Recognizing and Treating Erectile Dysfunction | – Guide

Status: 06/06/2022 2:58 p.m.

One in three German men over the age of 60 suffers from erectile dysfunction. If symptoms persist for months, clarification is advised. Medications and other therapeutic measures can help.

No man likes to talk about it: erectile dysfunction. About a third of men over the age of 60 suffer from it in Germany. Among 40-49 year olds, it is already 10%. 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 are reluctant to go 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 increase in blood supply to the penis. Blood is pumped under high pressure through dilated arteries into the erectile tissue. The veins are compressed. Result: the pressure in the erectile tissue increases and the penis stiffens. This process is only possible through the complex interplay of nerves, blood vessels and hormones.

There are many reasons for impaired erectile function. Most often 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 trail.

VIDEO: Recognizing and Treating Erectile Dysfunction (7 mins)

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. Nevertheless, 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, testosterone deficiency is congenital. Sometimes erectile dysfunction is also the result of taking medication, injury (eg broken pelvis) or surgery (on the prostate or intestines).

Erectile dysfunction due to lifestyle and previous illnesses

However, the main cause is usually lifestyle: smoking, alcohol, obesity and lack of exercise can damage blood vessels so that blood flow to erectile tissue is impeded. Potency disorders sometimes indicate impending heart attacks and strokes or are due to diseases affecting the central nervous system. These include Alzheimer’s disease, Parkinson’s disease and multiple sclerosis. Diabetes mellitus, arterial hypertension, hepatic steatosis or lipid metabolism disorders promote circulatory disorders and therefore erection problems.

Symptoms of erectile dysfunction

There is impotence 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 problems with activity over several months, those affected should therefore consult their family doctor or a urologist.

First, in a conversation with the doctor, it is clarified what previous illnesses, injuries, operations, medications or living conditions may be causing the disease.

Then there are several surveys. 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 cause an erection.

A trip to 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.

Treatment options for erectile problems

A physiotherapist and her patient are sitting on a ball © NDR

Not just for women: In addition to changing your diet, regular pelvic floor training can help those affected.

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 many therapeutic measures. Psychotherapy, medication, mechanical aids and also sports can all be considered.

Drug treatment: Testosterone, Viagra & Co.

Testosterone is often given as a gel or by injection. Tablets such as the well-known Viagra are also used: the substances they contain, called PDE-5 inhibitors, cause, among other things, dilation of blood vessels. In erectile tissue self-injection therapy (SKAT), the man injects medication 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 penetrates through the urethra into the erectile tissue via a kind of suppository.

Mechanical treatment of erectile dysfunction

Other patients achieve 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 riders. The saddle tip is missing from the medical saddle (also called the prostate saddle). The special shape prevents the nerves in this sensitive area from being 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 a greater release of testosterone.

Special vascular interval training for penile swelling cells can also be helpful. If the optimal tissue composition of the penis (55% erection-promoting cells) is not given, one can try to reconstruct the corresponding cells. For this, make a full effort for 30 to 45 seconds, for example running triplets, then take a break for three to three and a half minutes. Repeat it all. Cycling is not suitable, as the vessels can be compressed.

Untrained people should start cautiously with two intervals two days a week – with recovery time in between. Training can be increased up to three days per week with six intervals each. During the effort, the blood is aspirated; when the muscles relax, blood and oxygen return to the erectile tissue. This stimulates the formation of important cells via biochemical processes.

Pelvic floor training supports power

In addition, targeted 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.

Potency enhancing nutrition

If you have too many pounds on the ribs, you will especially benefit from weight loss. Above all, the fat in the abdomen between the organs must melt, because it produces large amounts of disruptive hormones.

In general, affected individuals should eat few sweets and reduce their meat intake. Instead, eat lots of blue-red vegetables and berries like red cabbage, red onions, blueberries and blackberries: a study confirms the circulatory power of the anthocyanins they contain. The protein component L-arginine has also been proven to have a similar effect to Viagra: it helps dilate vessels and increase blood flow. L-arginine is mainly found in pumpkin seeds, peanuts and almonds, beef, tuna, chicken and lentils.

Live sex – even without an erection

In conversations, sex therapists can help their patients find a new way to approach sexuality. Sexuality has a lot to do with assessments and expectations – there are a few things that can be learned and changed: If your partner is understanding, you can enjoy togetherness even without an erection.

subject matter experts

More information

Schematic representation of a budding erection © NDR

An erection is a complex process. This series of images explains how a penis stiffens as a result of the interaction of nerve impulses, muscles and blood flow. Photo gallery

Movement Doc Helge Riepenhof monitors a patient during exercises on the gym mat.  © NDR/nonfictionplanet

Regular endurance units are ideal – as well as muscle power training: pelvic floor exercises for men. After

A plate with pieces of carrot cake is on the table.  © NDR Photo: Claudia Timmann

Not too much white flour, but more anthocyanins and L-arginine: If you suffer from erectile dysfunction, you must include these in your diet. After

Red cabbage © fotolia Photo: womue

Reduce belly fat, eat vegetables with anthocyanins and enough L-arginine every day: natural remedies for more potency. After

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Visit | 07.06.2022 | 8:15 p.m.

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