Erectile Dysfunction Guide: Causes, Symptoms & Therapy Tips

If “He” can’t do what you want him to do anymore, it can be pretty stressful. After all, a fulfilled sex life is for most people one of the basic prerequisites or at least an important part of a happy partnership.

Maybe you also know this: When a man notices the first signs of sexual weakness, the panic is often great. You feel inferior, powerless and no longer a “whole man”. The problem with that:

Often a self-fulfilling prophecy begins. The pressure to have to be able again intensifies the problem – a vicious circle is set in motion, from which you can hardly get out on your own.

Erectile Dysfunction: This guide will help you!

I’ll explain all the important facts about erectile dysfunction, find out the causes and question them, and finally give you the necessary tips and tricks to get the problem under control as quickly as possible.

What is an erectile dysfunction?

Mann schämt sich
Patients often suffer very much from their disease.

Erectile dysfunction (ED) – which sounds very scientific and difficult to understand at first, is basically nothing more than a potency disorder or erectile dysfunction. In the vernacular one speaks also of Impotenz, although science and medicine make clear differences here. While in ED there may still be some erections, one only speaks of impotence when literally “nothing works anymore”.

Characteristic for erectile dysfunction is the fact that the man does not succeed in achieving a sufficiently strong erection of the penis over a longer period of time or in the majority of attempts, or to maintain it after achieving it. The emphasis on “longer period” is important here. If the erectile dysfunction only persists for a short period of time, it is usually not referred to as erectile dysfunction.

If erectile dysfunction is detectable, medicine distinguishes between two different forms. Which form is present is determined in particular by the time it occurs.

Primary erectile dysfunction
Primary erectile dysfunction occurs when symptoms have occurred since birth or sexual maturity, or when an erection is not possible. Primary ED is therefore comparable to complete impotence.

secondary erectile dysfunction
If the ED occurs after the man has had normal erections for a longer or shorter period of time, this is referred to as secondary erectile dysfunction

The proliferation of erectile dysfunction

If you are affected by erectile dysfunction, you are by no means alone. The diagnosis of ED is far more widespread than most patients believe. This is mainly due to a large number of unreported cases, as this is a classic taboo subject that only very few men can talk about openly.

Statistics show that about 52% of all men between the ages of 40 and 70 have erection problems in phases. Almost 10% of men suffer permanently from an insufficient or insufficiently long erection. The figures are slightly different for younger men. According to studies, about 16% of the men suffer from occasional erection problems, two percent of the interviewees have permanent erectile dysfunction.

Causes for erectile dysfunction

Unfortunately, erectile dysfunction also offers conflict potential in partnerships.

In principle, a distinction must be made between physical (organic) and psychological causes of erectile dysfunction. However, various scientific studies have shown that the purely psychological causes are clearly in the minority, statistically accounting for only about five percent of all cases. In the majority of cases, erectile dysfunction results from a mixture of different causes, both physical and psychological. In old age, this ratio shifts even more towards the physical causes, so that from an age of about 50 years more than 80% of all cases are physically caused.

Psychic causes

One of the main triggers of psychological causes of erectile dysfunction is anxiety. These fears, in turn, can result from relationship conflicts, separation experiences, professional failures, self-reproaches, etc. The role of pleasure in itself also plays a role here.

Surely you will have noticed that in advertising the focus on human desire has been increasing for years. The consequences are: Many people feel more and more pressure to live up to the image they have lived through. The perfect body, always and everywhere “able”, an always exciting sex life – that’s what advertising pretends to us. And we pant afterward…

It is precisely from this pressure that these fears arise, which often culminate in serious physical illnesses. They have become one of the most common causes of sexual disorders in younger people, both men, and women.

Organic Causes

The organic causes of erectile dysfunction are much easier to determine than the psychological ones. Let’s take a closer look at the most important of these causes:

Diabetes mellitus

Diabetes – no matter in which form – is one of the main organic causes of erectile dysfunction. As a result of diabetes, many parts of the body are less well supplied with blood (e.g. hands, feet, etc.), which also affects the penis.

high blood pressure

High blood pressure can have several negative effects on the ability to get an erection – directly and indirectly. If hypertension is not treated for a long period of time, the blood vessels are damaged, which in turn can trigger erectile dysfunction. If the high blood pressure is treated with medication, the side effects can lead to ED. And a successful lowering of the blood pressure can also ensure that the blood supply to the penis is poorer and erectile dysfunction occurs. It’s better not to let it get that far in the first place.

Hormonal dysbalances

A testosterone deficiency that is too low can also often provoke erectile dysfunction and problems with potency. Patients who have too little testosterone in their blood often suffer from libido loss and simply lose interest in sex. If the desire is missing, then also the erection does not have desire – it cannot be forced namely.

Smoking, alcohol and other drugs

Heavy smoke suffers more frequently from erectile dysfunction.

Do you like to look a little too deep into the glass or have been a more or less heavy smoker for many years? Then you are one of the risk patients for erectile dysfunction. Smoking generally narrows the blood vessels, alcohol can cause long-term damage, especially if consumed for many years. All this can result in ED. Maybe you should reconsider your lifestyle.

In addition to these main risk factors for erectile dysfunction, there are a number of other causes, some of which are very difficult to diagnose. Nevertheless, you should be aware of them:

  • injuries to the erectile tissue of the penis as a result of accidents or operations
  • General Vascular Calcification
  • Nerve damage in the area of the pelvis, e.g. after operations, radiation and metabolic diseases
  • Take-up of beta-blockers with corresponding side effects
  • Other drugs that affect blood flow and/or the nervous system (e.g., antidepressants, antiepileptics)
  • Blockades and tension of muscles, tendons and nerves in the lumbar spine
  • Spinal cord damage, often as a result of accidents
  • Too low testosterone level (especially below 8 nmol/l)

Important to know: If several risk factors are present simultaneously, the risk of developing erectile dysfunction increases exponentially.

How is erectile dysfunction diagnosed?

The other day it didn’t work out that well with you or your partner in bed. You panic. What if there are problems next time? The restlessness increases, and perhaps at this point you already ask yourself whether you could suffer from erectile dysfunction.


You should not worry your head in such a situation yet. Most erectile dysfunction is temporary and disappears by itself. In this case, medicine does not even speak of erectile dysfunction. However, when is this actually certain?

If despite everything, you suspect that you have potency problems with yourself and go to your family doctor, he will either take a sexual anamnesis himself or refer you to a specialist or to urology or andrology. The sexual anamnesis is a targeted and detailed survey of your sexual life.

Don’t worry: The doctor is subject to a legal duty of secrecy on the one hand, on the other hand, he has to deal with such cases on a daily basis – he wants to help you and therefore needs your full trust.

In addition to the sexual anamnesis, a psychological exploration (interview) may be necessary. If these examinations do not reveal any indications of a purely psychological cause for the sexual weakness, the doctor will then carry out a whole series of examinations in order to identify or rule out organic causes. These could be, for example, the following examinations:

  • Determine all relevant laboratory values (e.g. glucose, lipids, testosterone, prolactin, and liver values)
  • Nightly tumescence measurement (NPT)
  • sonography of the blood vessels of the penis
  • Biothesiometry of the penis
  • Cavernosometry / Cavernosography

After all examinations have been completed, you should be able to determine without any doubt whether you have a sexual disorder or even an erectile dysfunction.

What you can do with erectile dysfunction

Anatomy of the penis in erectile dysfunction
Erectile dysfunction is a common consequence of porn addiction.

How an ED is treated depends first of all on whether it is psychological or organic. If you have a psychic potency disorder, your doctor will advise you to undergo psychotherapy. Don’t worry: in this case you don’t have any “roof damage” and don’t have to sit on the infamous couch. The psychotherapist will have targeted discussions with you in order to find out the deeper causes and then suggest suitable therapy measures. These can also be conversations, but also practical exercises that you complete with your partner. The success rate with such psychotherapy is by the way very high!

In addition to the therapy, you can also be treated with medication, e.g. with a PDE-5 inhibitor such as Viagra or other preparations from pharmacy shelves.

Procedure for organically induced erectile dysfunction:

If you have been diagnosed with an organically caused ED, the possible treatment methods and therapies are very versatile. Again, it depends on which organic cause was found. In general, your doctor will first advise you to make various changes in your lifestyle that affect hormones, vascular health and general fitness. For example, erectile dysfunction due to high blood pressure:

Here it can already help to reduce a possibly existing overweight, quit smoking and/or drink less alcohol. A low-salt diet and the integration of sport into everyday life can also help. In any case read my article about potency enhancing foods!

In addition, drug therapy can be useful. A distinction is made between medications that are administered orally and those that are injected directly into the erectile tissue of the penis. Of course, you cannot use the latter yourself. In the meantime, there are also drugs that are inserted into the urethra with a special applicator.

Man holding his hands in front of his face
Don’t worry: Erectile dysfunction can usually be treated well.

Also known are so-called mechanical aids with which an erection can be induced or supported. For example, there is the penis pump, which is put over the penis. By pumping the air out of the cylinder, a slight negative pressure is created, which in turn allows more blood to flow into the erectile tissue. The outflow of blood is then prevented or made more difficult by a Penisring at the base of the shaft.

An alternative to the penis pump is a penis extender. This is a kind of belt which one wears e.g. at night when sleeping and is designed for different areas of application – among other things also with erectile dysfunction. If you are interested read my experiences with the Phallosan Forte.

Further possible approaches for the treatment of erectile dysfunction are hormone therapy and various surgical procedures that can be used, for example, to repair damaged vessels. Complete cavernous body implants are now also surgically inserted.

Caution against dubious treatment methods!

When searching the Internet, for example when you enter keywords such as “potency disorder” into a search engine, you will be struck dead with thousands of search results. Sometimes dubious websites promise you little remedies with which your problem should disappear into thin air within a very short time. Often such websites do not have sufficient imprint and offer preparations, which come from Asia or other distant areas and are not at all certified here in Germany.

My tip: Keep your hands off such preparations and the methods advertised on the Internet. They almost never keep what is promised. On the contrary: you can never know what is contained in the remedies and whether they can be harmful or even life-threatening.

I have made an extra list for it, I call you the honest list about potency means. There are all effective, not effective and dubious sexual enhancers listed, so that you recognize at first sight what you better keep your hands off.

Result: In most cases, erectile dysfunction is easy to control.

Don’t panic right away, if it doesn’t work out in bed the way you are used to or would like it to. Contact a doctor with your problem in confidence and have the causes of the problem clarified comprehensively. You can then take the necessary measures for therapy together with the doctor.

Show statistics: In most cases an erectile dysfunction can be reversed by reasonable action. So you can enjoy your love life to the full again!

This post is also available in: German

William C. Hilberg
As an author, Mr. Hilberg has published several papers on health issues that have gained international recognition. He is close to nature and loves the seclusion and activity as a freelance journalist. In his function as editor William C. Hilberg manages the entire content of PENP. Our team greatly appreciates his expertise and is proud to have him on board.