Urologist Tobias Jäger discusses the challenges men face in addressing erectile dysfunction, a common condition affecting around one in five men. Many avoid talking about it due to embarrassment. Jäger emphasizes the importance of understanding both physical and psychological causes, suggesting that lifestyle changes and medical treatments, such as PDE-5 inhibitors, can help. He also highlights that overcoming shame can lead to positive conversations about sexuality, ultimately benefiting men’s overall health and relationships.
After a routine check-up, urologist Tobias Jäger has already said his goodbyes, but just as his patient reaches for the door, he hesitates and adds, “Oh, I have one more thing.” This moment signals to Jäger that an uncomfortable topic is about to be discussed: erectile dysfunction.
Surveys indicate that only about a third to half of men experiencing this issue are willing to approach their doctor about it, often due to embarrassment—even when speaking with a specialist.
This shame is misplaced, as erectile dysfunction is a common condition affecting one in five men. It is defined as a persistent inability to achieve or maintain an erection suitable for sexual intercourse, lasting at least six months. While younger men rarely report such issues, the prevalence rises significantly with age, with over 50% of men over seventy experiencing erectile dysfunction.
Men facing this challenge should seek medical advice, as physical causes often underlie the problem. In some cases, erectile dysfunction may even serve as an early warning sign of a heart attack. Understanding the physiological process behind erections is essential to grasp their significance in overall health.
The Process of Erection
Erections begin in the brain, triggered by erotic thoughts, touch, or visual stimuli. These stimuli activate various brain regions, which send signals through nerves to the penis. The parasympathetic nervous system plays a key role during relaxation, while stress activates the sympathetic nervous system, which can inhibit the ability to achieve an erection.
Once the brain sends signals to the penis, chemical reactions occur, causing blood vessels to expand. Blood rushes into the erectile tissue while veins constrict, trapping the blood and leading to an erection. The pelvic floor muscles also aid in maintaining this engorgement.
Identifying Causes of Erectile Dysfunction
When a patient presents with erectile dysfunction at Tobias Jäger’s practice, he first employs a questionnaire to identify potential causes. “This helps to determine how severe the dysfunction is and whether it’s primarily psychological or physical,” he notes. He also reviews any medications the patient is taking, as certain drugs like beta blockers or antidepressants may contribute to the problem.
Next, Jäger conducts blood tests to check for elevated sugar levels, which can damage nerves and blood vessels, potentially leading to erectile issues. “These examinations can reveal underlying conditions like diabetes,” he explains.
He also assesses blood pressure and lipid levels, as erectile dysfunction is linked to a higher risk of heart attack. The small blood vessels in the penis can show plaque buildup before it occurs in larger vessels, leading to serious cardiovascular problems over time.
Testosterone deficiency can also impact erectile function, as this hormone is crucial for libido. Low testosterone often results in weight gain, further increasing the risk of developing diabetes, which can lead to erectile difficulties. Jäger advises all men to adopt healthier lifestyles through regular exercise and balanced diets as preventive measures.
Medications for Treatment
There are various medications known as PDE-5 inhibitors, which help keep blood vessels dilated longer to enhance blood flow to the penis. Viagra, which contains sildenafil, is among these treatments, though Jäger prefers prescribing tadalafil, citing its longer duration of action—24 to 36 hours—making it more convenient for use.
However, men should be cautious about purchasing erectile dysfunction medications online, as over two-thirds of illegally imported drugs consist of these stimulants. Obtaining them from unreliable sources can lead to counterfeit products lacking the proper ingredients.
Overcoming the stigma surrounding this issue is critical for men to seek help. “Men often feel like failures when facing erectile dysfunction,” says psychologist Ulrich Clement. He emphasizes the importance of addressing both psychological and physical causes, as they often intertwine. For older men, physical factors may contribute significantly, but fears related to aging can increase anxiety, worsening the condition.
In rare instances, if a man experiences normal erections during sleep or masturbation but struggles with intimacy, it may suggest purely psychological roots, warranting couples therapy instead of medical examination.
Clement’s approach in therapy can involve asking unconventional questions to uncover underlying issues. “For example, I might ask, ‘If your penis could talk, what would it say?'” Such inquiries can reveal deeper emotional or relational concerns that need to be addressed.
Through combined support from urologists and therapists, most men find effective solutions to their erectile dysfunction. The journey often ends on a positive note, as many are relieved to finally discuss their experiences openly, transforming shame into empowerment.
Ultimately, those crucial first words—”Oh, I have one more thing”—