There are several options for the therapy of erectile dysfunction in men. If existing diseases are the cause, it is enormously important to treat them. Psychological counseling can also be supportive to treatment and relieving in the case of a purely physical cause of erectile dysfunction.
Help with erectile dysfunction: Do not be afraid of the doctor!
In the initial consultation with the doctor, the affected person must often overcome some shyness – after all, very many private topics, for example, the sex life come up. It often helps to visit a urologist who specializes in erectile dysfunction – he often also offers questionnaires to fill out, which many patients find easier than talking about it. In addition, many questions are asked about habits, other complaints, previous diseases and medications to find clues to the causes.
Diagnosis of erectile dysfunction
During the following physical examination, not only are the sexual organs palpated (from the outside, the prostate from the inside via the rectum), but blood pressure and pulse are also taken, for example, and the heart is listened to. The blood and urine are then examined. Depending on the suspected cause, further examinations may follow:
- Duplex ultrasonography: ultrasound is used as an imaging procedure to examine the blood vessels of the penis at rest and possibly after injection of an erection-promoting drug (erectile tissue injection test). Possibly, a more detailed vascular imaging is also carried out by means of X-ray contrast medium.
- Nocturne penile tumescence measurement: this method uses a measuring device to check whether and how much the penis erects over the course of several nights during sleep. Thus, its principle functioning can be determined.
- Urethrocystometry and urethrocystrography: with the help of an X-ray and a contrast medium or with the endoscope, it is examined whether the urethra or urinary bladder have pathological changes that could cause the erectile dysfunction.
- Erectile tissue injection test (SKIT): here a substance is injected directly into the erectile tissue, which triggers an artificial erection. Thus, on the one hand, the condition of the arteries and veins in the penis can be assessed, as well as a possible subsequent treatment with this agent.
- Arterial angiography: here, too, an X-ray is used. After triggering an artificial erection, the doctor injects a contrast agent, so that erectile tissue and veins can be examined.
- Cavernosometry: in this examination method, a liquid is introduced into the corpus cavernosum of the penis by means of a pump. It is measured in which frame the inflow must be in order to maintain erection.
- Electrical stimuli: If diabetes exists, electrical stimuli are sometimes used to determine if nerve damage is the cause of the disorder.
Involvement of the partner
Often, the counseling and treatment involves the life partner or the partner – this relieves the pressure to perform through the open discussions and improves the fear of failure in possible erectile dysfunction. Often, talking to the woman can help break this vicious cycle.
Erectile dysfunction treatment
Various options are available for the therapy of erectile dysfunction – from tablets that enhance erectile function, to mechanical aids, to surgical interventions. Sex psychological therapies are also used, depending on the cause and the need. Erectile dysfunction should be taken seriously, as it can be a sign of a serious physical illness. Therefore, in case of erectile dysfunction, no false shame is indicated, but a quick visit to the doctor.
Medication for erectile dysfunction
The following medications can help with erectile dysfunction:
- Phosphodiesterase-5-inhibitors (PDE-5-inhibitors) are most commonly used, which prolong erectile dysfunction – provided there is a principle arousal and erectile function. In addition, the patient must not have any cardiovascular disease. Preparations are sildenafil (Viagra), tadalafil (Cialis) and vardenafil (Levitra).
- The active ingredient apomorphine (for example, Uprima, Ixense) is a dopamine receptor agonist that enhances the natural signals in the brain that trigger an erection.
- Phentolamine (Vasomax) is a non-selective alpha receptor blocker that can support an erection by acting on the penile muscles.
- If the erectile dysfunction is due to a deficiency of testosterone, this or its precursor dehydroepiandrosterone (DHEA) can be taken, injected, applied as a patch to the skin or applied as a gel to the skin.
- The substance alprostadil acts directly on the penis, either by injecting it into the erectile tissue with a very thin needle (erectile tissue auto-injection therapy) or by inserting it into the urethra as a mini-tablet. The drug has a vasodilator effect.
- In the case of erectile tissue auto-injection therapy (SKAT), an active substance is injected directly into the erectile tissue. Because an extremely thin needle is used, there is hardly any pain. The erection occurs after about 10 minutes.
All these means for the treatment of erectile dysfunction are not over-the-counter, but prescription. This has a good reason: the therapy should always be accompanied by a doctor. In addition, with otherwise purchased means, there is a risk that they are counterfeited, adulterated or – in the best case – ineffective. In this case, there are no liability claims in the event of side effects. In any case, it is helpful to discuss the problems openly not only with the doctor, but also with the sexual partner. This alone often creates relaxation and an improvement in the symptoms of impotence.
Mechanical aids for erectile dysfunction and surgery.
An erection can be achieved with the help of a vacuum pump and maintained with a penile ring (anatomically customized) subsequently slipped over the base of the penis. An operation in which the blood supply or the outflow of blood from the penis is controlled by a kind of bypass or vascular surgery is also possible. However, the chances of success of surgery for erectile dysfunction are very limited. More on the topic and further tips can be found in our photo gallery.
