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Erectile Dysfunction (ED), more commonly referred to as impotence, is a condition that occurs when a man cannot get an erection, or gets an erection but cannot sustain it adequately for sexual intercourse.

Several men have trouble getting or sustaining an erection at some time or the other, which isn't really a cause for concern. But if the problem becomes an ongoing thing, causing stress or strain in relationship, it is important to get it checked and treated by a medical expert as soon as possible. Most men are highly embarrassed discussing ED, which is why they neither speak to their doctors about it, nor get it evaluated.

However, early diagnosis and treatment can help overcome this problem to a great extent. Therefore, it is important that you visit your doctor as soon as you realize that you may be suffering from ED.

At first, your doctor may just ask you a few questions to determine your medical history, lifestyle and habits. You will also need to answer several questions on the symptoms you are experiencing.

After that, a physical exam will be conducted, where the penis and testicles will be carefully examined and the nerves will be checked for feeling. Don't be surprised if your doctor asks to interview your sexual partner too, for a deeper insight into the possible problem.

In case your doctor cannot zero in on the exact problem or wants to rule out the possibility of another underlying cause, you may be asked to undergo a few more diagnostic tests, like -

• Complete blood test: Also known as CBC, this can be described as a set of blood tests, which can help detect various conditions, including anemia. Men who are anemic usually have a low red blood cell count and often experience fatigue, which is one of the more common causes of ED. Like in case of any other blood test, a sample of blood will be collected from a vein in your arm.  
• Duplex Ultrasound: High frequency sound waves that produce images of the internal body tissues may be suggested, in order to check for problems like tissue scarring, artherosclerosis and venous leak. You will probably be given a drug to stimulate erection, so that the ultrasound can be performed while the penis is erect. The same test will also be conducted when the penis is in the flaccid state.
• Nocturnal Penile Tumescence (NPT): Under normal circumstances, men have about 5 to 6 erections when they are asleep and a complete lack of erection could point towards a nerve function or circulation problem. The NPT measures the erectile function in men, while they are sleeping. There are three ways in which this test can be performed -the snap gauge method, the strain gauge method and the electronic device method.
• Urinalysis: A lot of health information can be derived by analyzing a man's urine.  This test can alert your doctor to any abnormality in the levels of protein, sugar or hormones in the body. Common ED causing conditions like diabetes and kidney diseases are often detected through a urine test.
• Lipid profile: Conducted in the same way as a normal blood test, this measures the levels of fat or lipids in your body. At times, high cholesterol or fat levels causes hardening of the arteries, which in turn can affect the circulation of blood to the penis.
• Hormone studies: There are two main sex hormones present in men and a blood test may be suggested to check if there are any abnormalities in either of these hormones, which could be causing erectile problems.
• Thyroid function test: One of the main functions of the thyroid gland is to regulate the production of sex hormones in the body. Therefore, a thyroid function test is conducted to check if an abnormality in the gland could have caused a deficiency of sex hormones.

At times, your doctor may also ask you to go through other tests like a liver/kidney function test, penile biothesiometry, cavernosography and bulbocavernosus reflex to name a few. Before undergoing any test, do ask your doctor what is involved and why it is being conducted.

References

• http://www.ncbi.nlm.nih.gov/books/NBK38721/