Erectile dysfunction is a common issue that affects men of all ages. According to the National Institutes of Health, around 30 million men in the United States alone are affected by erectile dysfunction to varying degrees.
Although erectile dysfunction can be frustrating and stressful, it’s usually treatable through the use of medication, lifestyle changes and other treatment options.
If you’ve experienced difficulties getting or maintaining an erection and think that you may be affected by erectile dysfunction (ED), it’s best to talk to a healthcare provider.
You can also perform an erection self-test at home — a simple type of test that you can use to determine whether your erectile dysfunction symptoms are caused by a physical factor or by a psychological one.
Below, we’ve explained how the most common type of at-home erection self-test works, as well as how you can use it to get more information about your ED symptoms.
Erectile dysfunction can occur for several reasons. Some ED is physical, meaning a physical factor such as your cardiovascular health is affecting your body’s ability to supply blood to the soft tissue of your penis.
Common physical causes of ED include high blood pressure, thyroid conditions, and other medical conditions that affect blood flow, such as diabetes.
Additionally, certain oral medications, such as antidepressants, may play a contributing factor to ED.
Other cases of ED are psychological. If you have psychological ED, factors such as stress, low self-esteem, or sexual performance anxiety may make it more difficult for you to get and maintain an erection, even when you’re sexually stimulated.
Unlike many other medical conditions, which can be accurately diagnosed using clinical tests, there’s no standardized test that can confirm whether or not you have erectile dysfunction and why it’s occurring.
When you talk to a urologist or other healthcare provider about ED, they’ll likely discuss your symptoms with you in order to determine the best treatment.
They may perform physical exams to check for factors that may contribute to erectile dysfunction, such as high blood pressure, high blood sugar, or health issues that affect your blood circulation.
An erectile dysfunction test, or erection self-test, allows you to learn more about whether you have physical or psychological causes of ED.
One of the oldest erectile dysfunction “tests” is the nocturnal penile tumescence test, or NPT test.
Before we go into the specifics, we want to be clear: it’s outdated. It’s not really that accurate.
By itself, the NPT test doesn’t confirm that you have erectile dysfunction, or that a certain factor is causing it.
If you do give yourself the test, it’s best to treat your results as a basic guide.
If you’re concerned and want to treat your erectile dysfunction, the best option is to talk to a healthcare provider.
That said, the NPT test works by monitoring your ability to get an erection while you sleep.
All men with normal, healthy physiological erectile function will get spontaneous erections during sleep — a phenomenon that’s referred to as nocturnal penile tumescence.
If the NPT test shows that you don’t get erections while sleeping, it may indicate that your sexual dysfunction symptoms are linked to a physical health factor.
To perform the NPT test, you’ll need a strip of four to six postage stamps. You’ll also need to abstain from drinking alcohol or using any tranquilizers or sleep-inducing medications for two days before performing the test.
Here’s what you need to do:
Typically, you’ll need to repeat this test for three nights of normal, uninterrupted sleep to get an “accurate” result.
From here, it’s all about observation. If you get an erection during the night, the strip of stamps will tear along the perforated area at the edge of each stamp.
If the stamp ring doesn’t tear on any of the three nights, you may have ED that’s related to a physical health factor, such as a medical condition or use of medication.
Of course, that doesn’t mean anything definitively. For instance, if the stamp ring tears but you still know you’re having a hard time maintaining an erection, it’s very possible that your ED is psychological in nature — and that’s still ED.
If you find that your NPT indicates erectile dysfunction, or if your healthcare provider suspects that you have erectile dysfunction, they may request one or several tests to determine the cause.
These aren’t tests that you can do at home — instead, they’re done in a clinical environment such as your healthcare provider’s office. Other tests used to diagnose ED include:
Your healthcare provider may order a blood test. A variety of tests can be performed on a sample of your blood to check for low testosterone levels, other hormone deficiencies, thyroid function, cardiovascular health issues, diabetes, liver and kidney function and other factors that may contribute to erectile dysfunction.
After your healthcare professional orders these tests, they may refer you to a urologist for further diagnosis.
The two most common types of blood tests are a complete blood count test (CBC test), which tests the levels of all of the types of blood cells in your body, and a blood sugar test, which measures the amount of glucose in your blood.
A urine test can reveal information about your hormone levels, kidney function, diabetes and other factors that may contribute to erectile dysfunction.
These tests also look for factors like glucose levels or UTIs that can be mistaken for erectile dysfunction.
This type of test evaluates how effectively blood flows through your veins and arteries. It may show tissue scarring, hardening of the arteries and other physical factors that contribute to erectile dysfunction.
During this test, a small needle is used to inject the penile tissue with a vasodilator.
Then, an ultrasound wand is pressed to the side of the penis, allowing for echo waves to be collected.
Using the pitch of the echoes, the ultrasound can determine how effectively blood is flowing through your veins.
This test measures the nerve stimulation in your penis and spinal cord segments. Your healthcare provider may recommend this test if you have erectile dysfunction that could be related to abnormal nerve function due to spinal cord injury or a condition called spinal shock.
To perform this test, pressure is applied to the glans penis and anal contraction is observed.
If there is no contraction, bulbocavernosus reflex is not the cause of erectile dysfunction.
This test determines nerve sensitivity and function in your penis. It is performed by sending small vibrations on the left and right side of the penile shaft.
If the penis does not react to the vibrations, nerve damage may be the cause of erectile dysfunction.
Your healthcare provider may recommend this test, or others, if you have erectile dysfunction that could be related to nerve damage.
Other tests that may be used to diagnose ED include cavernosography and dynamic infusion cavernosometry, which may be used to locate and identify venous leak (loss of blood from the erectile tissue), vasoactive injection and arteriography.
Dealing with erectile dysfunction can be highly stressful. However, erectile dysfunction is almost always treatable.
Depending on the cause of your erectile dysfunction, your healthcare provider may suggest one or several of the following treatments:
Several FDA-approved prescription medications are currently available to treat ED, including Viagra® (sildenafil), Cialis® (tadalafil), Levitra® (vardenafil) and Stendra® (avanafil).
These medications work by increasing the flow of blood to your penis, making it easier for you to get and maintain an erection.
They’re available in a range of dosages to suit your needs and can be used by men in their 20s, 30s, 40s, 50s and older.
Our guide to the most common ED medications goes into more detail on how ED drugs work, as well as the key differences between the four most popular ED medications.
If your erectile dysfunction is a rare case that is caused by low testosterone and a low sex drive, testosterone therapy in combination with the medicines listed above may do the trick.
If you have an underlying medical condition that may contribute to erectile dysfunction, such as hypertension (high blood pressure), your healthcare provider may recommend treating the underlying condition.
It is important to discuss your medical history and any current health conditions with your healthcare provider in order for them to know which condition to treat.
Some conditions to consider are kidney disease, high cholesterol, heart disease, prostate cancer, or Peyronie's disease.
If your erectile dysfunction is linked to a psychological factor, such as sexual performance anxiety or stress, certain forms of psychotherapy may help you to improve your mental health and treat your erectile dysfunction.
Making certain changes to your lifestyle, such as exercising more, quitting smoking or losing weight, may help to improve your erectile health and reduce the severity of your erectile dysfunction.
A vacuum erection device is a plastic tube that fits over the penis and creates a tight seal with the skin.
This device along with a pump and an elastic band around the base of the penis can create an erection for up to 30 minutes.
Possible risks of using this device include blood vessel damage, bruises, and thickened skin.
Penile implants are typically a treatment option saved for men who have exhausted every other treatment with no success.
This prosthetic is implanted into the penile tissue, allowing men to get and maintain an erection during sexual activity.
Intracavernosal injections or alprostadil injections, otherwise known as penile injections, are a class of medicines injected into the base of the penis.
These injections increase flow to blood vessels, making it easier to get and maintain an erection.
Although it’s generally considered outdated and certainly isn’t perfectly accurate, the nocturnal penile tumescence test (NPT test) may help you to work out whether your ED is caused by a physical factor or a psychological one.
If you have erectile dysfunction, it’s best to talk to a healthcare provider.
Although ED can be frustrating, it’s almost always treatable with medication, psychotherapy, lifestyle changes or a combination of different treatments.
This article is for informational purposes only and does not constitute medical advice. The information contained herein is not a substitute for and should never be relied upon for professional medical advice. Always talk to your doctor about the risks and benefits of any treatment.