The study begins with a detailed medical history and a physical examination during which psychogenic and/or organic factors responsible for the problem may be identified. If it has been a while since your last blood test, it will be advisable to have one, also determining testosterone levels.
Depending on the data obtained from the medical history, physical examination and analysis, treatment can now be assessed or further studies undertaken such as a psychological evaluation or tests to try and determine whether the penile erection mechanisms are affected or not.
In certain cases it may be necessary to inject a vasodilator drug (Prostaglandin E1) in the penis itself. If a good erection is achieved on the majority of occasions, good preservation of the vascular mechanisms can be confirmed.
Another study that may be of use is that of keeping a record of nocturnal erections. All men present episodes of nocturnal erection coinciding with the REM phase of sleep (rapid eye movement). By the attachment of rings on the base and the tip of the penis connected to a recording unit which is subsequently evaluated by computer, it is possible to identify the number of erections throughout the night, as well as the quality of same (diameter and rigidity of the penis). If normal data is produced, this is indicative of the correct preservation of the penile erection mechanisms.
On other occasions it may be advisable to undertake a vascular study of the penis using a Doppler ultrasound scan in order to provide information about the penile arteries.