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Diagnosis of Sexual Problems

The diagnosis of erectile dysfunction consists of two levels and depends on the patient's goals and your partner as well as age, overall health, and medical condition of the subject. The first level is a detailed medical and psychosexual history, a complete physical examination and an evaluation of hormonal and basic laboratory, followed by the discussion of treatment options without resorting to other studies. And a second level, which aims to pinpoint the cause of erectile dysfunction, and requires one or more of the following tests: psychological counseling, testing nocturnal tumescence (NPT), advanced neurological evaluation and arterial studies and venous functional.

Diagnostic tests for erectile dysfunction are divided into highly recommended, recommended, optional and specialized:

Tests highly recommended: must be performed in all patients, and include a complete medical history and physical examination.

Recommended tests: must be performed in most patients, and consist of analytical determinations such as glucose, lipid profile, free or total testosterone, at age 50, or younger if signs or symptoms of hypogonadism, such as decreased sexual desire of bilateral testicular volume, and secondary sexual characteristics.
Optional tests: recommended in certain groups of patients, depending on medical criteria, are: blood count, renal and liver function, hormones (LH, prolactin, TSH, T4 and cortisol in blood and urine).
Specialized tests: are indicated in those cases where it is necessary to distinguish between psychogenic and organic nature of the process.

They are testing objectification of spontaneous erection:

The recording of nocturnal penile rigidity and tumescence (NPT Rigiscan-) is to record erections that occur while the patient is asleep. Registration is preferentially performed for three nights.
Test of visual stimulation: is the display of erotic films they produce an erection in most men. The presence of erection possible that the cause of erectile dysfunction is organic.
More specific vascular and neurological studies could also be performed in selected patients.

The objectives of the diagnostic evaluation, either exhaustive or limited, are:

Determine the medical and psychological causes.
Assess the severity and degree of responsibility for it.
Establishing a therapeutic strategy that supports the specific diagnosis and meets the expectations of the patient and his partner.