Treatment of erectile dysfunction follows a stepwise approach: medical consultation, lifestyle modification advice, and drug therapy.
General measures
- Nicotine restriction (refraining from tobacco use).
- Alcohol restriction (abstaining from alcohol)
- Regular physical activity (see also under sports medicine).
- Aim for normal weight! Determination of BMI (body mass index, body mass index) or body composition by means of electrical impedance analysis and, if necessary, participation in a medically supervised weight loss program or program for underweight.
- In the presence of diabetes mellitus, an optimal setting is required.
- Review of permanent medication due topossible effect on the existing disease!
- Avoidance of psychosocial conflict situations:
- Psychological problems
- Partnership problems
- Fear of failure
- Prolonged, exhausting work (“burnout syndrome“).
- Stress
Conventional non-surgical therapy methods
- Drug therapy
- Erectile tissue auto-injection therapy (SKAT) – the effect of SKAT, unlike drugs, is independent of intact nerve pathways. Therefore, corpus cavernosum auto-injection therapy can also help men in whom surgery has destroyed the nerves responsible for erection.
- Vacuum erection aid – oldest therapy method of erectile dysfunction (ED). The vacuum erection aid is particularly low side effects. Of disadvantage is the cumbersome handling. Couples living in a long-term relationship have a good acceptance for the procedure.Indication: failure of drug therapy.
Surgical therapy
- Implantation of penile prostheses/implantation of a semirigid or hydraulic penile implant (means of the very last choice)Implantation of one-piece semirigid penile prostheses can be performed under local anesthesia (local anesthesia).Indication: all conservative methods have failed!
Nutritional medicine
- Nutritional counseling based on nutritional analysis
- Nutritional recommendations according to a mixed diet taking into account the disease at hand. This means, among other things:
- Daily total of 5 servings of fresh vegetables and fruits (≥ 400 g; 3 servings of vegetables and 2 servings of fruits).
- Once or twice a week fresh sea fish, i.e. fatty marine fish (omega-3 fatty acids) such as salmon, herring, mackerel.
- High-fiber diet (whole grains, vegetables).
- Observance of the following special dietary recommendations:
- Diet rich in:
- Vitamins (niacin (vitamin B3))
- Trace elements (zinc)
- Other vital substances (L-arginine; L-carnitine)
- Diet rich in:
- Selection of appropriate food based on the nutritional analysis
- See also under “Therapy with micronutrients (vital substances)” – if necessary, taking a suitable dietary supplement.
- Detailed information on nutritional medicine you will receive from us.
Sports Medicine
- Endurance training (cardio training) and strength training (muscle training) – for prevention and therapy.
- For middle-aged and older men, every half hour of moderate to vigorous physical activity more per day reduces the risk of ED by about 40%.
- Preparation of a fitness or training plan with suitable sports disciplines based on a medical check (health check or athlete check).
- Detailed information on sports medicine you will receive from us.
Psychotherapy
- If psychological causes are present, psychotherapeutic treatment is helpful, if necessary, as couple therapy.
- Psychosexual therapy combined with a PDE-5 inhibitor resulted in satisfactory erections in more than half of cases in healthy men younger than 40 years.
- Detailed information on psychosomatics (including stress management) is available from us.
Complementary treatment methods
- Acupuncture
- Extracorporeal sound wave therapy (ESWT)