If you have problems getting or keeping an erection, your doctor will try to find out what's causing your problems. Your doctor will probably ask you some questions about your erection problems. And you may need one or more tests.

Questions

Your doctor may ask the following questions.

• Do you have erections at night, when you wake up in the morning, or both? If you do, then you're physically able to have erections. So it may be that your erection problems happen because of your thoughts or feelings. Your doctor may ask if you have problems in your relationship or if anything's changed in your life.

• Did you start having problems suddenly? If so, then something stressful may have happened to you. Or the problem may have started after you had an operation or an injury to your groin. If your erection problems are caused by another condition, such as diabetes or atherosclerosis, they usually happen more gradually.

• Do you take any medicines? How much alcohol do you drink? Both can cause erection problems.

Tests

Your doctor may check your blood pressure. Your doctor may also look at your penis and testes.

Your doctor may take some blood to check the levels of the following substances in your blood.

• Hormones: If you have too much or too little of certain hormones, this can cause erection problems.

• Sugar: If you have too much sugar in your blood, you may have a condition called diabetes. This can cause erection problems.

• Cholesterol : If you have too much cholesterol in your blood, your blood vessels can become blocked. This can cause erection problems.

Seeing a specialist

Your doctor may say that you need to see a specialist. This is more likely to happen if you are young and have always had erection problems or if you have had an injury to your penis or pelvis. A specialist may do some other tests to see if there's a problem with the blood flow into and out of your penis.

This is the most common type of test used to see if you have a problem with the blood flow into and out of your penis.

The doctor injects medicine into your penis to widen the arteries, so blood can flow in. Then your doctor, or a technician, uses an ultrasound machine. This uses sound waves to make pictures of the inside of your body. It can show whether the blood is flowing freely through the arteries in your penis.

This is a very specialised test that is usually done only if your doctor thinks you might need an operation on the blood vessels going to your penis.^[19]

Cavernosometry tests if your veins are closing tightly enough to keep blood in your penis. You'll have fluid injected into your penis at a steady rate. If your veins are working properly and not leaking, the fluid will keep your penis firm during the test.^[3]