Also, if you recently began taking a new medication to control high blood pressure, that could provide an important clue. For example, if you have a long history of diabetes, there's a strong possibility that your impotence is related to vascular disease or neuropathy, which are common complications of diabetes. Because ED is associated with many common medical conditions and medications, your accurate responses to these questions can provide important clues to the cause of your ED. The doctor will ask you questions about recent physical ailments; about your use of prescription, over-the-counter, or illegal drugs; and about your alcohol consumption and smoking habits. If you have been seeing a doctor on a regular basis, he or she should have your medical history, but the information will need to be updated. Physicians differ in the way they practice medicine, but a basic work-up generally includes a medical history, including the psychological and sexual aspects; a physical examination; and appropriate laboratory testing. A reputable physician will not prescribe treatment without taking a medical history and conducting a physical examination. An important word of caution: If a doctor offers a treatment option without thoroughly evaluating your medical and sexual history and conducting a basic Physical examination, it would be wise to see another doctor. If you are not comfortable with your current doctor, or don't have one, refer for advice on finding a doctor. If your doctor is unable to find a physical cause for your impotence, or feels that your emotions are a contributing factor, he or she may want you to consult with a psychiatrist or a psychologist. If your doctor finds evidence of a hormone deficiency, he or she may prescribe hormone replacement therapy for you, or refer you to an endocrinologist for further testing and treatment.

Many of my patients have been given testosterone preparations by their family physician or urologist before coming to see me. If you never wake up with a firm erection, then a Physical problem with your blood flow or your nerves ay be the cause. If you always wake up with an erection, it is unlikely that your impotence is caused by a physical problem. One of the most important questions your doctor will ask is: "Do you wake up in the morning with a full, firm erection?" Your sexual history provides important information that helps the doctor decide what further evaluation is needed. Some of these questions may seem too personal and embarrassing, but your doctor needs to know about your emotional health and your sexual functioning to correctly diagnose and treat your impotence. The doctor will also ask questions about your levels of stress and fatigue, as well as detailed questions about your sex life and your relationship with your partner.