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You are not alone: roughly one in three men over 40 struggles with erection problems at some point. The good news is that in most cases, help is available. In this article, you'll learn what causes erectile dysfunction, how diagnosis works, and which modern treatment options are available to you.
What Are the Most Common Causes of Erectile Dysfunction?
Erectile problems can have physical, psychological, or mixed causes. The most common triggers are:
Physical causes
- Circulatory problems (e.g. arteriosclerosis)
- Diabetes mellitus, in older age usually type II
- Testosterone deficiency, where the underlying cause must be investigated. Disorders can occur at various levels of the hormonal regulatory system. A testosterone deficiency often occurs as a side effect of the metabolic disorder in type II diabetes.
- Side effects of medication
Psychological causes
- Everyday or work-related stress
- Performance pressure
- Anxiety disorders
- Depression
Lifestyle factors
- Smoking
- Alcohol abuse
- Lack of exercise (due to the resulting poorer circulation and oxygen supply)
How Does Diagnosis at the Urologist Work?
The first step is an open, trusting conversation with your urologist. This covers not only your medical history, but also your current lifestyle.
Typical examinations
- Blood tests (e.g. hormone levels, blood sugar, cholesterol)
- Ultrasound of the penile blood vessels
- Erectile function testing (e.g. nocturnal penile tumescence testing, injection test)
Tip: openness is key – the more your doctor knows, the more precisely they can help.
Which Medications Help with Erectile Dysfunction?
In many cases, so-called vasoactive agents help, as they improve blood flow to the penis. Several preparations containing this active ingredient are available.
These should always be taken in consultation with a doctor, particularly in the case of cardiovascular disease or eye conditions.
What Alternatives to Tablets Are Available?
Not everyone responds to medication, or wants to take it long-term. Alternatives include:
Vacuum pump
A mechanical device that creates a vacuum, drawing blood into the penis.
Penile implant
A surgical procedure, primarily used for severe erectile dysfunction.
Shockwave therapy
A modern method to promote blood flow.
Injection therapy
Direct injection of an active substance into the corpus cavernosum using a fine needle.
When Does Psychological Support Make Sense?
When fears, mental blocks, or relationship conflicts play a role, sex therapy can be very helpful.
Benefits
- Understanding and resolving underlying causes
- Improving the relationship
- Building self-confidence
Many men benefit from a combination of medical and psychological therapy.
Erectile Problems Are Treatable
Erectile dysfunction is not a taboo subject. With the right diagnosis and an individual treatment plan, quality of life can often be significantly improved. Talk openly with your urologist – help is available!
