What should I do if I can't get into bed because my penis doesn't work? Does it no longer get hard enough or does the erection last long enough? This nightmare called erectile dysfunction affects many men, and some even struggle with it from a young age. But going to the doctor is often difficult, which is why many sufferers prefer to try a sexual enhancer from the Internet. Find out why this is not a good idea and how your doctor and pharmacist can help you get to the root of the problem.

Almost one in two people over the age of 70 has been affected

Many men suffer from this, few people talk about it: 30% of 60-year-old men and almost half of 70-year-olds suffer from erectile dysfunction. But this erectile dysfunction is not a suitable game for self-treatment. On the one hand, most effective aides are not available over the counter, and over-the-counter sex stimulants are at best ineffective, if not downright harmful. On the other hand, erectile dysfunction in at least half of all cases is due to physical causes - an important sign of this is the lack of erection in the morning. In addition to diseases of the prostate, penis or testicles, there are general diseases that need to be identified and treated, for example. B

(almost all drugs reduce potency), Parkinson's disease.

Erectile dysfunction is often also linked to lifestyle: obesity, alcohol, nicotine and chronic stress are among the main factors that provoke erection problems. In addition, psychological causes such as depression and partner conflicts can also lead to erectile dysfunction.

Note. Erectile dysfunction is now considered an independent risk factor for cardiovascular disease. Particularly in older men, this should be seen as a sign of an impending heart attack or stroke! Therefore, with the acute development of erectile dysfunction, it is recommended to have a cardiovascular examination by a doctor.

Helper #1: PDE-5 Inhibitors

But what arrows are there in the arsenal of medicine to combat erectile dysfunction? The easiest way is prescription PDE-5 inhibitors, also known as potency pills. Since 1998 Viagra®

Tip: PDE-5 inhibitors do not cause an erection, but strengthen and improve it. Whatever preparation you choose to undertake, make sure you provide a stimulating environment. Because without sexual stimulation and arousal, even PDE-5 inhibitors cannot work miracles.

Pumping, splashing or smearing

For men who cannot take PDE5 inhibitors, there are other options:

• For example, a vacuum pump does not require a prescription. After placing the plastic cylinder on the penis, a vacuum is created using a hand pump, causing the erectile tissue to swell.
• If you are not afraid of needles, (prescription) SKAT erectile tissue autoinjection therapy may be suitable for you. The person concerned injects vasodilators into the erectile tissue (following the instructions of the attending physician!). Suitable for this are alprostadil (eg Caverject® or Viridal®) or papaverine/phentolamine (eg Androskat® approved in Germany but not sold and available in international pharmacies under private prescription). 70-90% of men get sufficient erections with SKAT. However, for some, this lasts too long and becomes dangerous: if a painful erection lasts more than 2 hours, it is necessary to see a doctor, preferably a urologist. If a permanent erection is not treated for several hours, there is a risk of damage to the corpora cavernosa, followed by a persistent impossibility of erection.
• Those who shy away from a syringe can inject alprostadil into the urethra with a stick (such as MUSE ® ). This procedure helps 40% of men, an erection occurs in about 10 minutes and lasts up to an hour.

Tip. If you are not going to inject into erectile tissue or put anything into your urethra, ask your doctor if alprostadil cream (such as Vitaros ® ) might be right for you. After applying the cream to the tip of the penis, the penis should be erect in 5-30 minutes, and then after about 2 hours it will be ready for use.

Shockwaves get you started

Whether it is a vacuum pump or a SKAT, the methods mentioned are not very popular with men due to their bulkiness. Urologists meet the need for more careful potency with low-energy shock waves: they are designed to improve blood flow to the corpora cavernosa and, therefore, erections. It takes 4 to 12 thirty minute sessions to help the penis work. However, the situation in the studytion remains controversial. In one study, 60% of men treated with shockwaves experienced a significant increase in potency, but only 30% after 2 years. This method works especially badly with diabetics.

Workforce from nature?

Even if it's often effectively advertised, the power of nature doesn't really help the impotent. The effect of well-known drugs such as yohimbe bark, damiana leaves, and damiana herb on erectile dysfunction has not been sufficiently proven. Eating yohimbe bark even comes with some risks, such as insomnia, high blood pressure, and liver damage. Although the substances mentioned are harmless in homeopathic doses, the erectile effect of them has not yet been proven, even if the products are often advertised as treatments for "sexual weakness".

The amino acid arginine is also mentioned in the media as a substance that increases potency. Arginine is important for the formation of nitric oxide, which plays an important role in vasodilation. A dietary supplement with arginine only makes sense if there is a deficiency in the blood. There are conflicting opinions as to whether the replacement leads to improved erections. Arginine products are by no means recommended if the person is taking blood thinners, has had a heart attack, or needs nitrates as heart medications.

Note. In case of erectile dysfunction, do not trust questionable sources on the Internet, but seek the advice of your pharmacist or doctor. The products advertised on the Internet are mostly ineffective and some are even harmful: for example, the often advertised "potency gels" often contain nitrates, which can lead to a dangerous drop in blood pressure in people with heart disease or in association with PDE-5 inhibitors.

Penis training

Last but not least, the penis can also be exercised through sports and thereby prevent erectile dysfunction. Steps, leg presses, and recumbent biking work best, but targeted pelvic floor training is also good for blood flow to the erectile tissue. If you also watch your weight, get enough sleep, and limit smoking and alcohol consumption, you will create the best conditions for a satisfying erection in the long run.

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