Though most clinicians do not have the luxury of a detailed assessment of sexual dysfunction, a simple and quick assessment of erectile function is possible. The first step is to ask about sexual problems of any kind. Many patients may not volunteer information about their sexual difficulties, unless they are presenting with such a complaint. Studies have found that patients still face obstacles in addressing these concerns with their health care provider, often as a result of the clinician’s avoidance of the issue. Research indicates that patients with sexual dysfunctions wait, on average, 4 years before they receive appropriate treatment for their problems. Therefore, a general question about sexual problems should be a standard part of any medical or mental health evaluation.

Once a patient has identified a sexual concern, the next step is to determine if he indeed has a sexual dysfunction. Despite society’s apparent openness about sexuality, ignorance and misinformation about sexual function still abound. One important intervention that clinicians are often called upon to provide is accurate information about normal sexual response. Simple education and reassurance are sometimes the only treatment necessary. This depends on a clinician having both the requisite knowledge and the appropriate attitude to discuss sexual issues with his or her patient.

If the patient is experiencing ED, the next step is to describe the problem more specifically. The most important distinction to be made is between “generalized” ED and “situational” ED. Generalized ED is defined as a problem that occurs on all occasions of sexual arousal. This can be determined most simply by asking one question, “Do you ever have a full erection?” A patient who answers “No” manifests a generalized form of ED. Usually, more detailed questioning is required to accurately categorize the problem by asking the patient about: sexual activity with any partner, selfstimulation (i.e., masturbation), nocturnal erections, and spontaneous sexual arousal. The goal of all of these questions is the same, i.e., to determine if the patient is ever capable of a full erection. If the patient is able to obtain a full erection in any of these situations, the problem is labeled a situational case of ED. Viagra Australia – ed medications online in AUstralia.

Of particular interest are the patient’s nocturnal erections. Surprisingly, most patients are not aware that healthy men experience 4–5 erections every night during periods of REM sleep. It is therefore helpful to explain this when asking about nocturnal erections. The presence of at least occasional normal nocturnal erections is strong evidence that “the plumbing works” and is often a relief to patients.