Talking with your doctor about ED

Talking about erectile dysfunction (ED) is never easy, even when it's with your doctor.

"Many men are hesitant to discuss their ED out of embarrassment because they view it as purely a sex-related problem," says Dr. Martin Kathrins, a urologist with Harvard-affiliated Brigham and Women's Hospital. "But in many cases, ED is related to other issues like cardiovascular health, high blood pressure, mental health, or low testosterone. Once men understand that talking about ED means exploring other aspects of their health, and is part of regular maintenance health care, it's easier for them to open up."

Questions and answers

Your doctor may initiate a conversation about ED or other sexual issues during a routine check-up. Knowing what questions to expect can help men feel more at ease and provide the detailed information their doctor needs for a diagnosis. "Preparation on your part can help the conversation move in the right direction," says Dr. Kathrins. Here are some questions you may be asked:

Medical history. Do you have any chronic illnesses? What treatments and operations have you had, like prostate removal or prostate cancer treatment? What medications do you take? "Some medications can cause ED or affect sexual desire," says Dr. Kathrins. The most common medications linked to ED are blood pressure drugs like diuretics (which help the body get rid of sodium and water) and beta blockers.

Lifestyle habits. Do you drink alcohol and if so, how much? Do you smoke? If not, have you recently quit? Do you exercise? What kind and how often? Have you recently gained weight? Have you begun following a new diet? These habits are related to cardiovascular health, and the answers can help determine if your ED may be connected to an issue like high blood pressure.

Mental health. Your doctor will also likely ask about your psychological well-being: Do you suffer (or have you ever suffered) from depression? Are you under stress? Has any significant life event recently occurred, like the death of a loved one? "Almost any life changes can affect a person's mental and emotional health and thus affect their physical health, including their sexual health," says Dr. Kathrins.

Relationship status. Have you felt a loss of affection for your partner? Are you in a new relationship after being single for a long time?

Taking the lead

Men also can take the conversation lead with their doctor. Here are some strategies to help you prepare.

Practice icebreakers. Icebreakers are a great way to open the conversation. "These are phrases and questions that are comfortable for the individual and can help spark a discussion with their doctor," says Dr. Kathrins. Practice saying them aloud to yourself or with your partner before your appointment. This can boost your confidence and comfort level. Here are some examples:

• "How can I tell if I have ED?"
• "I'm having trouble getting erections."
• "I want to ask you about a men's health issue."
• "I'm having some problems in the bedroom."

Write down questions beforehand. Arriving prepared with a list of questions can increase the likelihood that you will get the answers you need. Your list will help you stay on track if you feel nervous or uncomfortable during the appointment.

Keep track of your symptoms. Write down your symptoms in as much detail as possible. For instance, do you have a problem getting an erection, maintaining it, or both? Do you have trouble achieving orgasms? How long have you had the issue?

"The more detailed information you can provide, the better chance your doctor can identify the possible causes for your ED and recommend a treatment strategy," says Dr. Kathrins. Treatment may include prescribing an ED drug or checking your blood for low testosterone. If your doctor thinks you might have a heart issue, you may be referred to a cardiologist. If your ED could be psychologically related, your doctor may recommend stress reduction therapies or consultation with a mental health counselor or sex therapist.

Image: © Ildar Abulkhanov/Getty Images