The most important thing you can do to determine if you have a sexual problem is to talk honestly and openly about your symptoms with your health care provider.
Your health care provider will probably ask about your relationships, partners, past sexual history, any history of trauma, possible symptoms of depression, and any other stresses or concerns that may be interfering with your ability to respond sexually. Though these topics may seem extraordinarily private, they must be covered to properly evaluate sexual dysfunction and help you have a more satisfying sex life.
When you're planning for a hot night under the sheets, you might not want to think about STDs. If you're happily smitten with your long-time partner, you may not think you have to.
But the possibility of infections and diseases are as much a part of sex as the fun is. Both men and women get them. Even if you didn't realize it, you've probably had an STD.
Knowledge is power when it comes to your sexual health. Recognizing the symptoms is a start, but you won't always notice chlamydia, gonorrhea,...
Your health care provider will give you a thorough physical exam, checking for high blood pressure, vascular disease, a neurological disorder, or obvious signs of conditions affecting your penis or testicles. You'll probably be given a blood test to check for diabetes, thyroid disease, testosterone level, and any other hormonal disorders your health provider may suspect. In addition, your health care provider will review the list of medications and substances you use (including natural remedies) to track whether your sexual dysfunction is connected with them.
Because men normally have multiple erections during sleep, you'll probably be asked about whether you ever awaken with an erection. Sometimes men are asked to undergo a test in a sleep lab to be monitored for erections during sleep. While this information can help tell whether erectile dysfunction may be due to problems with the vascular or nervous systems, it doesn't necessarily indicate whether the erection is sufficient for sexual penetration. An ultrasound exam that measures the blood flow within the pelvis (a penile Doppler study) can determine whether there is enough blood flow and pressure in the penis to allow for an adequate erection.
A measurement of blood pressure in the penis, called the penile-brachial index, may be helpful in diagnosing penile vascular disorders. A test dose of an erection-inducing agent, such as papaverine, is injected into the penis under a doctor's supervision, followed by monitoring for a subsequent erection. Also, penile blood pressure can be measured during the erection. During this exam, contrast dye may also be injected into an artery so X-rays can reveal any leaks in the vascular system that could account for erectile dysfunction.