Finding the cause

The patient's medical history will usually give a good indication as to the cause of the problem. As doctors, we try and find out whether one of the conditions is present. Information about these conditions may indicate a probable cause. Other features to look for are a family history of any of the diseases, including whether there has been an injury, trauma or surgery in the pelvis, the genitals or the rectum.
Your doctor will also ask you whether you have taken any of the following drugs in the past three months:
• prescription medications (sedatives, antihypertensives, anti-depressants, hormones, H2 antagonists for stomach ulcers or reflux)
• over-the-counter medications (pseudoephedrine, eg Sudafed)
• recreational drugs (alcohol, marijuana, cocaine, amphetamines, anabolic steroids, and so on)
• tobacco.

Finding out whether there is a psychological cause
The recording of a sexual history is important as well. This helps to determine whether the cause of your condition is psychological, or whether your condition has had a major psychological impact on your personality. The following questions are useful in this process:
• What problems do you have with intercourse?
• What problems do you have getting or keeping an erection with your sexual partner?
• How often do you wake up with an erection?
• Can you get an erection by other means such as fantasizing or masturbating?
• How often do you have problems with ejaculating?
• Under what circumstances do you have a problem with getting or maintaining an erection?
• How long has this been a problem?
• How satisfied are you with your sexual functioning?
• Under what circumstances do sexual images interest you?
Other questions will be asked that investigate whether you are having problems in your relationship:
• Are you and your partner sexually attracted to each other?
• When do you and your partner have problems in your relationship?
• How satisfied is your partner with your sexual interaction?
• How often do you argue with your partner?
• How emotionally attracted are you to each other?
• Under what circumstances do you enjoy each other's company?
• Under what circumstances do you feel rejected by each other?
• Do you talk things over with your partner?
• What do you find attractive about your partner?
• Are you in love with your partner? How strong is your love for your partner?
• What are your partner's feelings for you?
• How interested is your partner in sex?
The doctor may also try to establish whether there is a trigger for your erection failure. Was your problem at first associated with work or marital stress, drugs or alcohol, fatigue, a new partner, bereavement, anger, and so on? The doctor may try to search for issues that continue to plague your confidence such as anxiety with sexual encounters (performance anxiety, frustration with failure), arguing over sex, or resignation to not having sex.

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THE INTERVIEW

WHAT IS THE NORMAL SIZE FOR A PENIS?

WHAT CAN GO WRONG IN THE ERECTION PROCESS

News

TAKING ESTROGEN

With the onset of menopause, many women suffer from hot flashes and night sweats. Arlene March, 56, a Los Angeles psychotherapist, says she started getting hot flashes 5 years ago. “I’d be working,” she recalls, “and suddenly feel intense heat all over my body. I’d break out in a sweat. I’d have to stop work. Then Dr. Mishell prescribed estrogen pills, and I’ve not had a day of discomfort.”
Some women experience a drying and thinning of vaginal tissues in the absence of estrogen, making sex painful. They also might suffer urinary tract infections and incontinence. Estrogen therapy often helps.
Among the physicians consulted, the most cautious was Dr. Morris Notelovitz, founder of the nation’s first Menopause Center, at the University of Florida, and head of the Women’s Medical and Diagnostic Center in Gainesville, Florida. He says each symptom needs a different treatment and advises that genital tract problems be given estrogen treatment for a couple of years at most. He also urges special measurements of the bones before prescribing estrogen therapy for osteoporosis.
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WOMENвЂ™S HEALTH

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ERECTILE DYSFUNCTION SYMPTOMS

Most patients have a combination of two or more of these problems. They are usually first given a thorough medical history and examination to determine the extent of the problem and to hopefully pinpoint a cause. I want to briefly outline the nature of these four symptoms so that your problem will make more sense to you as a patient if you are experiencing any of them.

PRESCRIBED DRUGS

Taking prescribed medications with most vitamins is safe as is taking herbal complexes that are available through health food stores. However, you should always check with your doctor, your pharmacist or your naturopath. They are all trained to know what can go with what.

Weight loss

Overweight is most commonly a result of overeating and lack of exercise. Overweight and fluid retention often go together with people who have glandular problems or under-active thyroids. In such cases an iodine and phosporous deficiency may be the cause.

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