Most men will experience erectile dysfunction (ED) at some point in their lives.

Common causes of an occasional inability to get (and maintain) a good, hard erection include, anxiety, tiredness, stress, and too much alcohol.

So if erectile dysfunction has only been a rare happening with you, you’ve no need to feel anxious. If ED happens regularly, then you really should see your doctor about it.

See your doctor?
A proper medical assessment of ED is particularly important. Erectile dysfunction can sometimes be caused by another medical condition such as diabetes, high blood pressure or arterial disease or by the side effects of medication. Your GP is in a position to correct the problem if, for example, a change of medicine is all that is required.

If you need further specialist help, then of course your GP is the best person to arrange that for you.

The first appointment
Even if your GP or specialist is open and approachable it doesn’t automatically mean that broaching the subject will be easy. Many men find it inhibiting to talk about ED to a woman doctor.

Your anxiety about mentioning ED will probably soon disappear – no matter what sex your doctor is. Doctors know that ED is a far more common problem than people like to admit and will usually be keen to help. Since the advent of effective medicines ED has become much easier to treat successfully.

A good idea is to plan ahead. Work out what you’re going to say to the doctor. In particular, think about what words you’re going to use because a lot of men feel quite petrified about how to express the problem in words. Some men are embarrassed because they don’t know how to pronounce the word ‘impotence’. Others are scared that the terminology that they themselves would naturally use (like ‘I can’t get an erection’) might offend the doctor (this is extremely unlikely!). But there’s really no need to worry about all this nowadays. All you need say is: ‘Doctor - I think I’ve got a problem with my erections.’ With the ice broken, the conversation should move smoothly on thereafter.

Don’t go along to the doctor on the pretext of having something else wrong and only mention on the way out that you think you’re impotent. A skilled doctor will pick up the clue but some might not and the first part of the consultation may have wasted time that would have been better used talking about the real reason you’re there. It’s simpler just to tell the doctor at the outset that you think you have erectile dysfunction.

The doctor’s assessment
A doctor who is used to dealing with ED will make time to talk with you about the problem, even if it means you coming back on another day. (If your doctor is not used to dealing with ED, he or she will usually send you to someone who is more experienced in this field.) The doctor will ask you a set of frank questions about erection and sex. You can be better prepared to answer them if you think in advance about what they might be. First questions will probably be about the erection itself, such as:

  * Can you get an erection at all?
  * Do you have an erection on waking in the morning sometimes or never?
  * If you do get an erection, how often is it hard enough for penetration?
  * If you can successfully penetrate your partner, do you then lose the erection?
  * Can you get the erection back again?
  * Can you get an erection if you masturbate?

Then there will almost certainly be questions about your lifestyle:

  * Are you in a stable relationship or single?
  * How long have you been in the relationship?
  * Other than a problem with erections, is everything else alright with your partner?
  * If you have more than one partner, does the erection problem occur with only one of them or with all?
  * How much do you smoke?
  * How much do you drink?
  * Do you use drugs?

It is important to answer these questions honestly. Remember: what you tell the doctor is confidential. He or she will also ask you questions about your general health and check what medication (if any) you are on.

Questions you may want to ask the doctor
The consultation is a two-way process of course and at some stage you’ll want some answers to your own questions. Examples of things to think about and be clear on are:

  * What do you think is the cause of my ED?
  * Can it be treated?
  * What treatments are available?
  * Would a simple alteration of my lifestyle help?
  * Could any medicines that I’m taking be causing this problem?
  * Do I need medicines?
  * If so, what side effects could there be?
  * Could I get my treatment free on the GMS, or do I have to pay for it?
  * Will the problem ever go away so that I can stop using the treatment?
  * Would you be willing to see my partner and explain the situation to her?

Tests
In most cases of erectile dysfunction very few tests are necessary - unless the doctor’s examination suggests that you may have some physical disease. However, you should have your blood pressure checked, and you should certainly have your blood tested for sugar (to detect diabetes). Blood checks of the male hormone, testosterone, in assessing ED in a healthy man are controversial, but some doctors recommend them.

Conclusion
On the basis of the doctor’s talk with you, plus the examination and tests he may be able to tell you what is the likeliest cause of your erectile dysfunction - unfortunately, it is not always obvious. If he can treat you, he will. but he may need to refer you to someone else such as a Urologist or Psychosexual counsellor. There are a number of treatment options and failing on one type doesn’t mean you are not suitable for other options.