この記事の概要
When prescribing a prescription for erectile dysfunction (ED) medication in the United States, the physician will first review the patient's overall health and perform several tests to determine the cause of the ED. The specific tests will vary depending on the patient's symptoms and health status, but the following process is common.
When seeking treatment for erectile dysfunction (ED) in the United States, a physician will first assess the patient’s overall health and conduct several tests to identify the underlying causes of ED. The specific tests may vary based on the patient’s symptoms and health condition, but the following process is generally followed.

1. Medical History Review
- Review of lifestyle and medical history: The physician will start by gathering information about the patient’s overall health, including past medical history, current medications, and lifestyle habits (such as smoking, alcohol consumption, and exercise).
- Assessment of ED symptoms: The doctor will inquire about the specific details of ED symptoms, including frequency, strength of erections, and difficulties during sexual activity, as well as when the symptoms began. Changes in sexual desire and potential psychological issues (such as stress or relationship concerns) will also be discussed.
2. Physical Examination
- Examination of the penis and testes: The physician will check for physical issues (such as injuries or deformities) in the penis, testes, and prostate. Any abnormalities in blood flow or nerves in the penis that could cause ED will be assessed.
- Blood pressure and cardiovascular examination: Since blood flow issues can lead to ED, blood pressure and cardiovascular health will be evaluated. Cardiovascular problems can be a contributing factor to ED.
3. Blood Tests
- Testosterone measurement: To check for hormonal issues related to ED, blood tests will measure testosterone levels. Low testosterone (Low T) can be a cause of ED.
- Diabetes and cholesterol check: As diabetes and high cholesterol can contribute to ED, blood glucose and cholesterol levels will also be assessed. Specifically, diabetes can damage nerves and blood vessels, leading to ED.
4. Electrocardiogram (EKG/ECG)
- Assessment of heart health: If heart disease is suspected or if the patient has cardiovascular risks, an EKG will be performed to evaluate the heart’s condition. ED medications like Viagra and Cialis have vasodilatory effects, so they must be prescribed cautiously in patients with heart conditions.
5. Urinalysis
- Urinalysis will be conducted to check for diabetes or kidney function. Abnormalities in urine may indicate conditions related to ED.
6. Ultrasound (Penile Doppler Study)
- Evaluation of penile blood flow: If blood flow issues are suspected, a penile ultrasound may be performed to assess the condition of the blood vessels and blood flow within the penis. Inadequate blood supply to the penis can lead to ED.
7. Psychological Assessment
- Identification of psychological factors: If the cause of ED is psychological, factors such as stress, anxiety, or depression may be involved. The psychological assessment will evaluate the patient’s mental health and relationship with their partner. Counseling or psychotherapy may be recommended if necessary.
8. Nocturnal Penile Tumescence (NPT) Test
- Assessment of natural erections: Men typically experience erections during sleep. To confirm this, an NPT test may be conducted to measure the number and duration of nocturnal erections, helping to distinguish between physical and psychological causes of ED.
Conclusion
Before receiving a prescription for ED medication in the United States, patients undergo a review of their medical history, blood tests, and, if necessary, physical examinations and psychological evaluations to identify the causes of ED. Based on this process, appropriate treatment options (such as pharmacotherapy with Viagra or Cialis, counseling, or lifestyle modifications) will be proposed.
畠山 聡先生 (はたやま さとし)
医師・医学博士 / ヒロクリニック医師
略歴
- 2016年 大阪市立大学(現:大阪公立大学)卒業
- 2016年 育和会記念病院
- 2019年 大阪鉄道病院
- 2021年 大阪公立大学附属病院
- 2022年 大阪鉄道病院医長
- 2023年 ヒロクリニックなんば心斎橋院院長
資格・所属
- 日本泌尿器科学会認定の泌尿器科専門医
この記事は、ヒロクリニックEDの編集・監修体制にもとづき、資格を持つ医師が内容を確認しています。




