Erectile dysfunction is the medical term for erectile dysfunction. It is a sexual disorder that affects many men. Erectile dysfunction occurs when most attempts to have sexual intercourse fail. Erectile dysfunction should be clarified by a doctor. In older men in particular, it can be a sign of heart problems later in life.
Here you will find further information as well as selected specialists and centers for erectile dysfunction.
Erectile dysfunction occurs when at least 70% of all attempts at sexual intercourse fail. Around 20% of men are affected.
Erectile dysfunction is not a disease in its own right, but a symptom of another disorder. For example, it can be a sign of impending heart problems. If you suffer from erectile dysfunction, you should therefore definitely have an examination. This will allow you to have the underlying disease treated at an early stage.
Sexual dysfunction can also have a negative impact on your quality of life and your relationship. For these reasons, a visit to the doctor is highly recommended for erectile dysfunction.
Many sufferers do not want to seek medical help out of shame. But erectile dysfunction is not an isolated case: a study found that 52% of all men aged 40-70 are affected by erectile dysfunction at least some of the time.
The occurrence of erectile dysfunction depends largely on age. In the third decade of life, only around 2.3% of men suffer from erectile dysfunction. In the seventh decade, significantly more than 50 percent are already affected.
False shame is therefore not appropriate here
The causes of erectile dysfunction can be both psychological and organic. Various factors often play a role.
Erectile dysfunction often has several causes. They can be attributed to various factors that are mutually dependent.
In younger men, psychological problems are usually the cause of erectile dysfunction. Fear of sexual failure usually plays a role here. This fear often goes hand in hand with
Unsuccessful sexual intercourse can put a heavy strain on a couple's relationship © drubig-photo / Fotolia
With increasing age, organic causes play an increasingly important role. Typical risk factors are, for example
Vascular problems are a relatively common phenomenon. Nevertheless, this cause is rarely clarified - even by experienced doctors.
Erectile dysfunction is particularly common in diabetes patients. It occurs in around 75% of diabetics over the age of 60 and continues to increase as the diabetes progresses.
Around 50% of patients with heart disease are also affected by erectile dysfunction. Over 70% of patients who have suffered a heart attack also show this symptom.
Most heart diseases are caused by arteriosclerosis. The diameter of the blood vessels is reduced by deposits on the vessel walls. Circulatory disorders are the result.
A heart attack occurs when the coronary arteries of the heart are so narrowed that the heart muscle is no longer supplied with blood. The coronary arteries have a diameter of 3-4 mm.
Arteriosclerosis: Deposits in the vessels reduce the blood flow
Prior to this, the finer arteries in the corpus cavernosum of the penis (1-2 mm in diameter) may already be impaired.
For this reason, erectile dysfunction can be an early indication of more serious heart disease on the horizon. Nearly all patients suffer from erectile dysfunction around three years before they develop cardiovascular problems.
Therefore, everyone affected should have the cause of their erectile dysfunction investigated. If necessary, a specialist, such as an
should be consulted. In this way, serious illnesses can be detected at an early stage and serious consequences avoided.
Further information on the interdisciplinary approach can be found in the article"Interdisciplinary options for diagnosis and treatment of organic erectile dysfunction".
However, medication can also lead to erectile dysfunction, for example beta blockers or antiandrogens. These have the effect of inhibiting the action of male sex hormones.
You should always consult a urologist if you have erectile dysfunction. If necessary, the urologist can consult a neurologist and psychotherapist. Interdisciplinary collaboration is often necessary.
In the so-called anamnesis interview, the urologist clarifies what the sexual problems look like and how long they have existed.
In the best case scenario, it will already be clear whether psychological factors are causing the erectile dysfunction. The doctor will also check any medication the patient may be taking. Some active ingredients can promote erectile dysfunction.
Other examinationoptions include ultrasound and a blood test. An ultrasound examination can provide indications of injuries. The blood test can reveal hormonal disorders.
If the urologist detects organic damage, he will choose other methods to find out the cause of the erectile dysfunction.
These include the so-called NPTR measurement, which records any nocturnal erections. In an organically healthy man, these occur between three and six times a night and last up to ten minutes. If they also occur in a patient who suffers from erectile dysfunction, this is a clear indication of psychological causes.
To rule out a vascular disorder, the doctor often recommends erectile tissue injection therapy. This involves injecting medication to induce an erection. If this lasts for more than 15 minutes, damage to the blood vessels is very unlikely.
Vascular problems can be ruled out using duplex sonography (also known as Doppler sonography ). This method is used to obtain a wide range of data about the blood flow in a man's body.
Since September 2012, a medical guideline has recommended treatment options for erectile dysfunction. However, these guidelines are not binding and must be adapted to each individual case. There are also several approaches to treating erectile dysfunction.
In the case of psychological causes, psychotherapy or counseling sex therapy are the best forms of treatment. If necessary, the partner should also be involved. If an illness is actually present, the treatment costs are covered by health insurance.
Erectile dysfunction can also often be alleviated with the administration of potency-enhancing medication. However, affected patients should refrain from self-medicating. The patient can only be optimally adjusted to the medication under medical supervision.
Tissue hormones, known as prostaglandins, have also proven to be effective. They can either be injected or inserted into the urethra. They are introduced using a stick soaked in the active substance, which releases it into the mucous membranes in the urethra.
Vacuum pumps can help the patient to achieve an erection. When placed over the penis, they create a vacuum that fills the erectile tissue of the penis with blood and thus causes an erection.
The specialist literature speaks of a 70 percent satisfaction rate, whereby it was not just the man but the couple who were asked.
Under certain circumstances, catheter treatment can mechanically reopen the blocked arteries. Whether the prerequisites for this therapy are met is determined by the examinations carried out beforehand.
During balloon catheter dilatation, the angiologist inserts a tiny tube into the small pelvic arteries. These supply the penis with blood. He inflates a small balloon on the spot and thus opens the constrictions.
This procedure has been used for some time in the treatment of coronary heart disease. Thanks to the miniaturization of the catheter, the method is also suitable for even thinner blood vessels. The treatment can be performed under local anesthesia on an outpatient basis for the majority of patients.
Afterwards, however, heavily calcified vessels would constrict again. The angiologist therefore inserts drug-eluting stents in sections at risk. These are grid-like vascular supports that keep the vessel open.
For around 60% of patients, the treatment is successful and the erectile dysfunction is reduced. This means that the blood flow that is important for an erection can often be restored in a very gentle, minimally invasive way. Further information on this procedure can be found in the specialist article"Erectile dysfunction and cardiovascular medicine".
However, vasoconstriction recurs in a third of patients after 6 months.
Balloon catheter dilatation and stent deployment, here on the coronary arteries
Erectile dysfunction can also be treated surgically under certain circumstances. This is necessary if there are vascular injuries or if the patient has had a hernia.
Overall, around 80% of patients are satisfied with the surgical method.
Shockwave therapy is another treatment option for erectile dysfunction. However, the data is still too sparse to provide a clear picture.
This treatment is intended to stimulate blood flow locally at the erectile tissue. Around two thirds of patients who have undergone this treatment report positive effects.
An erectile tissue implant in the penis can produce an erection if desired. However, this irrevocably destroys the body's own erectile tissue. This option is therefore only used if no other therapy helps.
The level of suffering for those affected by erectile dysfunction is still enormous. In German-speaking countries, it is still not properly recognized. In addition, neither private nor statutory health insurance companies are obliged to cover the costs of sexual enhancers.
Erectile dysfunction is often equated with inability to conceive. However, this is not correct. Patients who suffer from erectile dysfunction can have ejaculations and also conceive children naturally. Erectile dysfunction therefore has nothing to do with a general inability to conceive.
Intensive efforts are currently underway to remove the taboo from the subject.
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