I Couldn't "Man Up"

By Max Kersting, Co-Founder of Regimen

“I had an erectile dysfunction.”

To speak this sentence aloud without shame took me ten years–it was that uncomfortable for me. I couldn't "man up" and I thought I was the only one. And I didn’t notice what an antiquated view of masculinity I had. But today, with different attitudes toward gender norms and sexuality, cisgender men also have a chance to reconsider our intimate issues and to finally pay attention to our personal health without shame and stigma.

I can vividly remember the first time I sat in front of a doctor, so ashamed I could barely explain why I was there: I had erection problems. Over months, my erection had become weaker and weaker. At the appointment, even more unpleasant than my nervousness was the reaction of the doctor. He looked at my penis, said it looked totally normal, and sent me home. I still knew something was wrong, but even so, it took me months to work up the courage to go to a urologist–who diagnosed a veno-occlusive dysfunction, a non-functional vein in my penis. All of this was incredibly embarrassing for me. Simply unable to discuss it with others, the frustration and shame continued to eat at me.

Erection problems are not unusual–up to 30% of the male population has had issues of some kind. My journey is also not as unusual as many might think. Medications (including Viagra, Cialis, and others) only work for about 70% of those who take them. These pills increase blood inflow to the penis, but when the regulation of blood outflow is the issue, boosting circulation helps about as much as trying to fill a bathtub without plugging the drain.

For years, doctors didn’t know what they should do with me. Ever-higher doses of the well-known medications produced only side effects. My shame grew. I had to self-administer penile injections, and even underwent a surgical operation in hopes of resolving my issue–all without success.

And I was ashamed. I was afraid that I would never be able to have a family. At some point, a doctor suggested I consider a penile implant. This moment was a turning point for me. I remember thinking “screw this!” and started reading medical databases myself, gathering research, and searching online forums for doctors recommended by others with erectile issues. These doctors helped me make a plan out of my findings and follow it for years. Pelvic floor training, lifestyle adjustments, meditation, as well as vacuum pump training, medications, and supplements. Even today, I don’t know exactly what effect each had on my situation. But after a year of my regimen, the pills finally started working, and from the two-year mark on–for more than ten years now–I have healthy erectile function. I was overjoyed.

I also learned that as a man, I could take responsibility for my own intimate health. While in the 90s and early 2000s homophobic jokes, misogynistic behavior and a one-dimensional depiction of masculinity were cemented into our culture, we also seem to have made some steps as a society–luckily. But as women have managed to develop a realistic dialogue around menstruation, body image, and other issues, and trans people work hard towards justice for their bodies and identities, male intimate health issues often remain a taboo topic.

In my daily work I see what opportunities and responsibilities we have as a society. With one of my earlier doctors and a capable team, our company Regimen is developing the kind of self-led holistic therapy program–self care, if you will–that helped me, in order to help folks worldwide struggling with the same issues. I am proud that we have developed the world’s first CE-certified digital therapy for erectile dysfunction, supported by health institutions including the UK’s National Health System, a Swiss insurance company, and globally leading doctors. And in our work, we gather information about the psychological influence of intimate problems on the male body. We are starting to understand the relationship between psychological and physical accompanying health issues.

But what we also notice every single day in our work is how much we as a society still struggle with the themes of masculinity and men’s health. Even the partners of those with intimate issues suffer from shame, loss of sexuality, and often a lack of communication. Many men hide intimate health problems from their partners, reminiscent of the 90s clichéd idea of women faking a headache as an excuse not to have sex.

And I see every day how uncomfortable many people are with these themes. Potential investors in our business are sometimes of the opinion that men absolutely only want pills. “Self-care”–and in particular pelvic floor training–are not thought of as masculine. Men we speak with quickly assert that they have never experienced this kind of problem. In particular, German health institutions make a prudish impression, insisting that erection problems are a private issue.

This attitude is nonsense. Not only because erectile dysfunction is one of the best indicators of cardiovascular disease, stroke, and heart attacks, or because it can have a serious negative influence on psychological health, or that either of these issues could become very expensive for society. The science is unmistakable–the approach that helped me with my dysfunction ten years ago has now been proved by scores of research studies. A holistic approach should always be the primary treatment approach, whether or not the patient is taking pharmaceuticals as well.

Societally, the stigma around erectile dysfunction is also devastating. Today, we have a massive opportunity to rethink masculinity, and recognizing erectile dysfunction as a real health issue plays a huge role in this. Until now, there has not been any space for public discussion of these problems. I don’t know of any Hollywood film in which a protagonist battles erectile dysfunction, or masculine role models who talk about this kind of issue. And “impotent” is still used as an insult.

In this era of open discussion about gender norms and sexuality, we have the chance to define masculinity and men’s health in a new, modern way. We cis-men can also manage to rid ourselves of the taboo and make the lives of people in partnerships happier and healthier–inspired by women and others who have fought to destigmatize menstruation and menopause, and for the sake of a world with reconsidered gender norms. Let’s talk–finally–about masculinity and men’s health, about getting rid of taboos, on our way to a modern new vision of masculinity.

This article has been translated from the original German published on Neues Deutschland on November 18, 2021.