What information should I provide to a healthcare provider to help them understand my erectile dysfunction?

What to Tell Your Healthcare Provider About Erectile Dysfunction

When presenting to a healthcare provider for erectile dysfunction, you must provide a comprehensive sexual, medical, and psychosocial history covering symptom onset and pattern, cardiovascular risk factors, medications, psychological factors, and relationship context to enable proper diagnosis and treatment planning. 1

Sexual History Details You Should Provide

Symptom Characteristics

• When did your erectile problems begin? Specify whether onset was sudden (suggests psychogenic causes) or gradual (suggests organic causes) 2
• How severe are your symptoms? Describe whether you have difficulty getting an erection, maintaining an erection, or both 1
• How much does this bother you? Quantify your level of distress about the problem 1
• Do you have morning or nighttime erections? The presence of these suggests (but doesn't confirm) a psychological component rather than purely physical causes 1, 2
• Can you achieve erections during masturbation? This helps distinguish between physical and psychological factors 1
• Is the problem situational? Specify if it occurs only with certain partners, in specific settings, or consistently in all situations 1
• What treatments have you already tried? Include any medications, devices, or other therapies and how well they worked 1

Medical History You Must Disclose

Cardiovascular and Metabolic Conditions

• Heart disease history: Including angina, heart attack, heart failure, irregular heartbeats, or stroke 1, 3
• Blood pressure problems: Both high blood pressure (especially if uncontrolled) and low blood pressure 1, 3
• Diabetes status: Including blood sugar control and duration of diabetes 1, 2
• Cholesterol levels: History of high cholesterol or lipid disorders 1
• Family history: Specifically family history of heart attacks or vascular disease 1

Other Medical Conditions

• Prior surgeries: Especially pelvic surgery, prostate surgery, or any surgery near the genitals 1
• Neurological conditions: Including spinal cord injury or nerve damage 1
• Kidney or liver problems: Including whether you require dialysis 3
• Eye conditions: Particularly retinitis pigmentosa or history of sudden vision loss 3
• Blood disorders: Such as sickle cell anemia, multiple myeloma, or leukemia 3
• Penile conditions: Including Peyronie's disease (curved penis), previous prolonged erections lasting over 4 hours, or deformities 1, 3
• Stomach ulcers or bleeding problems 3

Complete Medication List

• All prescription medications: Particularly antihypertensives, antidepressants, and tranquilizers, as these commonly cause erectile dysfunction 2
• Nitrate medications: Including nitroglycerin tablets, sprays, ointments, or patches for chest pain—this is critical as these cannot be combined with ED medications 3
• Recreational drug use: Including "poppers" (amyl nitrite, butyl nitrite) and other substances 1, 3
• Over-the-counter medications, vitamins, and herbal supplements 3

Psychosocial Factors to Discuss

Mental Health Status

• Depression or anxiety symptoms: These are primary or secondary contributors to erectile dysfunction 1, 4
• Major life stressors: Recent significant life events affecting your mental state 2
• Performance anxiety: Worry or stress specifically about sexual performance 4

Relationship Context

• Current relationship status: Whether you have a partner and the quality of that relationship 2
• Partner's perspective: How your partner views the problem and their level of distress 1
• Communication about sex: How comfortable you and your partner are discussing sexual concerns 1

Lifestyle Factors to Report

• Smoking status: Current or past tobacco use 1, 5
• Alcohol consumption: Frequency and amount 1
• Exercise habits: Level of physical activity and sedentary behavior 5
• Weight status: Current weight and any recent changes 5

What to Expect During the Visit

Physical Examination

Your provider will check 1, 2:

• Vital signs: Blood pressure and pulse
• Genital examination: Looking for penile skin lesions, urethral opening position, plaques, or deformities by stretching and palpating the penis from base to tip
• Testicular size and secondary sexual characteristics: To assess for low testosterone
• Cardiovascular assessment: Including checking pulses in your legs

Laboratory Tests

Expect blood tests including 1, 2:

• Morning total testosterone level: Must be drawn in the morning for accuracy
• Fasting glucose or hemoglobin A1c: To screen for diabetes
• Lipid profile: To assess cholesterol levels
• Additional tests if indicated: Such as thyroid function or prostate-specific antigen based on your history

Critical Safety Information to Understand

Erectile dysfunction is a risk marker for underlying cardiovascular disease—your provider will likely want to evaluate your heart health, as ED symptoms often appear three years before coronary artery disease symptoms 1, 5

Never take ED medications if you use nitrates or "poppers"—this combination can cause dangerous drops in blood pressure leading to heart attack or stroke 3

Sexual activity itself carries cardiovascular risk—your provider needs to assess whether your heart can safely handle the physical demands of sex, which typically requires 2.5-5.4 metabolic equivalents of energy 6