Dossier: Sexuality

Erectile dysfunction? Let’s talk about it!

Men of all ages are affected by erection problems, but only a few manage to talk about it openly. If a man’s penis doesn’t function properly, it can cause anxiety and put strain on a relationship. That’s why it’s all the more important to be aware of the causes and find the right treatment.

Text: Julie Freudiger & Stefan Schweiger; photo: Claudia van Zyl / Unsplash

The fact is that one in four men in Switzerland over the age of 45 is estimated to suffer from erectile dysfunction (ED). If you think that number seems high, that’s probably because it’s not talked about openly. Men often suffer in silence, because ED is often associated with shame or personal failure. But in the vast majority of causes, it’s caused by physical factors.

Erectile dysfunction = impotence? A definition

Experts class erectile dysfunction (ED) as the inability to get and keep an erection firm enough for sex in at least two out of three planned sexual encounters over a period of six months. Having trouble getting an erection from time to time isn’t necessarily a cause for concern. An erection is the ability of the penis to become and remain erect. Potency doesn’t just refer to a man’s ability to experience sexual satisfaction, but also the fact that he can produce offspring. The concept of impotence is therefore more wide-ranging. And erectile dysfunction isn’t just a symptom of old age. Even though the risk of ED does increase as you get older, new diagnoses are estimated to affect one in four men under the age of 40.

Cause of erectile dysfunction

In an estimated 80% of cases, erectile dysfunction is caused by physical factors. For example, the blood supply to the penis is insufficient or the muscles in the penis are damaged which means they can’t swell sufficiently. Diseases that impair blood flow – such as diabetes, arteriosclerosis or high blood pressure – also increase the risk. “Contrary to hasty diagnoses that have been made in the past, erectile dysfunction is very rarely caused by psychological factors alone,” explains Professor Nicolas Diehm from the Centre for Erectile Dysfunction in Aarau. It can also be caused by damaged nerves, testosterone deficiency, medication, obesity or smoking. Veins are often the problem with many young men, says Diehm: “Although enough blood flows into the penis, the veins cannot hold it and it flows out again too quickly.” If the block is mental, stress or depression are often behind it. As erectile dysfunction can be a sign of cardiovascular disease, it’s best to seek medical advice, preferably from a urologist or andrologist.

Which treatment is best?

To achieve an erection, nerves, blood vessels, hormones and the head all have to play their part – a complex interplay. With mild ED, a change in lifestyle is often enough, by losing weight, stopping smoking or reducing stress for example. Studies show that physical activity can improve erectile function. If the blood in the veins of the penis drains too quickly, pelvic floor exercises can help. The most commonly used medication is the PDE-5 inhibitor, better known as “Viagra”. It relaxes the smooth muscle cells in the erectile tissue of the penis and thus boosts the blood supply. At best, this facilitates an erection again, but without increasing the libido. However, medication doesn’t get to the root of the problem. The next treatment option is to close the veins using tissue adhesive. If the problem is caused by a narrowing of the vessels and medication no longer helps, a stent, similar to ones used for the heart, can be used to open up the narrowed or closed arteries. A penis pump can provide mechanical support. It creates negative pressure, which increases the flow of blood into the penis.

How you can help a partner who is suffering from ED

If your partner experiences erectile dysfunction, it helps if they don’t feel like they have to deal with the problem on their own.

  • If your partner has experienced ED, you may have wondered if you’re to blame. Perhaps they no longer find you attractive? It’s important to understand that erectile dysfunction isn’t a question of blame.
  • Find a suitable moment to talk about it. Talking openly can ease the pressure.
  • Show understanding – but not pity. Instead, offer your support. For example, suggest you go with them to see a doctor.
  • It can’t be said often enough – a good relationship is based on more than a functioning erection. That will take a lot of the pressure off.

Why is it important to talk to your doctor about erectile dysfunction?

“Erectile dysfunction can – but may not necessarily – be a cause of great anxiety for a man. It often affects his relationship, quality of life and well-being. It can even cause depression. Furthermore, erectile dysfunction may be an early warning sign to help prevent a possible heart attack or stroke. As the arteries in the penis are very small, any blockage – which could later lead to a heart attack or stroke – is noticed there first. This makes it possible to intervene early on so that the vessels don’t change any more.”

Regimen: holistic programme to treat erectile dysfunction

The Regimen app takes a holistic approach aimed at helping men with erectile dysfunction solve their problems for good. Scientists and doctors have developed an online programme based on the latest research findings. The app developers claim that Regimen helps three out of four men improve their erectile function by up to 5 points of the International Index of Erectile Function within 12 weeks. 

Users of the Sanitas Portal app benefit from a 25% discount on an annual subscription. You can find Regimen in the Sanitas Portal app under “Living healthily”.

To the offer

“I approached the problem holistically”

Erectile dysfunction is a taboo topic. Max Kersting has had problems since his early 20s. But he found a solution – and developed the Regimen app to help men affected by erectile dysfunction overcome their problems. Today Max Kersting knows:

Myth 1: Erectile dysfunction is a normal part of ageing

That’s not true. Although erectile dysfunction is more likely to occur as you get older due to decreasing testosterone, age isn’t the only factor in performance problems, and ED can affect both younger and older men.

Myth 2: No erection means no arousal – and vice versa

False. If you fail to get an erection at times or in general, it doesn’t mean you’re not aroused. A range of factors have to be in play in order to get an erection. Sexual pleasure and tenderness are possible without an erection.

Myth 3: You can’t have an orgasm without an erection

That’s a short-sighted view. Although an erection, orgasm and ejaculation are the holy trinity of sex for men, each is possible independently of the other. You can orgasm without a stiff penis, because other nerves are involved. You can also experience an orgasm without ejaculation.

Myth 4: Cycling makes you impotent

False! More recent studies show no connection between cycling, erectile dysfunction and infertility. Regardless of how long a man spends on the saddle. But if you feel your penis going numb while cycling, you should invest in a more comfortable saddle.

What’s true and what not? Getting to the bottom of erection myths

Myths and half-truths spread more easily when it comes to taboo topics. It’s time to clear up some common myths and make life easier for men with erection problems.

There’s no one-size-fits-all treatment for erectile dysfunction.

“When pills, injections and even operations didn’t help, I started to read studies. I learned that lifestyle, cardiovascular and psychological health and also the pelvic floor can all influence erections. With help from doctors, I took a holistic approach and was slowly able to overcome all my problems for good.”

It takes courage to seek help.

“For a long time, I thought I was the only one. The first and most important step to tackling ED was admitting that I had a problem. Society’s established image of masculinity has so far not involved taking responsibility for our intimate health.”