There are a number of unique self-evaluation techniques you can perform to evaluate your condition to determine if you might be facing impotency.
The ability to masturbate successfully, with a full erection, constitutes a test for chronic impotence that can be easily performed at home. When attempted, there are several possible outcomes:
- There is an absence of both erection and ejaculation.
- Ejaculation takes place in the absence of an erection
- Both full erection and ejaculation take place
- Full erection is achieved, but ejaculation does not take place.
When masturbation performed under suitable conditions, consistently results in neither erection nor ejaculation, chronic impotence of a physical nature is strongly indicated. In western culture, however, a strong religious and social taboo has historically existed against masturbation. As a consequence, it is possible that some individual who cannot obtain an erection from self-stimulation, or has no recollection of ever having an erection, is well-advised to seek professional help.
It is quite possible for a man to masturbate to ejaculation despite the absence of an erection, or to ejaculate with an erection of insufficient firmness for vaginal penetration. Chronic impotence is most likely present in such individuals, and professional help should be sought. Because the ability to ejaculate successfully suggests the absence of a psychological barrier against masturbation, it’s quite likely that the impotence has physical causes.
When a man who has been experiencing impotence symptoms during sexual intercourse is able to masturbate successfully to ejaculation with a full erection, psychological impotence is a definite possibility. It is possible, however, that the condition has a physical origin. For example, the problem may again be the steal syndrome: the limited physical activities associated with masturbation are not sufficient to result in loss of erection, in contrast with the increased sexual activity that occurs during regular intercourse and that result s in loss of erection. Regardless of the origin of the problem, professional attention is definitely indicated for men who can successfully masturbate and ejaculate with full erection, but consistently prove impotent during sexual relations with a partner.
The final masturbation possibility, erection without ejaculation, indicates the dysfunction known as ejaculatory failure. An individual who can achieve erection through masturbation, but cannot ejaculate, is usually capable of vaginal penetration.
Postage Stamp Test
Nocturnal erections occur in period known as rapid eye movement (REM) sleep, in intervals typically 5 to 30 minutes long, during which dreams usually occur. While in the REM state, it is highly unlikely that psychological factors can prevent erections in a man physically capable of having an erection.
In the professional investigation of impotence, an electronic monitoring instrument is sometimes used to determine the incidence of nocturnal erections. During the test, a sensor is attached to the penis to monitor and record changes in penis size.
It is possible to obtain a reasonable approximation of the test with only a roll of perforated U.S. postage stamps.
For economy, use of one-cent stamps is suggested. Prior to retiring for the evening, simply encircle the soft penis with a sufficient number of stamps to form a ring. Moisten the back of one of the end stamps. Overlap the face of the stamp at the other end of the ring and hold the ring in place long enough to stick.
Immediately after awakening the next morning, examine the stamps. If the ring is broken at any one of the perforations, it means that at least one erection did occur during the night. (The postage stamp test, of course, will not reveal whether there has been more than one erection, as can be done with the more complicated medical device. It also will not reveal whether or not the erect penis would have had sufficient rigidity to permit vaginal penetration or whether the erection would have been of sufficient duration of successful intercourse.)
If the postage stamp test, however, reveals the absence of a nocturnal erection, there is very good indication of chronic impotence of a psychological or physical nature is still a possibility.
Simple Neurological Test
Three simple tests can be performed at home, by yourself or with a partner, which provide clues to the functioning of the neurological system of the penis and pelvic area. The first, known as the cremasteric reflex test, measures the adequacy of the neural connections to the pelvic area. To perform this test, lie on your back, then either you or your partner should make a light quick stroke with a blunt pointed object across several inches of the inner side of your upper thigh. The normal response is a quick upward movement of the testicle on the same side of the body where the stroke was made the lack of such movement on either side of the body indicates the possibility of a neurological problem in the spinal column or brain. Professional investigation is recommended both for the treatment of impotence as well as for general health.
As all healthy men living outside the tropics know, the scrotum will tighten up and draw upward into the body when exposed to low temperature conditions. This response is part of the normal mechanism used to maintain seminal fluid at the proper temperature for reproductive purposes. In the ice-cube test, an ice cube or some other very cold object is placed momentarily on the scrotum. The normal response should be a rapid, easily observed contraction. Lack of this response indicates a neurological problem warranting professional investigation.
The final test is for the more adventurous, but actually it can be performed easily. The bulbocavernosus (BC) reflex test involves the insertion of a finger in the anus and the simultaneous quick squeezing of the tip of the penis. If the neurological system is functioning properly, a quick contraction in the rectal area should be felt.
Simple Vascular Tests
Several simple home tests or observations can be made that provide clues to the possible existence of vascular or blood flow problems possibly related to impotence. The results of these test or observations are by themselves not conclusive, but they may indicate an overall pattern.
The first is a simple walking test. To perform this test merely walk a distance of at least one mile at a fairly fast pace. While overexertion should be avoided, the pace and distance should be both faster and somewhat longer than usual. Of course, caution is advised for individuals with known cardiovascular problems. If a fairly piercing pain is noted in either or both calves, evidence exists of an oxygen insufficiency and impaired blood flow to the lower portion of the body. While the walking test does not directly indicate impaired blood flow to the penis it is a good indication of the possibility. Should you experience significant pain wen performing the walking test, it would be a good idea to bring this to the attention of your physician, in view of its general implications as to your cardiovascular health.
Examination of the genital area may also yield significant evidence of possible vascular problems. When the penis is found to be consistently cold, even when exposed to warm temperatures, there is a possibility of vascular insufficiency. In men with light-colored skin, the penis may take on a distinct blue color when blood flow is impaired. The effect is not as easy to detect with dark-skinned men, but a definite difference in appearance may be noted.
A final observation concerns the presence of firm, hard areas in the penis. Such areas are typically found along both sides of the penis, in the general area where the penis is attached to the body. It is not uncommon to encounter patients at the urologist’s office who have noticed hard areas of the penis and are fearful of cancer. Such hard areas, however, usually result from the calcification of the corporal bodies (blood-carrying bodies) in the penis due to the gradual accumulation of plaque. The resulting restriction in blood flow can cause erection difficulties.
While examining your genital area for indications of vascular problems, it would be a good idea to take a moment and feel through your scrotum for any possible abnormality such as a lump or a testicle that seems larger than usual. Doing so might just provide early warning of testicular cancer.
Review Your Medical History
A thorough self-evaluation should include the careful analysis of your personal medical history, particularly with respect to specific health problems (flown to be linked with impotence. It is especially important to try to relate the onset of any known impotence-linked problem with the first appearance of significant impotence symptoms.
The following list summarizes the important factors of your medical history that you should consider when per-forming a self-evaluation in connection with possible erectile dysfunction:
- Cardiovascular diseases
- Diabetes mellitus
- Endocrine (glandular) problems, other than diabetes
- Neurological disorders
- Pelvic surgery and radiation therapy
- Accidents to the head, spinal cord, and pelvic area
- Exposure to known environmental hazards
Men with a history that includes some type of cardiovascular disease should definitely be aware of a possible link with impotence. This is especially true for individuals with heart disease, blood vessel disease, or hypertension or those who have experienced coronary artery bypass surgery. A history of any of these problems, combined with frequent impotence episodes and any possible symptoms observed in the simple vascular tests, strongly indicates the need to seek professional assistance.
Given the strong link between impotence and diabetes, any man with a known case of diabetes should be on the lookout for impotence symptoms, and should be prepared to seek assistance, even if such symptoms have not yet appeared. It is a primary responsibility of any physician treating a diabetes patient to explain the possible sexual ramifications of the disease and to encourage consultation with specialists on sexual dysfunction when indicated. All older men should be on the lookout for possible diabetes symptoms, as the disease often occurs later in life in marginal form and may take a while to be detected. A real warning sign would be a combination of impotence, renal (kidney), and retinal (eye) problems.
Individuals with known glandular disorders, other than diabetes, should consider the possibility of a connection with any impotence symptoms that are being experienced. This is particularly true should you have a history of pituitary and adrenal gland disorders. Men with known problems of the testicles, particularly those associated with inadequate testosterone production, should also be prepared to seek professional attention when impotence symptoms are noted. The same advice applies to men with known problems of the thyroid. When there are no known glandular problems, the presence of extreme obesity chronic fatigue, breast enlargement and other feminine characteristics, and erectile dysfunction can be an indication that such problems may very well exist.
Neurological disorders are generally believed to be of lesser importance as underlying causes of impotence than cardiovascular disease or diabetes. Men with known nervous system disorders, including epilepsy, Parkinson’s dis-ease, and multiple sclerosis, however, should be aware of the possible connection, and are advised to seek professional help when experiencing impotence symptoms. Impotence is also linked to various types of brain tumors, which is another good reason not to neglect the presence of persistent impotence symptoms.
Any man who has experienced major surgery or radiation therapy- in time pelvic region, especially procedures involving the prostate gland, anus, rectum, bladder, and colon, should seek professional help if impotence symptoms are experienced. Usually, impotence shows -up fairly soon after such procedures, although the onset of the problem can be delayed. Men scheduled for such surgery should always discuss the possibility of impotence in advance with their physician, in the hope that a problem can be avoided or at least minimized.
Individuals who have experienced accidental injuries to time head, spinal cord, and pelvic area are also advised to obtain professional help -whenever frequent impotence episodes are noted_ It would be helpful to ask the parents or other relatives of a patient about his past injuries or accidents because major childhood injuries, which the patient may have completely- forgotten, can be a cause of adult impotence. This can be the case especially- with injuries that took place to young boys while they were in a straddle position, such as when riding a bicycle_ Straddle injuries can be particularly serious as sharp blows to the perineum (crotch) and the pelvic bone may result in damage to the arteries supplying blood to the penis or scar erectile tissues in that portion of the penis inside the body.
Environmental health is an increasingly important medical specialty. If you were exposed to any known environmental hazard as a child or have worked in occupations where there has been a chance of exposure to toxic chemicals or radiation, you should note this in your self-evaluation. A partial list of hazardous materials that may be encountered on the job include lead, mercury, cadmium, beryllium, pesticides, and industrial solvents. Exposure to hazardous materials and radiation can result in impotence due to nerve damage, although the possibility does exist of damage to internal organs, which, in turn, may contribute to erectile dysfunction. Lead poisoning can be particularly damaging to the peripheral nervous system. Lead-based paints are no longer permitted for inside use, but the possibility exists for exposure, especially to children raised in older homes.
Review Your Use of Prescription and Nonprescription Drugs
The link between impotence and many frequently used medications is discussed, along with a listing of many of the problem drugs currently in use today. It is important to recognize that because new drugs are constantly being introduced in the pharmaceutical field, no listing of problem drugs will ever be complete. Fortunately, many newer drugs are much improved with respect to impotence and other side effects, but that is not always the case. If information on any drug that you are taking or will be taking has not been provided by your regular physician, you would be well advised to consult the latest edition of the Physicians’ Desk Reference published annually by Medical Economics Company, Oradell, New Jersey. This book, commonly known as the “PDR,” is usually found at better public libraries. The contents of the PDR are now also on computer and your physician may have access through a data network. The Physicians’ Desk Reference for Nonprescription Drugs, by the same publisher, provides information on the side effects of over-the-counter products.
The American Urological Association (AUA) has in the past published a listing of drugs linked to sexual dysfunction.
Any man who has been using a prescription drug linked to impotence should not immediately discontinue its use upon becoming aware of that fact. This sometimes happens, particularly in the case of men using medications for high blood pressure. Such men, of course, subject themselves to the long-term danger of strokes, heart attacks, and other problems. With some drugs, precipitous withdrawal can present a very real and immediate danger. The best course of action is to first talk with the physician who has prescribed the suspected drug. Some-times an alternative medication is available, with lesser side effects. Should your physician be unresponsive, get a second opinion before discontinuing the drug.