Open with it
The most common failure mode is saving it for the end. You mention it with a hand on the door, the doctor has four minutes left, and you get a prescription instead of an assessment.
When you book, say you want to discuss a men's health issue and ask for a longer slot if that is an option. Then lead with it. A sentence that works:
"I've been having trouble with erections for about eight months and it's getting worse. I'd like to work out what's causing it, not just get a pill for it."
That sentence does three things at once: it names the problem, it gives a timeline, and it signals that you want a work-up. Clinicians respond to that framing.
What to bring
- Every medication and supplement you take, including over-the-counter ones. Photograph the boxes if it is easier than writing a list.
- A timeline. When did it start? Gradual or sudden? Getting worse, or stable?
- Whether you still get morning erections. This single detail meaningfully narrows the diagnosis, and doctors often forget to ask. How to observe and report it.
- Your other symptoms. Fatigue, low mood, low libido, urinary changes, snoring and daytime sleepiness are all relevant and all commonly left out — the last two more than the rest. Why snoring belongs in an ED appointment.
- Family history of heart disease or diabetes.
What normally happens
Less than men expect. The appointment is mostly conversation. Expect questions about the pattern and timeline, a review of your medications, blood pressure, and blood tests — usually glucose or HbA1c, lipids, and often a morning testosterone.
A genital and sometimes a prostate examination may be offered depending on your symptoms and age. It is brief. You can ask for a chaperone. Specialist tests such as penile Doppler ultrasound are reserved for specific situations and are not part of a first appointment.
Questions worth asking
- Could any of my current medications be contributing, and is there an alternative?
- What does this suggest about my heart and blood vessel health?
- Should I have a cardiovascular risk assessment?
- What is the starting dose, and how many times should I try it before we call it a failure?
- What is the plan if this first option does not work?
- Is there anything here I should see a urologist about?
If the conversation goes badly
Some men get brushed off — told it is just age, or handed a prescription without any assessment. That is not adequate care and you are entitled to more.
You can ask directly for a referral to a urologist, or see a different clinician. An online clinic is a legitimate way to get a prescription conveniently, but it is not a substitute for someone checking your blood pressure and blood sugar. How to judge an online clinic.