Vascular erectile dysfunction occurs when blood flow to or from the penis is disrupted. An evaluation examines medical history, sexual health, physical findings, and blood flow, and these areas help identify possible causes. The process includes several assessments, but not every person needs specialized testing.
Reviewing Your Medical History
The evaluation of vascular erectile dysfunction begins with a discussion of medical and sexual history. A specialist asks about symptoms, medications, and health factors, and questions about erections help establish how the condition presents. The discussion also covers when symptoms began and whether erections occur during sleep or in the morning.
You will likely complete the IIEF-5 questionnaire. It contains five questions that assess erectile function, and the total score helps categorize the severity of erectile dysfunction. The questionnaire also provides a way to track changes over time, while the medical history gives the specialist additional information about the condition.
Learning About Vascular Erectile Dysfunction
The physical exam is focused and relatively brief. A specialist examines general body characteristics, and the genital exam checks the testicles and penis for findings that could relate to erectile dysfunction. The exam also includes a neurological check, which assesses sensation and reflexes, while a digital rectal exam checks the prostate.
These assessments address several possible contributors. The specialist looks for physical findings that relate to hormonal, neurological, or other causes, and the results add information to the medical history. A physical exam also provides information that helps guide the next part of the evaluation, while the specialist determines whether additional testing is needed.
The examination covers several areas. General findings provide information about overall health, and the genital exam focuses on structures related to sexual function. When the initial evaluation provides enough information, specialized testing is not always needed, but further assessment is available when the cause remains unclear.
Reviewing Blood Tests
Blood work forms another part of the evaluation. A morning total testosterone test is used, and additional testing can include hemoglobin A1C and a full lipid profile. These tests assess hormone levels, blood sugar, cholesterol, and triglycerides, while other hormone tests might follow when testosterone levels are low or borderline.
Blood testing also supports the broader evaluation. Erectile dysfunction has associations with conditions such as diabetes and cardiovascular disease; the results provide information about factors that can contribute to the condition. When blood work is scheduled, fasting might be required before the appointment.
Performing Vascular Testing
Specialized vascular testing is used when the cause remains unclear. Penile Doppler ultrasound is the most common specialized test; it measures blood flow into and out of the penis after medication triggers an erection. The ultrasound evaluates arterial blood flow and can identify findings associated with venous leakage.
The vascular evaluation also examines whether the problem involves insufficient blood entering the penis or blood leaving too quickly. Arteriogenic erectile dysfunction involves narrowed or blocked arteries, while venogenic erectile dysfunction involves venous leakage. When these findings are identified, the evaluation can distinguish between the two vascular categories.
Schedule a Professional Evaluation
A vascular erectile dysfunction evaluation combines several types of information. Medical and sexual history provide context, while physical exams and blood tests add clinical findings. When the cause remains unclear, specialized vascular testing provides additional information, and the results help identify whether the condition has an arterial or venous component.