Sexual problems such as erectile dysfunction, premature ejaculation (ejaculatio praecox), and sexually transmitted diseases (STDs) can be highly distressing for men. These topics are frequently accompanied by feelings of shame, causing many of those affected to hesitate before seeking professional help. Yet modern diagnostic and therapeutic procedures are available that can bring about a significant improvement in symptoms. Prostate conditions, which often occur with advancing age, can also have an impact on sexual health and should not be ignored. Nevertheless, statistics show that erectile dysfunction and other sexual problems remain a taboo subject in our society. It is therefore all the more important to provide information about causes, risk factors, and treatment options, and to lower the threshold for seeking help.
As a urologist and andrologist with extensive national and international experience at a modern private clinic in Düsseldorf, I am your qualified point of contact for all questions relating to male sexual health. Please feel free to make an appointment to find individual solutions and regain quality of life.
Physical Causes
Circulatory disorders are frequently responsible for erectile problems. After all, an erection occurs primarily because sexual stimulation causes increased blood flow into the penis while venous outflow is simultaneously reduced. If the blood vessels are narrowed or blood flow is impaired, the body finds it difficult to pump sufficient blood into the penis. Cardiovascular disease, diabetes, hormonal disorders, or nerve damage are therefore common triggers. Excessive alcohol consumption and smoking can likewise increase the risk of erectile dysfunction.
Psychological Causes
Stress, anxiety, or depressive moods can also have a negative effect on sexuality. Performance anxiety and relationship conflicts in particular influence the experience of arousal and desire. Traumatic experiences, performance pressure, or unresolved relationship issues can also impair erectile function.
Possible Influence of COVID-19
Current studies suggest that a COVID-19 infection may under certain circumstances promote erectile dysfunction. Not all the mechanisms behind this have yet been clarified, but it is suspected that inflammation, vascular damage, and psychological strain caused by the illness play a role.
The Mechanism of Erection – How Does Rigidity Occur?
To understand why erectile dysfunction can occur, it is helpful to look at the natural process of erection. During sexual stimulation, the arteries in the penis dilate, allowing more blood to flow into the erectile tissue. At the same time, the veins responsible for blood outflow are constricted. In this way, blood is retained in the penis, pressure in the erectile tissue increases, and the penis becomes rigid. This complex process is based on the interaction of nerves, hormones, blood vessels, and psychological factors. Even minor disturbances in any of these areas can lead to erectile problems.
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Contents
Premature Ejaculation (Ejaculatio praecox)
Another common sexual problem in men is premature ejaculation. This involves ejaculation occurring before or shortly after penetration, without the affected person being able to control it. Approximately four percent of men experience this problem in a form considered clinically relevant – meaning there is barely any control over the timing of ejaculation, which can cause significant psychological distress for the patient and his partner.
Many myths surround the average duration of sexual intercourse, so men often have unrealistic ideas about the “normal” time to orgasm. In reality, this is around five minutes for most men, but can vary considerably and depends on many factors. Age, general physical condition, and emotional aspects also play a role.
For affected men, the question arises as to when treatment is actually required. A medical diagnosis of premature ejaculation (ejaculatio praecox) is generally made when early ejaculation is experienced as distressing and constitutes a significant burden. Various treatment options can help in such cases, for example sex-therapeutic approaches, specific exercises for ejaculatory control, or pharmacological treatments.
STDs – Sexually Transmitted Diseases (HPV, Urethritis, and Others)
Sexually transmitted diseases (STDs) are another important topic affecting many men but rarely discussed openly. The most common STDs include infections with human papillomaviruses (HPV), genital herpes, chlamydia, gonorrhoea, and syphilis. A particular form of bacterial infection is urethritis, which can lead to inflammation of the urethra.
HPV (Human Papillomaviruses)
HPV is one of the most common sexually transmitted infections worldwide and can be highly contagious. Infection frequently goes unnoticed and resolves spontaneously. However, certain HPV types can lead to genital warts (condylomata) or, in rare cases, to cancers in the genital area. In some patients, HPV vaccination can significantly reduce the risk of infection with certain high-risk types. Treatment of the partner is advisable in the vast majority of cases.
Urethritis (Inflammation of the Urethra)
Urethritis is an inflammation of the urethra caused by bacteria, viruses, or other pathogens. Typical symptoms include a burning sensation when urinating, discharge, or frequent urge to urinate. Early diagnosis and treatment are important to prevent complications and possible transmission to sexual partners.
My Advice:
Have suspicious symptoms clarified early to rule out unnecessary risks. As a specialized urologist and andrologist, I can offer you the most modern diagnostic and therapeutic procedures to restore your sexual health as quickly as possible.
Diagnostic and Therapeutic Options
Treatment of sexual problems is always guided by the underlying cause. For this reason, the process begins with a thorough medical history and examination in which both physical and psychological factors are assessed. In cases of erectile dysfunction, for example, specific vascular examinations or hormonal analyses can provide information about possible organic causes.
- Pharmacological therapy: PDE-5 inhibitors (such as sildenafil) are frequently the first choice for erectile problems. Medications that can delay the timing of ejaculation are also used in some cases of premature ejaculation.
- Sex therapy and couples counselling: Therapeutic support is particularly useful when the causes are psychological or when relationship problems are present. Ways are worked out together to reduce pressure and promote more open communication.
- Help with STDs: In the case of sexually transmitted diseases, precisely targeted pharmacological treatment is key – for example, specific antibiotics for various bacterial infections. It is also important to inform and treat the sexual partner in order to prevent re-infection between partners.
Lifestyle and Self-Help – Important Building Blocks for a Stable Sex Life
In addition to targeted therapies, lifestyle factors also play a major role in maintaining healthy sexuality. Regular exercise, a balanced diet, and abstaining from nicotine and excessive alcohol consumption generally have a positive effect on health, as well as on the cardiovascular system and hormonal balance. For many men, talking with a therapist or in self-help groups is also helpful for reducing anxiety and shame.
When to See a Doctor and How to Prevent Problems?
As a general rule: if problems persist for longer than a few weeks or cause significant distress, an andrological assessment is worthwhile. This applies to erectile dysfunction as well as to premature ejaculation or possible symptoms of an infection.
Early diagnosis makes it possible to initiate appropriate therapeutic measures quickly and to prevent further complications. Regular preventive check-ups help to identify risk factors in good time and to maintain sexual health. Men over 40 in particular should speak more openly about their sexuality and make use of medical check-ups.
Take the opportunity to have your sexual problems assessed discreetly and competently. Book your outpatient appointment at our private clinic in Düsseldorf now and benefit from my many years of experience in andrology.
Frequently Taboo but Solvable Challenges
Sexual problems are by no means rare and are often associated with treatable physical or psychological causes. An open conversation with an experienced andrologist is the first step toward reflecting on one’s own needs and finding individual solutions. Erectile dysfunction, premature ejaculation, and STDs such as HPV or urethritis do not have to be accepted. The sooner those affected seek help, the better the prospects for successful treatment. A healthy sex life contributes significantly to overall well-being – and in most cases it is achievable once the causes are clearly identified and consistently addressed.
Three Additional Questions about Sexual Problems in Men
Not necessarily. Many factors can temporarily impair an erection. Only if the problems persist over a longer period should medical clarification be sought.
In addition to relaxation techniques and specific exercises, healthy stress management and open communication with one’s partner can help to achieve better control over ejaculation.
Psychological factors such as stress, anxiety, or depressive moods are often partly responsible. It is therefore worthwhile to clarify and treat both physical and psychological causes together.
Frequently Asked Questions about Sexual Problems in Men
Some medications, for example those for high blood pressure or depression, can promote erectile dysfunction as a side effect. However, every body reacts differently, which is why individual clarification with a specialist is advisable.
Mild or short-term disturbances can indeed often improve spontaneously – for example when stress subsides. However, if complaints persist or worsen, you should seek medical advice.
A balanced diet supports cardiovascular function, which can have a positive effect on erection. However, special diets are not strictly necessary as long as all required nutrients are supplied in adequate amounts.