Impotence, erectile dysfunction or sterility: differences and similarities

Impotence, erectile dysfunction or sterility: differences and similarities

Around 20 per cent of all German men between the ages of 30 and 80 have erectile dysfunction. But the number of unreported cases is probably much higher. Because “impotence” has a negative connotation, many men are reluctant to address the problem in their partnership or even with the doctor.

What is impotence?

First, this term, often used differently, needs to be explained in more detail. In the medical sense, impotence is the inability to conceive in a man or woman. It is also known as impotentia generandi. However, there is also a less narrow definition, according to which impotence generally includes the inability to have satisfactory intercourse.


forms of impotence

In everyday language, it is often difficult to distinguish between erectile dysfunction, impotence or infertility. Looking at impotence under the broader definition, three common forms can be summarized under it:

Sterility/Inability to reproduce

If a man is sterile, he is infertile. This means that sexual intercourse can take place, but no reproduction takes place as a result. Infertility in men can be triggered by diseases of the testicles or the vas deferens, a dysfunction of the sperm or as a result of various diseases such as Prader-Willi syndrome or a heart attack.



Anejaculation is the absence of ejaculation during sex. However, orgasm can still occur. Anejaculation is caused by damage to the nerves that trigger ejaculation. This happens, for example, as a result of metabolic diseases such as diabetes mellitus, as a result of operations or as a result of spinal cord injuries.

Erectile dysfunction

Erectile dysfunction means that the man is unable to have satisfactory sexual intercourse – either because an erection does not develop at all or because it cannot be maintained long enough. This means that the increase in size of the penis up to complete rigidity (“rigidity”) is disturbed. Erectile dysfunction can be both chronic and spontaneous and is independent of the level of sexual arousal felt by the man.

Causes of erectile dysfunction

For an erection to come about, a complex set of rules made up of nerves, blood vessels, hormones, and the psyche must work together. The possibilities are correspondingly diverse when it comes to erectile dysfunction. In the vast majority of cases, there are organic causes that trigger erectile dysfunction, especially in men over 50 years of age. These include primarily:

Thus, erectile dysfunction is often a warning sign of a potentially more serious illness that must be treated in any case. Therefore, erectile dysfunction should always be taken seriously and examined by a doctor, usually a urologist.

investigations and diagnosis

Extensive investigations are necessary to track down the causes of the various forms of impotence. To do this, the person concerned not only has to overcome the shyness of going to the doctor for the first time but also be prepared for the doctor to ask a series of very personal questions relating to sex life, partnership, everyday work and leisure time. An experienced doctor will also involve the partner in the consultation and treatment.

Once it is clear which form of impotence is present, psychological and physical causes must be explored. Suppose you continue to look for organic causes. In that case, ultrasound examinations of the blood vessels of the penis can be carried out at rest and after the injection of an erection-promoting drug (SKIT cavernous body injection test). However, this test can also be falsely negative due to nicotine consumption or stress during the examination. Electrical stimuli are used in people with diabetes to determine whether nerve damage is the cause of the disorder.

If sterility is present, the sperm is often examined under a microscope (spectrogram). The mobility, appearance and volume of the semen are checked. In addition, the affected person is examined for further physical causes, such as damage to the vas deferens.

therapy of impotence

Adapted to the precise diagnosis, impotence therapy is then carried out with medication or mechanical aids. Surgery is also possible, depending on the cause. You can find more information on the diagnosis and treatment of erectile dysfunction in this article.


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