Review your medical history. Relevant items include: your age, weight, cholesterol level, blood pressure, smoking, drinking, over- the-counter and prescription drug use (see page 90), recreational drug use, any recent acute illnesses, and any history of depression, anxiety, heart disease, stroke, diabetes, prostate surgery, pelvic injury, hormonal problems, multiple sclerosis, sickle-cell anemia, spinal cord injury, priapism, Peyronie's disease, or exposure to toxic chemicals.
Review your psychological history. This includes any symptoms of anxiety, depression, phobias, panic attacks, or a fundamentalist religious background in which sex was considered taboo. Bear in mind that drugs used to treat anxiety and depression may have erection-impairing side effects.
Drugs. jot down all the medications you take, both over-the-counter and prescription. Take the list with you. Also, honestly declare how much alcohol you drink and any recreational drugs you use.
Get tested. Tests should include:
- Blood pressure. High readings are associated with ED.
- Cholesterol. High levels increase risk of ED.
- Testosterone. Abnormally low levels usually suggest
libido loss, but also contribute to erection problems.
- Glucose tolerance. This tests for diabetes, which
increases your risk of ED.
- Thyroid function. Low levels of thyroid hormone are
linked to ED.
- LH and Prolactin. Low levels of these pituitary hormones
may cause ED.
- PSA. The screening test for prostate cancer.
- Nocturnal Penile Tumescence. This test involves attaching a strain gauge to the penis to see if you have erections while you sleep. The absence of nighttime erections strongly suggests that physical factors are causing the problem.
While physicians are well-equipped to evaluate the physical
causes of erection impairment, they may not be the best
professionals to evaluate the extent to which the problem
results from the very real issues of sexual mythology,
relationship problems, emotional stress, or nonsensual
lovemaking. To explore these issues, consult a sex therapist.
(See chapter 15.)
Regardless of its cause, erection impairment has a major
impact on men's lives. The University of Chicago survey asked
men with and without ED if they felt happy or unhappy. Those
with ED were four times more likely to say they were unhappy.
"For many men," Sugrue says, "the ability to raise an erection
is the very essence of manhood. As a result, many men consider
an erection problem much more than just a sex problem. Many
men with ED consider themselves complete failures as men. That
can cause tremendous anguish."
Reprinted from Great Sex: A Man's Guide to the Secret
Principles of Total-Body Sex by Michael Castleman. Permission
granted by Rodale, Emmaus, PA 18098.
Copyright © 2008 Michael Castleman
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