Vascular / Cardiovascular
Reduced blood flow and vascular health.
Men’s Health
Erectile Dysfunction Assessment
Sexual Health · Cardiovascular Risk · SHIM Screening
Confidential assessment for erectile concerns, with physician-led evaluation of sexual health, contributing medical factors and appropriate treatment options.
Confidential
Private men’s sexual-health assessment.
Physician-Led
Clinical evaluation before treatment.
Whole-Health Approach
Sexual, cardiovascular, metabolic and hormonal factors considered.
Personalised
Investigation and treatment based on the individual.
Erectile difficulties are common — and worth discussing.
Changes in erectile function can be distressing, but many men delay seeking help because of embarrassment or assume the problem will resolve on its own.
Erectile dysfunction can have multiple possible causes, including vascular health, diabetes, hormonal factors, medications, psychological wellbeing, lifestyle, relationship factors and other medical conditions.
Erectile dysfunction is a medical concern, not something you need to be embarrassed about.
Erectile function can also provide clues about wider health.
There is an association between erectile dysfunction and cardiovascular disease. For some patients, erectile symptoms may appear alongside underlying vascular or metabolic risk factors.
A physician may therefore consider whether broader assessment is appropriate depending on age, symptoms, cardiovascular history, blood pressure, cholesterol, diabetes risk, smoking, weight and metabolic health, and medication history.
ED does not necessarily indicate cardiovascular disease, but in some patients it can be an important reason to review cardiovascular and metabolic health.
What can cause erectile dysfunction?
Metabolic
Diabetes, obesity and metabolic-health factors.
Hormonal
Low testosterone or other endocrine concerns.
Medication-Related
Certain medicines may contribute.
Psychological
Stress, anxiety, depression or performance concerns.
Other Medical / Lifestyle Factors
Sleep, smoking, alcohol, neurological issues or other health conditions where relevant.
When should you speak with a physician?
Consider booking if you have:
- Persistent difficulty obtaining an erection
- Difficulty maintaining an erection
- Reduced confidence in erectile function
- Changes in sexual function
- Reduced morning erections
- Erectile symptoms alongside diabetes or cardiovascular risk
- Erectile symptoms alongside reduced libido or possible hormonal concerns
- Questions about medication
- Symptoms causing distress or relationship difficulty
A single occasional episode does not necessarily indicate erectile dysfunction. Persistent or recurrent concerns are more useful to discuss medically.
Screening Tool
Sexual Health Inventory for Men (SHIM)
A short 5-question screening tool that can help identify the severity of erectile difficulties over the previous six months.
This questionnaire is a screening tool, not a diagnosis.
Thinking about the last six months, select the answer that best reflects your experience.
Question 1 of 5
Adapted from Rosen RC et al. Development of an abridged, 5-item version of the International Index of Erectile Function (IIEF-5) as a diagnostic tool for erectile dysfunction. Int J Impot Res. 1999;11:319–326.
Questionnaire answers are calculated in your browser only and are not stored by this page.
What to Expect
What happens during an ED assessment?
01
Private Conversation
- Symptoms
- Duration
- Sexual health
- Relationship context where relevant
- Goals and concerns
02
Health Review
- Cardiovascular risk
- Diabetes / metabolic health
- Medications
- Hormonal symptoms
- Lifestyle
- Psychological wellbeing where relevant
03
Investigation Where Appropriate
- Blood pressure
- Laboratory testing
- Diabetes / metabolic testing
- Testosterone / hormonal assessment
- Cardiovascular evaluation
- Other tests based on symptoms
04
Personalised Plan
- Underlying causes
- Lifestyle measures
- Medication where appropriate
- Further investigation
- Referral if needed
- Follow-up
Why cardiovascular health may be relevant
Erections depend partly on healthy blood vessels and blood flow. Because vascular disease can affect smaller blood vessels, erectile difficulties can sometimes occur alongside cardiovascular risk factors.
Depending on the individual, the physician may consider blood pressure, cholesterol, diabetes, smoking, weight, physical activity, family history and existing cardiovascular disease.
Further cardiovascular assessment is considered according to your history, symptoms and individual risk.
Could hormones be contributing?
Testosterone deficiency or other endocrine concerns can sometimes be relevant, particularly where erectile problems occur alongside reduced libido, reduced morning erections, low energy, fertility concerns, changes in muscle mass or other hormonal symptoms.
Treatment depends on the cause.
For many patients, oral medicines may be effective when clinically appropriate. Examples include sildenafil, tadalafil, vardenafil and avanafil.
Prescription ED medication should be selected after appropriate medical assessment because suitability can depend on cardiovascular health, other medicines and individual circumstances.
- Sildenafil
- Tadalafil
- Vardenafil
- Avanafil
Medication should be reviewed properly.
The clinician considers cardiovascular health, blood pressure, current medicines, other medical conditions, previous treatment, side effects and treatment response. This page does not provide dosing instructions.
- Cardiovascular health
- Blood pressure
- Current medicines
- Other medical conditions
- Previous treatment
- Side effects and response
More than medication
Depending on the cause, management may also consider:
- Cardiovascular risk reduction
- Diabetes / metabolic management
- Hormonal evaluation
- Medication review
- Smoking cessation
- Physical activity
- Psychological / relationship support
- Specialist referral
The goal is not simply to prescribe a tablet — it is to understand what is contributing.
Private, respectful and confidential care.
Sexual-health concerns can be difficult to discuss. Consultations should provide privacy, time, respectful communication, non-judgemental care and opportunity to ask questions.
When urgent medical attention may be needed
Seek urgent medical attention for serious or sudden symptoms such as:
- Significant chest pain or cardiovascular symptoms
- Severe acute genital pain
- Prolonged painful erection
Why Choose Cayman Medical
Confidential Care
Private consultation for sensitive concerns.
Physician-Led
Medical assessment before treatment.
Whole-Health View
Sexual health considered alongside cardiovascular, metabolic and hormonal health.
Connected Diagnostics
Testing or referral coordinated when clinically appropriate.
Personalised Treatment
Treatment based on the individual rather than a one-size-fits-all approach.
Frequently asked questions
Erectile dysfunction is persistent difficulty obtaining or maintaining an erection sufficient for satisfactory sexual activity. Occasional difficulty is common and does not always mean ED.
Yes. Erectile difficulties are common and often under-reported. Many men delay seeking help because of embarrassment.
Not necessarily. A single occasional episode does not necessarily indicate erectile dysfunction. Persistent or recurrent concerns are more useful to discuss medically.
There is an association between erectile dysfunction and cardiovascular disease. In some patients, ED may be a reason to review cardiovascular and metabolic health.
No. ED does not necessarily indicate cardiovascular disease, but broader assessment may be appropriate depending on your history and risk factors.
Diabetes and other metabolic factors can contribute to erectile difficulties. Assessment may include metabolic health review where relevant.
Hormonal factors, including low testosterone, can sometimes contribute — especially when erectile symptoms occur with reduced libido or other hormonal concerns.
The Sexual Health Inventory for Men is a short five-question screening tool that helps estimate the severity of erectile difficulties over the previous six months.
Scores range from 5 to 25 and map to screening categories from no significant ED to severe ED. Your physician can help interpret the result in clinical context.
No. A SHIM score is a screening result, not a medical diagnosis.
Depending on your history, assessment may include blood pressure, laboratory testing, diabetes or metabolic testing, hormonal assessment or further cardiovascular evaluation.
Oral PDE5 inhibitors such as sildenafil, tadalafil, vardenafil and avanafil may be discussed where clinically appropriate after medical assessment.
No. Suitability depends on cardiovascular health, other medicines and individual circumstances. Medication should be reviewed properly before prescribing.
Yes. Sexual-health consultations are private, respectful and confidential.
Book through the contact page, call 623-1000, or WhatsApp 326-1000. You can request a men’s health consultation when you get in touch.
Men’s Sexual Health
You do not have to manage erectile concerns alone.
Start with a confidential medical consultation to understand what may be contributing and which next steps are appropriate for you.
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