For most men, oral medication is the first line of therapy for erectile dysfunction. This may be safely prescribed after a full evaluation by a general urologist. However, there are situations in which it is appropriate to seek the evaluation and treatment of a specialist:

1. If you want to thoroughly understand the cause of your erection problems. There are four main causes of erection problems: vascular, neurological, hormonal, and psychological. Often, two or more of these are contributing factors. The specialist is uniquely qualified to diagnose the cause or causes of the problem and treat it as effectively and efficiently as possible.

2. If oral medication is not working as well as you had hoped or if you cannot take oral medication because of other existing medical conditions or conflicting medication. Oral medications have truly revolutionized the treatment of erectile dysfunction. However, they are contraindicated or do not work well in approximately 40% of all men. Unfortunately, the vast majorities of these men do not seek alternative treatments or have it suggested by a physician. An impotence specialist is expert in the full range of diagnostic and treatment options.

3. If you want to understand the differences in oral medication and decide which one among them might work best for you. You can see a summary and brief description of the new oral medications under the "Frequently Asked Questions" section of this website. However, if you want more thorough information or would like to discuss with a doctor the pros and cons in your particular case you may want to consider a specialist.

4. If you have premature ejaculation or penile curvature. Both of these conditions are treatable but they require a high degree of skill and experience. For example, premature ejaculation is often an independent problem but can also be a natural outgrowth of certain other erection problems. Also, the treatments for both of these conditions are continually evolving. You want to be treated by a physician who is absolutely current on all the latest developments.
Other reasons you may want to consider seeing a specialist include:

• if there has been a sudden onset of erectile dysfunction;
• if you are under 50;
• if you have Peyronie's disease.

Some men may choose to start the process with a specialist even if they do not fit these criteria, as they may want the time that a specialist generally puts aside to evaluate, understand and get to know a patient. Also a patient may want to fully understand the physical aspects of his problem as well as the psychological issues and ramifications. Finally the atmosphere in a specialist's office may be more personal and private.

TAKE OUR SELF ASSESSMENT QUIZES
Do I have erectile dysfunction? Back to top
Do I need to see a specialist? Back to top

Sexual Health Inventory For Men Back to top

Over the past 6 months:
1. How do you rate your confidence that you could get and keep an erection? Circle One

• 1 - very low
  
• 2 - low
  
• 3 - moderate
  
• 4 - high
  
• 5 - very high

2. When you had erections with sexual stimulation, how often were your erections hard enough for penetration (entering your partner)? Circle One

• 0 - no sexual activity
  
• 1 - almost never or never
  
• 2 - a few times (much less than half the time)
  
• 3 - sometimes (about half the time)
  
• 4 - most times (much more than half the time)
  
• 5 - almost always or always

3. During sexual intercourse, how often were you able to maintain your erection after you had penetrated (entered your partner)? Circle One

• 0 - did not attempt intercourse
  
• 1 - almost never or never
  
• 2 - a few times (much less than half the time)
  
• 3 - sometimes (about half the time)
  
• 4 - most times (much more than half the time)
  
• 5 - almost always or always

4. During sexual intercourse, how difficult was it to maintain your erection to completion of intercourse? Circle One

• 0 - did not attempt intercourse
  
• 1 - extremely difficult
  
• 2 - very difficult
  
• 3 - difficult
  
• 4 - slightly difficult
  
• 5 - not difficult

5. When you attempted sexual intercourse, how often was it satisfactory for you? Circle One

• 0 - did not attempt intercourse
  
• 1 - almost never or never
  
• 2 - a few times (much less than half the time)
  
• 3 - sometimes (about half the time)
  
• 4 - most times (much more than half the time)
  
• 5 - almost always or always

SCORE: ________
Add the numbers corresponding to questions 1-5. If your score is 21 or less, you may want to speak with your doctor.

Sexual Health Inventory For men Back to top

YOU SHOULD CONSIDER SEEING AN IMPOTENCE SPECIALIST IF YOU ANSWER YES TO ANY OF THE FOLLOWING QUESTIONS:

1. Are you under 50?
2. Have you already tried Viagra and found that it does not work at all or well enough?
3. Are you unable to take Viagra for medical reasons?
4. Do you have complicated high blood pressure or cardiovascular disease?
5. Do you have penile curvature?
6. Do you have premature ejaculation?
7. Have you found a nodule (lump) in your penis or testicles?
8. Is there pain when you have an erection?
9. Have you already tried psychological therapy and found that it did not work for you?
10. Have you had any trauma to the penis?

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