How to treat erectile dysfunction

Let's be honest: There are some things people don't like to talk about. Erectile dysfunction is pretty high on that list.
It affects more men than you might think—and most importantly:
There are very effective ways to address it today.

Dr. med. Daniel Seiler

26. August 2026

Maybe it's just stress…

Many men are familiar with this situation: One time it doesn't go as usual—and immediately the worrying begins.

Was it just stress? Am I just tired? Or is there more to it than that?

Common physical causes

  • Circulatory disorders (vascular causes)
  • High blood pressure
  • Diabetes mellitus
  • Elevated blood lipids (cholesterol)
  • Hormonal disorders (e.g., low testosterone)
  • Neurological disorders

Drug-related causes

  • Antidepressants (SSRIs)
  • blood pressure-lowering medications
  • Certain sedatives

Psychological factors

  • Stress and pressure to perform
  • Fear of failing again
  • Relationship conflicts
  • Depression

Medication Options for Erectile Dysfunction

Treatment for erectile dysfunction is now very effective and can be tailored to the individual. The mainstay of treatment is so-called PDE-5 inhibitors, which improve blood flow to the penis.

The following active ingredients are most commonly used:

  • Sildenafil (e.g., Viagra, generic versions) — takes effect in about 30–60 minutes, lasts for about 4–6 hours
  • Tadalafil (e.g., Cialis, generic versions) – lasts up to 36 hours (“weekend pill”), also suitable as a daily low dose (2.5–5 mg)
  • Vardenafil (e.g., Levitra) – similar to sildenafil, sometimes with a slightly faster onset of action
  • Avanafil (e.g., Spedra)—onset of action is rapid (sometimes within 15–30 minutes)

Erectile dysfunction as an early warning sign

Erectile dysfunction can be an early warning sign of cardiovascular disease. The blood vessels in the penis are particularly delicate. As a result, circulatory problems often become apparent earlier than, for example, heart problems. A urological evaluation can therefore help not only to improve sexual function but also to identify relevant risk factors at an early stage.

The urological evaluation is structured and tailored to the individual:

  • a detailed medical consultation (medical history)
  • physical examination
  • Blood tests (testosterone, blood sugar, blood lipids)
  • vascular diagnostics as needed (e.g., Doppler ultrasound)

The goal is to identify the cause and treat it specifically.

When an evaluation is advisable

If you experience erectile dysfunction more frequently or notice any changes, it’s worth seeking medical evaluation.

The sooner the cause is identified, the more effectively both erectile function and any underlying risk factors can be treated.

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