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Understanding Erectile Dysfunction Your Patient History Evaluating ED begins with your patient history. Your doctor will ask about your physical health, sexual health, relationship, and emotional health. Your answers will be kept confidential. So answer as completely as you can. Complete answers will help you get the most from your treatment. Learning About Your ED Be honest and open when you talk with your doctor. Don't leave anything out. Talk about health problems or diseases you've had. List the drugs you take. Tell your doctor how and when your ED problems began. Also, discuss how you and your partner are getting along. Mention recent changes in your life. To prepare for talking with your doctor, answer the following questions.  Your Physical Health  Illnesses, Injuries, or Surgery Yes No  Has a doctor ever diagnosed you with: High blood pressure? Heart disease? Stroke or vascular disease? Diabetes? Alcoholism? Kidney disease? A disease of the nervous system?   Do you have a family history of any of the diseases listed above?   Have you been injured in your pelvis, genitals, or rectal area?   Have you had surgery of the prostate, bladder, rectum, or spine?   Drugs and Alcohol Yes No  In the last three months, have you used any drugs such as: Prescription (peptic ulcer drugs, antidepressants, blood pressure medications, sedatives, or hormones)? Over-the-counter (cold or allergy medications, aspirin, antacids, vitamins, or herbal preparations)? Recreational (marijuana, cocaine, or amphetamine)? Tobacco (cigarettes, cigars, or chewing tobacco)? Alcohol? Your Sexual Health Erection Problems Yes No Did your erection problem begin suddenly? Do you get erections but have problems keeping them? Do you ever wake up in the morning with an erection? Is your erection rigid enough for intercourse? Can you get an erection by fantasizing or masturbating? Do you have any problems climaxing or ejaculating? Your Relationship Yes No Are you and your partner sexually attracted to each other? Are you emotionally attracted to each other? Are there any ways you feel rejected by each other? Are you and your partner having problems with your relationship? Are you arguing with your partner a lot these days? Do you talk things over with your partner? Will your partner take part in treatment with you? Your Emotional Health Causes of Erectile Dysfunction When you first began to have ED, were you: Yes   No   Under a lot of stress (job, relationship, money)? Using drugs or alcohol? Frequently feeling tired? Becoming involved with a new partner? Feeling a lot of anger? Having other emotional problems? Have you and your partner:     Felt nervous about having sex? Fought over sex recently? Decided not to have sex? Do you feel despressed for reasons other than ED? Previous  |  Next This information is not intended as a substitute for professional medical care. Only your doctor can diagnose and treat a medical problem. ©2001 The StayWell Company, 1100 Grundy Lane, San Bruno, CA 94066-3030. www.staywell.com 800-333-3032. All rights reserved.