Problems with erections usually have deeper underlying causes that should be diagnosed and treated in a differentiated manner. Self-medication is often the worst possible solution.

Press release dated 27/11/2025

Why medication should not automatically be the first choice for erectile dysfunction – investigate the causes instead of reaching for the “blue hammer”

What many consider an age-related problem is increasingly affecting younger men as well: studies show that up to one third of men under 40 now report erectile dysfunction. In this age group, the causes are predominantly psychological, as well as excessive consumption of pornography. However, very few of those affected are willing to get to the bottom of the problem. Dr. med. Ralph Oberneder, Chief Physician at the Urological Clinic Munich-Planegg, explains why reaching for the “blue pill” is not only of little help here, but can even be a health concern.

Medications with active ingredients such as sildenafil are still the treatment of choice for most men when sexual performance declines. Since patent protection expired in mid-2013 in most Western nations, the “blue pill” and related substances have also become significantly cheaper in the form of numerous generics.

This is driving brisk sales: an estimated 1.5 million packs of so-called PDE-5 inhibitors are sold over the counter in German pharmacies every year. The number of potency enhancers obtained illegally online is many times higher. A study on illegal online pharmacy trade concluded in early 2025 that Viagra remains among the most frequently counterfeited medicines in Europe.

Investigating the causes can be life-saving

Dr. med. Ralph Oberneder, Chief Physician at the Urological Clinic Munich-Planegg, strongly advises against self-medication from the internet. “It goes so far – I know this from patients who have tried it – that a tablet is ordered and two hours later it is already in your mailbox at home. Without a sender, package leaflet, or anything similar. Such offers are extremely dubious – and potentially dangerous to your health.”

This is especially true because erectile dysfunction can be caused by psychological factors as well as serious pre-existing conditions that, if undetected and untreated, can even become life-threatening. Oberneder therefore advises taking erectile dysfunction seriously and not simply fighting a symptom blindly. In fact, there are now very simple and discreet ways to investigate the causes yourself and, for example, determine psychological causes with relative certainty – or rule them out.

One option is to record nocturnal erectile activity: a textile sensor cuff that is slipped over the penis before going to bed is connected to a small, handy control module. In the morning, the results can be viewed in a smartphone app that works without registration and is completely anonymous. “Normally, every man has several erections per night, sometimes even sustained for longer periods. The number and duration of nocturnal erections show how well the body’s nocturnal ‘training program’ is working and whether physical causes may be responsible for the erection problems,” explains Andreas Wagner, CEO of 2N8life, which developed the device and even obtained certification as a medical device. “If activity is low, this could in turn be an early indicator, for example, of incipient vascular disease, including of the heart.”

This means that an increased risk of heart attacks or strokes can be signaled years in advance by abnormalities in nocturnal erectile activity. For this reason in particular, urologist and Chief Physician Ralph Oberneder would like to see more men have the causes of erectile dysfunction medically clarified instead of simply taking a pill. “If monitoring shows that only a few or weakened erections occur at night, then we would, for example, actually prescribe a PDE-5 inhibitor such as sildenafil. However, if, at an appropriate age, additional risk factors such as smoking, high blood pressure, excessively high blood lipids, or a blood sugar disorder are present, then an internal medicine evaluation, for example by a general practitioner or cardiologist, would be advisable to rule out a condition such as coronary artery disease.”

For risks and side effects, read the package leaflet.

Even though so-called PDE5 inhibitors generally have a favorable side-effect profile and relatively low risks, especially in men with heart disease the additional strain of sexual intercourse, like any other physical exertion, can represent a significant source of danger.

“With our monitoring system, we want to help men develop a better sense of their body and their health,” says Andreas Wagner of 2N8. “On the one hand, this includes rebuilding self-confidence in cases of psychologically caused erectile dysfunction.” This is much easier when the person affected understands that there is nothing “wrong” with their body. “On the other hand, we also want to encourage people to listen to the body’s signals in cases of physical causes and then actually go to a cardiologist,” Wagner adds.

Since 2025, 2N8 has been officially approved as a medical device and was developed and manufactured entirely in Germany.

More information about 2N8 can be found here: https://2n8life.com/