Erectile disfunction checklist

Creating a checklist

To keep the consultation short with your doctor, go through the following questionnaire. Printing out the page will help you start the conversation and give your doctor basic information from which to assess the situation.

This is not an interactive questionnaire and your answers are not stored or shared with anyone else.

Your doctor needs to know the following:


	1. How often do you find it difficult to get or maintain an erection? I never have any difficulty Once in a while 25% of the time 50% of the time 75% of the time or more 1 / 5 Next 2. What other medical conditions do you have? Select all that apply. I have no other medical conditions High levels of cholesterol High blood pressure Diabetes Other (specify) 2 / 5 Next 3. Have you recently had surgery? Yes (affecting which part of the body) No 3 / 5 Next 4. What kinds of medications are you currently taking? Select all that apply. I am not taking any drugs Herbal medicines Over-the-counter drugs Prescription drugs 4 / 5 Next 5. Do you smoke or drink? No I only smoke I only drink I smoke and drink 5 / 5 Next Checklist Completed To help you start the conversation with your doctor, print out this page and hand over the answers to your doctor.

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How can your partner help?

It always helps to talk about it. Encourage him to talk it through with his doctor and get treatment....

What you really need to know?

Always take detailed advice on whether you can mix Viagra with other medications. ...