No man likes to talk about that: erectile dysfunction. About a third of men over the age of 60 in Germany suffer from it. In those between 40 and 49 years old, it is already ten percent. Experts assume that the number of unreported cases is much higher. Because erectile dysfunction (ED) is still a taboo subject in our society. Many men avoid going to the doctor. The result: without treatment, for example with medication, the symptoms worsen and those affected suffer more and more.
frequent Causes of erectile dysfunction
An erection is caused by an increased blood supply to the penis. Blood is pumped under high pressure through dilated arteries into the erectile tissue. The veins are compressed. The result: the pressure on the erectile tissue increases and the penis becomes hard. This process is only possible through the complex interaction of nerves, blood vessels and hormones.
There are many reasons for impaired erectile function. Most of the time it is caused by physical causes, but psychological factors can also play a role. There also seems to be a connection between Long Covid and erectile dysfunction: researchers are currently on the way.
Psychological reasons for erection problems
Psychological reasons such as stress, depression, anxiety disorders, or stressful events are more likely to trigger erectile dysfunction in younger men. However, they should always be considered as a cause.
Testosterone deficiency as a cause of erectile dysfunction
A (naturally) declining testosterone level can cause problems as you age. In rare cases, a testosterone deficiency is congenital. Erectile dysfunction is also sometimes the result of taking medications, injury (for example, a pelvic fracture), or surgery (on the prostate or intestines).
Erectile dysfunction due to lifestyle and previous diseases
However, the main cause is often lifestyle: smoking, alcohol, obesity, and lack of exercise can damage blood vessels, thereby impeding blood flow to erectile tissue. Potency disorders sometimes indicate impending heart attacks and strokes or are due to diseases that affect the central nervous system. These include Alzheimer’s disease, Parkinson’s disease, and multiple sclerosis. Diabetes mellitus, arterial hypertension, fatty liver or lipid metabolism disorders favor circulatory disorders and, therefore, erection problems.
Symptoms of erectile dysfunction
There is a helplessness when
- a man cannot get or maintain an erection sufficient for sexual intercourse,
- the problem occurs in more than two thirds of the relevant situations and/or the problems persist for several months.
Diagnosis of erectile dysfunction
Sometimes erectile dysfunction indicates a serious condition. If there are potency problems for several months, those affected should see their family doctor or a urologist.
First of all, in a conversation with the doctor, it is clarified what previous illnesses, injuries, operations, medications or living conditions may be the cause of the disease.
Then there are several investigations. The level of testosterone in the blood is measured and the penis is examined for any nerve damage with weak electrical impulses. Additionally, a corpus cavernosum injection test can provide information about the functionality of the corpus cavernosum. A drug is injected into the penis to induce an erection.
A stay in the sleep lab can also help find the causes of problems. A nocturnal penile tumescence measurement measures spontaneous erections during sleep. If the values are normal, this tends to indicate psychological causes of the disease.
Therapy Options for Erection Problems
Depending on the result of the examination, the urologist will refer the patient to other specialists such as psychologists, neurologists or cardiologists. To treat the symptoms, the expert can suggest numerous therapeutic measures. Psychotherapy, medication, mechanical aids and also sports can be considered.
Drug treatment: Testosterone, Viagra & Co.
Testosterone is often given as a gel or by injection. Pills such as the well-known Viagra are also used: the substances they contain, the so-called PDE-5 inhibitors, cause, among other things, a dilation of the blood vessels. In erectile tissue self-injection therapy (SKAT), a man injects a drug into his penis with a very fine needle. The so-called medicinal urethral system for erection (MUSE) works in a similar way: the active ingredient passes through the urethra to the erectile tissue through a kind of ovule.
Mechanical treatment for erectile dysfunction
Other patients get the desired result using a vacuum pump. It is also possible to implant silicone pads in the erectile tissue. However, this method cannot be undone.
Medical saddle for erectile dysfunction
Buying an ergonomic saddle can make sense for frequent cyclists. The saddle tip of the medical saddle (also known as a prostate saddle) is missing. The special shape prevents the nerves in this sensitive area from becoming strained.
Sport promotes the release of testosterone
A healthy lifestyle with a balanced diet and regular exercise is essential for functional potency. Strength and endurance sports strengthen muscles and tissues and thus lead to an increased release of testosterone.
A special interval vascular training for the swollen cells of the penis can also be helpful. If the optimal penile tissue composition (55 percent erection-promoting cells) is not provided, one can try to rebuild the corresponding cells. To do this, go all out for 30 to 45 seconds, for example running triplets, then take a three to three and a half minute break. Repeat everything. Cycling is not suitable, as the vessels can be squeezed.
The untrained should cautiously start with two intervals two days a week, with recovery time in between. Training can be increased up to three days a week with six intervals each. During exertion, blood is sucked out; when the muscles relax, blood and oxygen return to the erectile tissue. This stimulates the accumulation of important cells through biochemical processes.
Pelvic floor training supports power
Also, specific pelvic floor training can be helpful: what helps women after pregnancy acts as a natural sexual enhancer for men. Because in the pelvic floor are the power muscles, which are functionally connected to the cavernous bodies of the limb.
If you have too many pounds on your ribs, you will especially benefit from weight loss. Above all, the belly fat between the organs must be melted away, because it produces large amounts of disruptive hormones.
In general, those affected should eat few sweets and reduce meat consumption. Instead, eat plenty of bluish-red vegetables and berries like red cabbage, red onions, blueberries, and blackberries – a study confirms the power of the anthocyanins they contain to improve blood circulation. The protein component L-arginine has also been shown to have an effect similar to Viagra: it helps to dilate vessels and increase blood flow. L-arginine is mainly found in pumpkin seeds, peanuts and almonds, beef, tuna, chicken and lentils.
Live sexuality, even without an erection
In conversations, sex therapists can help their patients find a new way to deal with sexuality. Sexuality has a lot to do with evaluations and expectations: there are some things that can be learned and changed: if your partner is understanding, you can enjoy the union even without an erection.
subject matter experts