Are you worried that you may have erectile dysfunction (ED)? Well, you ought to talk to a doctor about it. Don't suffer in silence! But first of all, let's just make clear what ED is.

It's what people used to call 'impotence'. And that means inability to get an erection when you want to. In other words, your penis won't get stiff enough when you want to have sex. Or it may get stiff for a while - and then you 'lose it'. So, satisfactory intercourse becomes almost impossible - which is very frustrating and distressing.

However, can we just say that if it only happens to you once or twice, then you probably have nothing to worry about. All men have a so-called 'failure' in this department at some time in their lives. Likely causes of an occasional inability to get (and maintain) a good, hard erection include:

anxiety

tiredness

stress

too much alcohol.

So, if it's only been a very rare happening with you, then you've no need to feel anxious. But if it's happening regularly, then you clearly do need a spot of advice from a doctor.

Why should you see a doctor - rather than someone else?
These days, other people do try and offer advice about erectile dysfunction. But you definitely need to see a properly-qualified medical doctor.

Why? For several reasons:

only a doctor can assess your case and decide whether you have any medical problem.

only a doctor can do any tests that may be necessary.

if it becomes necessary to prescribe treatment then only a doctor can do this.

We would strongly advise you not to go to clinics that aren't run by doctors (or which don't have doctors on the staff). These are likely to charge you a lot of money, and they cannot provide you with the services we've listed above.

Be particularly wary of private clinics where you are greeted by white-coated individuals, who are described as 'Consultants'. If in doubt, ask to see written evidence of a medical qualification before proceeding any further.

So which type of doctor should you consult about ED?
There are various types of doctor who you can go and talk to initially. These include:

your own GP.

a doctor at a family planning clinic.

a doctor at a youth advisory clinic (or Brook Advisory Clinic for young people).

a doctor at a genito-urinary medicine (GUM) clinic.

a private doctor - who could be a specialist in sex medicine, or a urologist (a surgeon who deals with the genital and urinary systems).

Talking to your GP
There's a lot to be said for beginning by talking to your own general practitioner. After all, he or she has your medical records, and may already know a lot about you (and your family).

Also, if your doctor can't actually help you, he or she should know the name of another doctor to refer you to. However, we are aware that a lot of men still find their GP somewhat unapproachable (or even embarrassed ) on sexual matters.

If this is the case with your general practitioner, then you should talk to one of the other types of doctor listed above.

Building up the courage to visit a doctor
You may feel very diffident - or even scared - at the prospect of going to a doctor. But have courage! Medical men and women are used to dealing with this sort of thing. And ED is so common these days that many of them see half a dozen cases a week. So it's quite a routine matter for them.

A good idea is to plan ahead. Work out what you're going to say to the doctor. In particular, think about what words you're going to use.

You see, a lot of men feel quite petrified about how to express the problem in words. Some guys are embarrassed because they don't even know how to pronounce the word 'impotence'.

Others are scared that the terminology that they themselves would naturally use (like 'I can't get a hard-on') might offend the doctor. (This is most unlikely!)

But there's really no need to worry about all this nowadays. All you need say is: 'Doctor - I think I've got ED.'

In the very unlikely event that the doctor doesn't understand you, just say: 'Erectile dysfunction,' instead.

Questions you may want to ask the doctor

What do you think is the cause of my ED?

Can it be treated?

What treatments are available?

Would simple alteration of my lifestyle help?

Could any pills that I'm taking be causing this problem?

Do I need medicines?

If so, what side effects could there be?

Could I get my treatment free on the NHS, or do I have to pay for it?

Will the problem ever go away so that I can stop using the treatment?

Would you be willing to see my partner and explain the situation to her/him?

Don't pretend you've got something else wrong!
Many men are so ashamed about their erection difficulties that they pretend they've got something else wrong instead!

So, they go to their GPs about some real or made-up affliction, like a sore throat or backache. And when the doctor has sorted out that problem - and it's time to leave - the patient stops by the exit and says: 'Oh, there's another thing, doc. I think I'm impotent.'

Skilled doctors are well aware of this 'ploy', which they encounter regularly. But we couldn't really recommend it! It's simpler just to tell the doctor at the outset of your consultation that you think you have ED.

What will the doctor do?
A doctor who is used to dealing with ED will make time to talk with you about the problem, even if it means you coming back on another day.

(If your doctor is not used to dealing with ED, he or she should send you to someone who is more qualified in this field.)

The doctor will ask you a set of frank questions about erection and sex. You shouldn't be shocked by them. We'll tell you what they are, so you can be prepared to answer them.

Questions the doctor should ask you
The first questions will be about erection.

Can you get an erection at all?

If so, is it hard enough for penetration?

If you can successfully penetrate your partner, do you then lose the erection? And can you get it back again?

Then there will almost certainly be questions about your lifestyle.

Are you married?

Are you gay or bisexual?

How many partners do you have at the moment?

Does the erection problem only occur with one of them, or with all?

Do you get morning erections?

Can you get an erection if you masturbate?

How much do you smoke?

How much do you drink?

Do you use drugs?

It is important to answer these questions honestly. Remember: what you tell the doctor is totally confidential.

He will also ask you questions about your general health and about what medication (if any) you are on.

Being examined
Next thing is a physical examination. A good doctor will always do a brief physical check-up in cases of ED. The doctor is mainly looking for any bodily disorders that might be the cause of your problem.

Please understand that you do have to take your clothes of for this! Many British males are extremely reluctant to 'strip off' and go to extraordinary lengths to try to keep their underpants on. But the doctor does need to see your whole body, including your genitals.

Yes, he should examine your penis and testicles with his hand - but he won't hurt you. Some doctors - but not all - do a rectal examination too. And if there is any possibility that you might have a neurological (nerve) disorder, the doctor's examination will include checking your reflexes and seeing if you can feel things like cotton wool, or a pin, applied to your skin. (This is not really an unpleasant experience.)

What about tests?
In most cases of ED, very few tests are necessary - unless the doctor's examination suggests that you may have some physical disease (which is unlikely). However, you should have your blood pressure checked, and you should certainly have your urine tested for sugar (the presence of which suggests diabetes) and for protein (the presence of which suggests kidney problems).

A minority of doctors will do blood tests, to check your male hormone levels. But most experts think this is unnecessary for the average man.

What happens next?
On the basis of his talk with you, plus his examination and tests, the doctor should probably be able to tell you there and then what he thinks is the likeliest cause of your ED. If he can treat you, he will. But he may need to refer you to someone else for this. However, please be assured that whatever the cause of your ED, there's every chance that it can be successfully treated these days.

Thanks to recent innovations - like the remarkably successful new medications for erection problems - the outlook in ED has never been brighter. So don't hesitate to have that chat with the doctor.

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