Diagnosing impotence

If you suspect that you have impotence then your next step is to visit your GP. This is particularly important if your impotence or erectile dysfunction persists for several weeks, you are a diabetic or you are taking a prescribed medicine.

Embarrassed to seek help for impotence?

But, seeking help for impotence is something many men find difficult to do. Let’s be honest: no man finds it easy to admit that they have a problem with their sexual performance or are unable to achieve an erection.

Plus men are more reluctant to discuss medical problem with their partner let alone visit their GP. This seems to be something which women find easier to do than men. Women are encouraged to seek help for their medical problems whereas traditionally, men have been expected to keep a ‘ stiff upper lip’about their medical complaints.

Another factor is a reluctance to discuss ‘ intimate matters’such as sex with your GP. Many men are embarrassed or ashamed to do so and would rather suffer in silence than discuss their personal problems with another person, especially if their GP is a woman.

Some men wait for up to five years before seeking help for their impotence.

But impotence is treatable. We recognise that it is an embarrassing subject to talk about but it is important that you do so as it may be a warning sign of a more serious condition such as heart disease.

But before you visit your GP it is important to discuss this first with your partner.

Talking about impotence with your partner

Men are not very good at discussing their health or emotional issues. They prefer to keep this to themselves but with something such as impotence it is important to talk about it as it impacts upon both of you.

If you are experiencing impotence then this will affect your partner as well. It will impact upon your ability to satisfy your partner and your sex life in general. This is even more important if both of you are hoping to start a family.

Note: when we say discuss this with your partner we mean this for both heterosexual and homosexual couples. Much of this advice applies to both. We have used the term ‘ she’ here but this information also applies to homosexual couples.

It is not uncommon for men to say to their GP that they are unable to discuss their impotency with their partner but not doing so can lead to all sorts of problems.

If you don’t talk about your impotence with your partner then the following may occur:

• Your partner will feel rejected or that you have lost interest in her.
• She may think you are having an affair (a very common reason).
• She may feel unattractive or undesirable
• She may think there is something wrong with her.
• Your partner may decide to ‘ get her own back’ by having an affair or affairs.
• Your partner may assume that you are gay and have a male lover.

The worst case scenario is that she decides to divorce you.

This is why it is essential that you talk to your partner. She will be sympathetic and offer emotional support to help you overcome this. It will also reassure her that you have not found someone else or have lost interest in sex.

It is important to do this and to assure her that it is not caused by her but requires further investigation.

Plus your partner can also help you to achieve an erection. She can use her hands to stimulate you physically or orally.

Make an appointment to see your GP.

Discussing impotence with your GP

Ask your partner to accompany you when you visit your GP. It can make a difference to have your partner there as a form of moral support. It will also help when your GP discusses treatment options with you.

Are you embarrassed at the thought of talking about your impotence with your GP?

Rest assured that this is a very common problem which GP’s see all the time. They are used to dealing with cases of impotence on a regular basis and will consider it a routine matter.

Will I be wasting my GP’s time?

No. Your GP will treat this matter seriously and sympathetically. He or she (you may prefer to see a male GP) will be familiar with the symptoms and causes of impotence and the various forms of treatment.

Doctors are aware that this is something which many men find embarrassing so will adopt a matter of fact approach to it.

If you are uncomfortable at the thought of discussing this with your GP then you can always speak to a doctor at a ‘ Well Man’ clinic or a specialist such as a urologist who deals with male urinary and genital problems.

So what questions should you ask your GP?

It is a good idea to prepare a few questions beforehand and write these down. Take these with you when you visit your GP and make a note of the answers. This can make the process easier to deal with.

If you are worried about not using medical terminology to describe your problem then have a look at the glossary of medical terms in this guide. But, do not worry if you use slang or colloquial terms as your GP will be familiar with those.

Here are a few suggestions for questions to ask your GP:

• What do you think is causing my impotence?
• How it will be treated?
• Would making a few lifestyle changes help?
• Is my prescription medication causing my impotence?
• Do I need to take medication?
• Are there are any side effects of this medication?
• Is this treatment available on the NHS or do I have to pay for it?
• Will my impotence be cured?

Some men adopt an approach in which they visit their GP with another medical problem but then mention about their impotence before they leave. Whilst it may seem easier and less embarrassing it is better for you and your GP if you are honest and upfront about your impotence.

Remember: your GP will be used to dealing with this problem on a regular basis and will take the time to discuss it with you. If for some reasons, he/she is not experienced in this matter then he/she will refer you to someone who is.

Whatever information you give your GP will be kept confidential.

What your GP will ask you

Your GP will ask you a few questions in regard to your erectile dysfunction. Whilst these may seem frank they are designed to find out what might be causing your impotence.

He or she will ask you about your lifestyle, medical history and symptoms. He/she will also ask if you are taking any medication and if so, what type and, if you drink or take drugs.

Please be honest with your answers. Your GP will not pass judgement on your lifestyle but is there to find out the causes of your impotence before recommending a course of treatment.

Your GP will also ask you about your sexual history and relationship with your partner. This will include questions about your problems getting or sustaining an erection.

Examples of questions can include:

• Are you able to achieve an erection?
• How often can you achieve an erection?
• Do you only have problem getting an erection when you are with your partner?
• Can you sustain an erection?
• Do you lose your erection during sexual intercourse?
• Are you able to get an erection if you masturbate?
• Do you get an erection first thing when you awake?
• What is your sexual orientation?

Again, please answer these questions honestly as the more information your GP has the better he/she will understand your problem and how to treat it.

Your GP will talk to you and your partner about your sex life which is why it is important that both of you attend. He or she will ask if either of you have any medical conditions or have experienced any changes in your life. One such example is if your partner is going through the menopause as this often causes the vagina to become dry which may cause discomfort during sex.

Physical examination

The next step is a physical examination. This might fill you with dread but rest assured that your GP has seen it all before and will perform this examination in a professional manner.

This will include a look at your genitals and may include a rectal examination to examine your prostate gland.

Further investigation

Your GP will carry out a series of tests which include a blood test, urine test (possibly) and a blood sugar test “ if you are a diabetic. He/she may also check your blood pressure as high blood pressure is a major cause of erectile dysfunction.

If your GP thinks that you have low hormone levels then he/she may check this but this tends to be rare.

Your GP may order further tests if you are under 40 as erectile dysfunction is quire rare in young men. These specialised tests will include:

• Ultrasound: this gives a detailed overview of your penis and how the blood vessels function within it.
• Cavernosometry: a technique in which a dye is injected into your penis: this is so the doctor is able to see how this passes through blood vessels within your penis. This is a useful way of detecting any blockages or weaknesses within the blood vessels.
• Intracavernous injection test: a test in which a synthetic hormone is injected into your penis to stimulate an erection. If this fails then there is likely to be an underlying cause of this failure.

These tests are only carried out if your GP suspects that there is a serious underlying cause of your erectile dysfunction, for example, arteriosclerosis. They are designed to see how efficient blood flow is to the blood vessels within your penis and if the nerves are working correctly.

The outcome

Your GP will review the test results and any other findings before informing you of his/her decision. He or she should be able to tell you what is causing your impotence and how it can be treated.

As we have mentioned earlier: impotence is treatable and there are wide variety of options to choose from. Your GP will recommend the most suitable for you.

The important thing to remember is that all men experience some form of impotence at some point in their lives. It is very common and affects both young and old men although it is more likely to occur in men aged 40 and above.

In most cases, men only experience one or two instances of impotence but if it happens on a regular basis then you need to see your GP.

Once your GP has discussed this with you the next step is choosing a course of treatment.