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How is ED diagnosed?

Patient History

A person's medical and sexual histories help define the degree and nature of ED. The medical history can disclose diseases that lead to ED, and a simple recounting of sexual activity might identify problems with sexual desire, erection, ejaculation, or orgasm.

Use of certain prescription or illegal drugs can suggest a chemical cause because drug effects are a frequent cause of ED.

Physical Examination

A physical examination can give clues to systemic problems. For example, if the penis is not sensitive to physical touch, a problem in the nervous system may be the cause. Abnormal secondary sex characteristics, such as unusual hair pattern or breast enlargement, can point to hormonal problems, which would mean the endocrine system is involved. The doctor might discover a circulatory problem by observing decreased pulses in the wrist or ankles. And unusual characteristics of the penis itself could suggest the source of the problem-for example, a penis that bends or curves when erect could be the result of Peyronie’s disease.

Laboratory Tests

Several laboratory tests can help diagnose ED. Tests for systemic diseases include blood counts, urinalysis, lipid profile, and measurements of creatinine and liver enzymes. Measuring the amount of available testosterone in the blood can yield information about problems with the endocrine system and may explain why a patient has decreased sexual desire.

Other Tests

Monitoring erections that occur during sleep-nocturnal erections-can help rule out certain psychological causes of ED. Healthy men have involuntary erections during sleep. If nocturnal erections do not occur, then ED is likely to have a physical rather than a psychological cause. Tests for nocturnal erections are not completely reliable, however. Scientists have not standardized such tests and have not determined when they should be conducted for best results.

Psychosocial Examination

A psychosocial examination, using an interview and a questionnaire, can reveal psychological factors. A man's sexual partner may also be interviewed to determine expectations and perceptions during sexual intercourse.

Cleavage Enhancement

Cleavage enhancement encompasses a range of techniques used temporarily to improve the appearance of a person's breast cleavage or to create the illusion of breast cleavage on a person who has no such cleavage. This ranges from brassieres bras that lightly push the breasts together without any padding through a range of increasingly padded bras to techniques where chest skin is pulled towards the centre to generate cleavage and completely artificial breasts, such as breast prostheses are added to cover the materials used to pull the skin.

Cleavage enhancement may also include the use of makeup to deepen the appearance of the cleavage and make the breasts either side of the cleavage appear more prominent.

Cleavage enhancing bras are most commonly referred to as push-up bras. They vary in design from unpadded designs which simply push the breasts towards each other through to molded cup designs with large molded pads in the bottom and outside of the cups to force the breasts upwards and inwards.

Some cleavage enhancing bra designs incorporate removable pads to allow the extent of the push-up effect to be altered by the insertion or removal of pads.

Padding used in bras has been manufactured in a variety of styles, including sealed bags containing air, water or some form of liquid or gel, and from semi-rigid materials such as molded polyurethane foam rubber. Various methods are used to pull loose skin from the front of each breast towards the centre to create two vertical bulges of skin, then imitation breasts such as mastectomy breast forms are worn outside those skin bulges such that only the inside edges of those bulges are visible past the bra, top or dress.

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