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How is ED diagnosed?

Patient History

A person's medical and sexual histories help define the degree and nature of ED. The medical history can disclose diseases that lead to ED, and a simple recounting of sexual activity might identify problems with sexual desire, erection, ejaculation, or orgasm.

Use of certain prescription or illegal drugs can suggest a chemical cause because drug effects are a frequent cause of ED.

Physical Examination

A physical examination can give clues to systemic problems. For example, if the penis is not sensitive to physical touch, a problem in the nervous system may be the cause. Abnormal secondary sex characteristics, such as unusual hair pattern or breast enlargement, can point to hormonal problems, which would mean the endocrine system is involved. The doctor might discover a circulatory problem by observing decreased pulses in the wrist or ankles. And unusual characteristics of the penis itself could suggest the source of the problem-for example, a penis that bends or curves when erect could be the result of Peyronie’s disease.

Laboratory Tests

Several laboratory tests can help diagnose ED. Tests for systemic diseases include blood counts, urinalysis, lipid profile, and measurements of creatinine and liver enzymes. Measuring the amount of available testosterone in the blood can yield information about problems with the endocrine system and may explain why a patient has decreased sexual desire.

Other Tests

Monitoring erections that occur during sleep-nocturnal erections-can help rule out certain psychological causes of ED. Healthy men have involuntary erections during sleep. If nocturnal erections do not occur, then ED is likely to have a physical rather than a psychological cause. Tests for nocturnal erections are not completely reliable, however. Scientists have not standardized such tests and have not determined when they should be conducted for best results.

Psychosocial Examination

A psychosocial examination, using an interview and a questionnaire, can reveal psychological factors. A man's sexual partner may also be interviewed to determine expectations and perceptions during sexual intercourse.

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This is the Government on Crack

The war of drugs is now four-decades old. President Nixon started the campaign in 1971. After thousands of deaths, millions of arrests and billions of tax dollars spent, drug prohibition remains solidly intact despite fervent debate contesting the effectiveness of this now forty-year old policy.
A recent report by LEAP, the Law Enforcement Against Prohibition, details how the current administration policies continue to do more harm than good despite the Obama rhetoric to the contrary. LEAP members consist of current and former local, state and federal law enforcement agencies that have battled the war on drugs. According to former Baltimore narcotics officer and LEAP director, Neil Franklin, the United States jails more people than any other country in the world, making nearly two million drug arrests a year.

Drug Czar

The Obama administration and his drug czar, Gil Kerlikowske, the head of the Office of National Drug Control Policy, now devote more resources to policing than prevention. The 2004 federal drug budget was split 55 percent for supply reduction, policing and 45 percent for demand reduction, prevention and treatment. The 2012 Obama budget now has a 60 percent increase in policing while reducing prevention and treatment to 40 percent.
Obama rhetoric with regard to medical marijuana has been more talk than walk. During 8 years of the Bush administration there were about 200 federal raids, while under Obama there have already been about 100 raids in just two and a half years, notes LEAP.
The drug war only empowers the structures they purport to combat, reports former DEA agent, Sean Dunagan, who worked in Mexico and Guatemala. The illicit drug trade is big business and the prohibitionist model only turns a multi-billion dollar industry over to the criminal cartels. The huge profit incentive combined with powerfully resilient criminal organizations have shown that prohibition is a failure and alternatives need to be sought to address the problem of addiction as a social problem. While LEAP members acknowledge that ending prohibition will not defeat the drug cartels, it will decrease the power of the cartels.
The report by LEAP is only one of many that support ending prohibition for a four-decade old policy.