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In order that erectile dysfunction may be diagnosed, you have to "bring it up". Talk with your physician – your erectile dysfunction is not obvious to anyone outside of your sexual partner(s). Once addressed, your physician will likely conduct a detailed history and physical examination in an attempt to elucidate the potential causes of your ED.
Typical investigations in the work-up of ED:
At times the baseline work-up may be entirely negative or normal. It is at this point that your physician may refer you to a specialist or urologist. The use of nocturnal penile tumescence testing helps to differentiate physical causes of ED from psychological causes. There are low and high tech methods that document the presence and frequency of erections while you sleep. One method is a penile strap attached to the flaccid (limp) penis at bedtime. If the band is broken upon rising, then an erection is recorded. The typical number of nocturnal erections is three to four per night. A simple evaluation is the presence or absence of morning erections (piss hard-on). When present in the face of sexual difficulties, the problem is likely psychological.