Erectile Dysfunction

Men's Health

Struggling with erectile dysfunction? You’re not alone.

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About Erectile Dysfunction

Overview

Erectile dysfunction (ED) is the medical term for difficulty getting or keeping an erection firm enough for sex. While occasional erection problems are normal, persistent symptoms can be stressful and affect self‑esteem. ED is extremely common; over half of men aged 40–70 experience erectile problems and more than a quarter of younger men may also be affected. Physical causes include narrowed blood vessels, high blood pressure, high cholesterol, diabetes and hormone imbalances. Emotional or mental health issues such as stress, anxiety and depression can also play a role.

If you’re concerned about ED, remember you are not alone. Treatment suitability will be assessed by a UK‑registered prescriber following a secure online consultation, and help is available to restore confidence and sexual wellbeing.

Symptoms & Diagnosis

Symptoms

ED symptoms can vary in severity. People may experience:

  • Difficulty getting an erection despite feeling sexually aroused
  • Inability to maintain an erection long enough to have sex
  • Reduced sexual desire or libido
  • Feelings of embarrassment, anxiety or stress about sexual performance
  • Morning erections continuing when erections during intercourse are not possible (this often suggests a psychological cause)

Seek help if erection problems persist or affect your quality of life. A UK‑registered clinician can discuss your symptoms confidentially.

Diagnosis

A healthcare professional usually diagnoses ED through a discussion about your medical and sexual history and a physical exam. They may ask about lifestyle factors (smoking, alcohol, cycling, stress), relationships and mental wellbeing. Basic health checks such as blood pressure and examination of the genitals help rule out obvious physical causes.

Further tests may be required to look for underlying conditions. These can include:

  • Blood tests – to check for diabetes, high cholesterol, hormone levels and heart disease
  • Urine tests (urinalysis) – to screen for diabetes or kidney problems
  • Ultrasound of penile blood vessels – to see how blood flows to the penis
  • Mental health assessment – to evaluate stress, anxiety and depression that may contribute to ED

Not everyone needs formal testing; however, addressing any underlying health issues is important for long‑term improvement.

Treatments

Lifestyle changes

Simple lifestyle adjustments can improve ED, especially when the cause relates to blood vessel health or general wellbeing. Evidence‑based steps include:

  • Maintain a healthy weight and exercise regularly – physical activity improves circulation and cardiovascular health
  • Eat a balanced diet rich in fruits and vegetables
  • Stop smoking and limit alcohol consumption
  • Get enough sleep and manage stress through relaxation techniques or mindfulness
    Reduce cycling time if you ride more than three hours per week

These changes also lower the risk of conditions like high blood pressure and diabetes, which are linked to ED.

Medical treatments

Prescription medicines work by improving blood flow to the penis. A prescriber will discuss suitability and potential side‑effects. Commonly used PDE‑5 inhibitors include:

  • Sildenafil (Viagra) – the first‑line treatment, taken 30–60 minutes before sex
  • Tadalafil (Cialis) – lasts up to 36 hours; there are daily low‑dose tablets for continuous effect
  • Vardenafil (Levitra) and Avanafil (Spedra) – alternative options

These medicines enhance natural erectile responses when you are aroused and do not work without sexual stimulation. They may cause headaches, flushing, nasal congestion or indigestion for some users. They are not suitable for people taking nitrate medications, those with severe heart disease or very low blood pressure.

Other medical options include:

  • Alprostadil cream – a topical vasodilator applied to the tip of the penis; it can improve erectile function in up to 83 % of men
  • Self‑injection therapy – alprostadil injections into the base or side of the penis produce an erection within 10 minutes
  • Vacuum erection pumps – devices that draw blood into the penis using a vacuum; effective and drug‑free
  • Men with psychological ED often benefit from counselling or sex therapy; cognitive‑behavioural therapy (CBT) can help address anxiety, negative thoughts and relationship issues contributing to ED. A prescriber may combine psychological support with medication to optimise outcomes.

 

Addressing underlying conditions

If ED is caused by high blood pressure, high cholesterol, hormone imbalance or medication side‑effects, treating the underlying problem can restore erectile function. Your GP may adjust medicines, prescribe statins or antihypertensives, or recommend hormone therapy when appropriate.

Prevention

While not all cases of ED can be prevented, healthy lifestyle choices and early management of chronic conditions reduce risk. To lower your chances of experiencing ED or prevent it recurring:

  • Maintain a healthy weight and be physically active
  • Eat a diet high in fruits, vegetables and whole grains
  • Stop smoking and limit alcohol intake
  • Manage blood pressure, cholesterol and blood sugar with regular check‑ups and prescribed medicines
  • Address stress through mindfulness, therapy or relaxation techniques
  • Communicate openly with your partner to reduce anxiety and build intimacy

Misconceptions

“ED only affects older men.”

Although ED becomes more common with age, it can occur at any age. Over a quarter of younger men experience ED.

“If you have ED, you’re not attracted to your partner.”

ED often results from physical health issues or stress rather than lack of attraction. Emotional support and communication are important.

“ED means something is seriously wrong.”

Occasional erection problems are normal. Persistent ED can indicate an underlying condition, but it is usually treatable with lifestyle changes or medicines.

“Only medication can fix ED.”

Lifestyle improvements, counselling and treating underlying health conditions can significantly improve or resolve ED.

Frequently asked questions

  • What is erectile dysfunction (ED) and how does it happen?

    Erectile dysfunction means a man finds it hard to get or keep an erection firm enough for sex. A good erection needs nerves, hormones, blood flow and being turned on. If something blocks one of those for example, if blood vessels are narrow, or nerves are damaged,  then an erection might not work well.

  • How common is erectile dysfunction (ED), and at what age does it start?

    Erectile dysfunction (ED) is quite common. Many men get mild erection problems sometimes. It becomes more likely as men get older. For example, men in their 40s have fewer issues than those in their 60s or 70s, but problems can happen at almost any age.

  • Can erectile dysfunction (ED) be a sign of other health problems (like heart disease or diabetes)?

    Yes. erectile dysfunction (ED) can sometimes be a clue that something else is going on in the body. Things like high blood pressure diabetes, high cholesterol, or heart problems can make it harder for blood to flow well. When blood flow is weak, erections can be weak too. If you have ED, it's smart to get checked by a doctor.

  • What causes erectile dysfunction (ED) in young, healthy men?

    Even if you're young and seem healthy, erectile dysfunction (ED) can happen. Causes can be: feeling very stressed, being tired, drinking a lot of alcohol, taking certain medicines, feeling anxious about sex, or even problems like being overweight or not sleeping well. Sometimes it can be a mix of things.

  • Can stress, anxiety, or depression cause erectile dysfunction (ED)?

    Yes. The brain plays a big role in erections. If you feel worried, stressed or sad, it can make it harder to “turn on” physically. Sometimes people still have erections in the morning but not with their partner - that can be a sign the issue is more about how you think or feel than something physical. It’s okay to ask for help.

  • What treatments are available for ED in the UK?

    Treatments include tablets such as sildenafil, tadalafil, vardenafil and avanafil, which help increase blood flow to the penis. Other options include vacuum devices, injections, testosterone treatment if levels are low, and counselling when stress or anxiety plays a role.

  • How long do ED tablets take to work?

    ED tablets usually work within 30 to 60 minutes, though this varies. Tadalafil can last up to 36 hours, and avanafil may work within 15 minutes. A heavy meal or alcohol can slow down the effects, so timing and routine can make a difference.

  • When should I see a clinician about ED?

    You should consider seeing a clinician such as your GP if ED keeps happening, lasts for several months or affects your confidence or relationships. You should also seek advice if you have symptoms that might suggest an underlying health condition such as diabetes or heart disease.

  • Can stress, anxiety or depression cause ED?

    Yes. Mental health plays a big role in sexual function. Stress, low mood and anxiety can reduce arousal and interrupt the body’s normal response. Men often still get morning erections but struggle during sex, which can suggest emotional rather than physical causes.

  • Can lifestyle changes improve ED?

    Lifestyle changes such as regular exercise, reducing alcohol, stopping smoking, improving sleep and losing weight can help improve ED. These changes support better blood flow, energy and mood, and often make tablet treatments work more effectively.

  • Is ED permanent or can it go away?

    ED is often temporary and can improve once the cause is treated. If ED is due to stress, tiredness or lifestyle habits, changes can help erections return. If it is related to a medical condition, treatment of that condition often improves symptoms.

  • Can ED medicines interact with other medicines?

    Yes, some medicines can interact with ED tablets, including nitrates for chest pain or certain blood pressure medicines. This can cause unsafe drops in blood pressure. Your clinician checks all your medicines to recommend the safest treatment.

  • Does pornography affect ED?

    Pornography doesn’t cause ED directly, but excessive use can affect arousal and create unrealistic expectations, which might contribute to performance anxiety. Reducing usage and focusing on real intimacy can help if it is affecting confidence.

  • What tests might I need for ED?

    A clinician may check your blood pressure, blood sugar, cholesterol and hormone levels to identify any underlying causes. These tests help guide personalised treatment and ensure any medical issues are treated properly.

  • Are there myths about ED that aren’t true?

    Yes. Tight underwear, masturbation or cycling rarely cause ED. Most erectile issues have medical, lifestyle or emotional explanations. If something worries you, it’s better to discuss it with a clinician rather than rely on myths or assumptions.

  • Is ED more common in men with diabetes or heart disease?

    Yes. Diabetes and heart disease can reduce blood flow or damage nerves, which are both essential for erections. Treating these conditions often helps ED improve, and tablets may work better once health issues are controlled