Erectile Dysfunction: Therapy: Symptoms, Causes, Treatment

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

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.

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 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)
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.

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.

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.