Should You Use an At-Home Test to Check for ED?
Stereotypes about men abound. They don't read the instructions. They don't ask for directions. They don't go to the doctor. The list goes on. This do-it-yourself-ness applies to all aspects of many guys' lives, including their health.
Before they see a doctor about erectile dysfunction (ED), some men may feel compelled to take matters into their own hands and try an at-home ED test. And there are a few ways to self-test for ED at home, including a nocturnal penile tumescence (NPT) test, a penile plethysmograph and a blood test.
The NPT test, or "stamp test," involves placing an intact roll of stamps around a man's flaccid penis to see if a nighttime erection will "break through" the stamps. The thinking is that while men normally experience erections during sleep, a man with ED will not. If the man wakes up and the roll of stamps is still intact, the assumption is he did not have an erection and he has ED. If the stamps have separated, the man apparently had an erection and his ED might not be due to physical causes.
The penile plethysmograph is a device that can be used at home to measure a man's erection as he views or listens to arousing sexual material. A blood test checks for problems, such as heart disease, diabetes and low testosterone, that could potentially lead to ED.
However, before you buy anything and start testing your penis at home, you should know some urologists don't think such tests are worth it. The stamp test, for one, is outdated and often inaccurate. Save those sticky squares for the other mail. Ultimately, only a qualified medical doctor can officially diagnose your ED.
"My opinion on at-home testing for erectile dysfunction is that it is completely unnecessary and it is not something men should waste their money on," said Petar Bajic, M.D., a urologist at the Center for Men's Health in the Glickman Urological & Kidney Institute at the Cleveland Clinic. "If they're having the symptoms, it doesn't matter what the blood flow test shows—it's not going to change the fact that we have treatments we can try that are effective and we can help that guy restore his [erectile] function."
Tests are rarely conducted at the office
Bajic emphasized that urologists don't routinely do testing in the office for men who suspect they have ED, because it is a clinical diagnosis, meaning it's determined by a man's history and symptoms. Although ED is a blood-flow problem, a blood-flow assessment is not even typically needed.
"If they've got a history of stuff like blood pressure, cholesterol, diabetes, tobacco use, and if they have either difficulty getting or maintaining an erection, they have erectile dysfunction," Bajic said. "There's no need for any kind of test, either done at the office or at home."
In select circumstances, a penile duplex Doppler ultrasound may be used if it's unclear whether a man has a blood-flow problem, but Bajic estimates this is only done for 1 in 100 ED cases.
Questionnaires can be helpful
There is one test Bajic said men can do at home: a validated questionnaire.
The International Index of Erectile Function (IIEF) and the Sexual Health Inventory for Men (SHIM), which is essentially an abbreviated version of the IIEF, are the two questionnaires Bajic commonly gives to patients.
"We will use them to establish the baseline and then track a man's progress as he undergoes treatment to see how much improvement he's getting," Bajic said.
The questionnaire also quantifies the severity of the ED.
"Absolutely, guys can do that at home," he said.
Historical and academic value only
ED testing is done very rarely these days because doctors can screen for ED through an interview and a medical and sexual history, said Martin Kathrins, M.D., an assistant professor of surgery at Harvard Medical School and a urologist at Brigham and Women's Hospital in Boston.
"They have more of a historical role, I think," Kathrins said of the tests.
Even if a man does conduct a stamp test at home, Kathrins wondered what they would do with the results.
"Is that man going to seek out a sexual therapist? I worry that some of these patients will be guided to frustrated paths or they're going to have difficulty interpreting some of these home remedy tests," he said. "Just like any test that we do in medicine, what is that person going to do with that information that he generates? That's not entirely clear."
As for the penile plethysmograph, Kathrins said he has one at his office, collecting dust.
"We use it very, very rarely, primarily because, as a clinician, it's unclear to me exactly what I'm going to do with the results of that test," he said. "It's not going to make me turn left when I was trying to turn right."
The penile plethysmograph is of "academic interest only," and using it is not going to influence his medical therapies, surgeries or referrals, he said.
It's also not a good use of the patient's time.
"Patients get understandably anxious about tests, and you're generating data that has no destination," Kathrins said.
Bajic said these tests have fallen out of favor because they don't change the management of erectile dysfunction in any way.
"There's no sense in ordering these expensive tests if they're not going to change what we do," he said.