Your 2 minute consultation

Do you smoke?

On average, how many units of alcohol do you drink in a week?

Do you suffer from high or low blood pressure, faints or collapses?

What is your blood pressure? (Please enter your blood pressure reading i.e. 140/90)

Have you been advised to avoid strenuous exercise, or do you have difficulty in walking for more than 5 minutes at a fast pace?

Do you have any known allergies to any medications or substances?

Do you have any eye problems, such as hereditary degenerative retinal disorders or macular degeneration?

Do any of the following apply to you:

Do you receive any treatment for one of these conditions listed above?

Have you ever been tested for diabetes?

Have you ever had any problems with your kidneys, urinary system or with your liver?

Do you experience any of the following problems in relation to urination?

In the last month, have you been diagnosed with a stomach or duodenal (peptic) ulcer?

Are you currently suffering any emotional or psychological problems? (e.g. little interest in doing things, feeling down / depressed / hopeless / nervous / anxious / on the edge / worrying enough that it impairs your ability to function at work or at home?)

Do you suffer from any conditions where sexual activity is not advised?

Are you currently on any strong painkiller tablets?

Are you currently taking any other prescription-only medications, alternative medications or recreational drugs than already mentioned?

Do you have any other health problems or conditions that you think we should know about?

Do any of the following factors apply:

If you are NOT circumcised, do you have trouble retracting your foreskin fully when your penis is erect?

Have you ever had penile surgery?

Do you have any of the following:

If you have any of these penis conditions listed above, please provide further details of any pain you experience, if this condition interferes with your sex life and if you are receiving or have received any treatment for this condition?

Do you persistently have difficulty getting and maintaining an erection?

How did your erectile dysfunction begin?

Have you ever been treated for erectile dysfunction? (This includes both prescription and over the counter medications, as well as any other treatments i.e. pumps, injections, implants etc.)

When masturbating, does your erection remain hard until orgasm or as long as you would like?

Do you wake up with an erection?

How often are you able to get an erection hard enough for penetration?

How difficult is it to maintain an erection until completion of intercourse?

How often do you find sexual intercourse satisfactory?

Are you experiencing decreased libido (sex drive)?

In the last 3 years, have you have a medical examination of your genitals (penis, testes, and groin)?

Is there any other information you would like to share with us, to help our doctors make an informed and a fair decision?