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This is a delicate topic, and your doctor should be sensitive and caring to make you comfortable about sharing these intimate details of your private life. Schedule enough time with your doctor to conduct a full interview and physical examination. The first step in the medical management of erectile dysfunction is taking a thorough sexual, medical, and psychosocial history.
 

• Your doctor will ask if you have difficulty obtaining an erection, if the erection is suitable for penetration, if the erection can be maintained until the partner has achieved orgasm, if ejaculation occurs, and if both partners have sexual satisfaction.
  
  
• You will be asked about current medications you are taking, about any surgery you may have had, and about other disorders (history of trauma, prior prostate surgery, or radiation therapy, for example). 
  
  
• The doctor will want to know all medications you have taken during the past year, including all vitamins and other dietary supplements.
  
  
• Tell the doctor about your tobacco use, alcohol intake, and caffeine intake, as well as any illicit drug use.
  
  
• Your doctor will be looking for indications of depression. You will be asked about libido (sexual desire), problems and tension in your sexual relationship, insomnia, lethargy, moodiness, nervousness, anxiety, and unusual stress from work or at home.
  
  
• You will be asked about your relationship with your sexual partner. Does your partner know you are seeking help for this problem? If so, does your partner approve? Is this a major issue between you? Is your partner willing to participate with you in the treatment process?

A physical examination is necessary. The doctor will pay particular attention to the genitals and nervous, vascular, and urinary systems. Your blood pressure will be checked because several studies have demonstrated a connection between high blood pressure and erectile dysfunction.

The physical examination will confirm information you gave the doctor in your medical history and may help reveal unsuspected disorders such as diabetes, vascular disease, penile plaques (scar tissue or firm lumps under the skin of the penis), testicular problems, low male hormone production, injury, or disease to the nerves of the penis and various prostate disorders.

You can achieve a satisfactory erection and sexual health, and working with your doctor or a specialist (urologist) is the best way to get help.

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