| Clinical Clues |
Implication |
|
Historical clues
|
| Abrupt onset |
Psychogenic impotence, e.g., due to performance anxiety or difficulty |
| Absent nocturnal or early morning erections |
Vascular or neurologic disease |
| Loss of erection after penetration |
Anxiety or vascular steal |
Exam clues
|
| Reduced femoral or peripheral pulse |
Vascular disease |
| Reduced beard and body hair growth, reduced muscle bulk, testicular atrophy |
Hypogonadism |
Laboratory clues
|
| Low serum free testosterone, high prolactin, or abnormal TSH levels |
Endocrinologic dysfunction |
