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Assessment for Erectile Dysfunction

Erectile Dysfunction

1 About Your Health

Are you male and aged between 18-75?

Do you currently smoke or consume alcohol?

Have you previously taken Viagra (sildenafil), Levitra (vardenafil), Nipatra, Spedra, or Cialis (tadalafil) on at least four separate occasions without experiencing any side effects?

2 Your Symptoms

Do you have difficulty getting or keeping an erection?

Over the past 6 months, how often have you experienced difficulty achieving or maintaining an erection during sexual activity?

3 Your Health

Do you have high blood pressure (greater than 160/90), or are you currently receiving treatment for high blood pressure?

Have you been diagnosed with hypotension (blood pressure below 90/50)?

Have you ever been advised by a healthcare professional to avoid strenuous exercise?

Do you have any problems walking at a fast pace for around 5 minutes?

Do you feel low or depressed but have not sought medical advice from your GP?

Have you ever had an allergic reaction or adverse side effect when taking Viagra, Levitra, Spedra, Cialis, or any other erectile dysfunction treatment?

Have you ever suffered from, or do you currently have, any of the following medical problems?

4 Medication

Do you take any medicines called nitrates (for chest pain/angina) or nitric oxide donors (‘poppers’)? These can be sprays, tablets, or patches, such as glyceryl trinitrate, isosorbide mononitrate, or isosorbide dinitrate.

Do you use any prescription, non-prescription, or recreational drugs at the moment?

5 Agreement

Are you aware that erectile dysfunction can be associated with underlying conditions like hypertension, diabetes, high cholesterol, or heart disease, and that a medical review with your GP is recommended within 6 months of beginning treatment?

I understand that if I have an erection lasting longer than 4 hours, or if I suddenly experience visual impairment, I must seek urgent medical help.

Do you agree to the following?

Assessment Progress

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