When men can no longer do as they wish
Erectile dysfunction (ED) , also known colloquially as impotence , refers to the persistent inability to get or maintain an erection sufficient for satisfactory sexual intercourse.
Every man experiences occasional "lapses" - it only becomes problematic when erectile function is impaired in more than two-thirds of cases over a period of at least six months .
Erectile dysfunction particularly affects men between 40 and 60, often going unrecognized or untreated , as shame, insecurity, or misconceptions can prevent diagnosis. However, erectile dysfunction is not just a sexual problem, but often a systemic health issue – with indications of cardiovascular risks, hormonal deficiencies, or psychological stress.
What is erectile dysfunction?
By definition, it is a sexual dysfunction in which:
- an erection fails to occur
- an erection lasts too short a time
- or the erection is insufficient for penetration
despite existing sexual desire.
Unlike "normal" loss of libido, in ED the desire often remains intact. The "ability" is impaired, not the "wanting".
How does erectile dysfunction manifest itself in men?
- Difficulty getting an erection during sexual intercourse
- The erection "disappears" during intercourse.
- Decreased morning or spontaneous stiffness
- Increasing insecurity, avoidance of intimacy
- Shame, withdrawal from the relationship
Often, a vicious cycle begins of fear of failure, stress and even greater insecurity, which exacerbates the symptoms.
What are the causes of erectile dysfunction?
Erectile dysfunction is multifactorial . Physical and psychological factors often interact.
Physical causes:
- Circulatory disorders (e.g., arteriosclerosis)
- High blood pressure, diabetes, lipid metabolism disorders
- Hormonal causes: testosterone deficiency (hypogonadism), low DHEA or dopamine levels
- Nerve damage (e.g., from prostate surgery)
- Side effects of medications (e.g., beta-blockers, antidepressants)
Psychological causes:
- Performance pressure, fear of failure
- Relationship conflicts
- Stress, lack of sleep
- Depression or chronic dissatisfaction
- Pornography addiction or sensory overload
Lifestyle factors:
- Overweight, especially abdominal fat
- Lack of exercise
- Smoking, alcohol, drugs
- Poor sleep quality
How is erectile dysfunction diagnosed?
The diagnostic process begins with a detailed medical history interview. Important questions:
- How frequently does this problem occur?
- Do you experience spontaneous morning erections?
- Do nocturnal erections occur?
- Are there any underlying medical conditions or medications present?
Also useful:
- Laboratory analysis (testosterone, free testosterone, DHEA, SHBG, prolactin, cortisol, thyroid, blood sugar, lipids)
- Penis Doppler ultrasound (examination of blood flow)
- Questionnaires , e.g., IIEF (International Index of Erectile Function)
A very helpful screening tool is the AMS questionnaire , which you can use directly on our website free of charge:
👉 Fill out the AMS questionnaire now
How can erectile dysfunction be treated?
1. Cause-related therapy
- Treatment of underlying diseases (e.g., high blood pressure, diabetes)
- Hormone replacement therapy (e.g., testosterone therapy in cases of proven deficiency)
- Improving blood circulation through lifestyle changes
- Stress management and sleep optimization
- Psychotherapeutic support if ED is psychogenic
2. Drug options
- PDE-5 inhibitors (e.g., sildenafil, tadalafil): Promote vasodilation in the penis.
- Vacuum pumps , penile injections , penile prostheses (in severe cases)
Use only under medical supervision – especially in cases of cardiovascular disease.
3. Natural Strategies and Supplements
- L-Arginine , Citrulline : Promote nitric oxide production
- Zinc, vitamin D, B vitamins : Improve hormone balance
- Adaptogenic plant substances (e.g., Ashwagandha, Ginseng)
- Endurance training & strength training : Promote blood circulation, testosterone production, dopamine
Erectile dysfunction as an early warning system
ED is often the first sign of silent vascular damage, approximately 3-5 years before a heart attack or stroke may occur. Therefore, it should not be viewed as an isolated problem , but rather as a serious indicator of:
- Vascular health
- Hormone status
- Total stress on the body
What concrete steps can men take?
- Take the symptoms seriously, don't ignore them
- Speak openly with your doctor – the sooner, the better.
- Have your hormone levels checked regularly
- Consciously designing nutrition, training and sleep
- Strengthening partnership communication
Conclusion
Erectile dysfunction is widespread and, in the vast majority of cases , easily treatable . It is not a sign of weakness, but rather an indication of changes in the body that deserve attention.
Those who take action early can not only regain their sexual function, but also stabilize their heart, hormones and mental health .
You can learn more about erectile dysfunction in our blog article “ **Erectile Dysfunction: All in the Mind or a Health Warning Sign? **.
🎧 Also listen to our men's health podcast with PD Dr. Jäger about causes, myths and modern therapies for erectile dysfunction:
