question 17: Did your sexual problem begin soon after taking a new drug?

If your difficulty with erectile dysfunction began after starting a new drug, it could be that this is causing  your problem.

Question 18: Have you ever had an erection that lasted several hours?

Although unlikely, if you've ever had an erection that lasted more than four or six hours, there may have been damage to your erectile tissue, and sadly, this is usually permanent.

Question 19: Do you smoke, drink excess alcohol, use illegal drugs, or have a too-high cholesterol level?

Any of these things - smoking cigarettes, elevated cholesterol levels, excess alcohol, or lack of exercise - may cause erectile dysfunction.

Question 20: If you have had heart problems, or you have ever had a heart attack, do you fear dying during intercourse (or is your partner frightened of this?)

Anxiety after a heart attack may stop you having sex, and if your partner is worried about this too, she may be frightened of sex for fear of you having another a heart attack or stroke. You may think she is simply not interested: communication is the key to understanding what is going on here.

These questions are intended to help you understand ED: especially, is it psychological or physical, or both? Once you know the cause of your difficulty, you will better know how to deal with it.

Other sections of this website about erectile dysfunction

Home ] Diagnosis of Erectile Dysfunction ] The Causes of Erectile Dysfunction ] Effects of Erectile Dysfunction On Men and Their Partners ] Treatment for Erectile Dysfunction ]