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Erectile dysfunction

Dr Karen Martin
Reviewed by Dr Karen MartinReviewed on 19.10.2023 | 3 minutes read

Erectile dysfunction is when you are unable to get an erection or maintain an erection in order to have sex. It can sometimes be referred to as impotence or shortened to ED, and it is a very common symptom men can experience from time to time. In most cases, there is no serious underlying cause, and it may improve on its own, although it is important to know there is a treatment that can help. It is especially common in older men, with around 1 in 2 men over the age of 40 experiencing ED at some point.

Some of the things that can contribute to erectile dysfunction include tiredness, stress, or excessive alcohol. The causes of longer-term erectile dysfunction can be split into 3 main types, which are psychological, physical health, and medication-induced.

Psychological causes of erectile dysfunction include stress, performance anxiety (or any anxiety around having sex), relationship issues, or mental health conditions such as depression. With psychological causes, erectile dysfunction usually starts suddenly, not gradually, and it is best to treat the cause (e.g., the mood symptoms) rather than treating the symptom of erectile dysfunction. Treat the mood symptoms, and the erectile dysfunction will hopefully improve.

Physical causes are usually the reason for ED in men over 40, with reduced blood flow to the penis being at the top of that list. The arteries in the penis become too narrow for enough blood flow to cause an erection. Men who smoke, have high blood pressure, or have high cholesterol levels are more at risk of developing this. With physical causes, erectile dysfunction tends to occur more gradually over time rather than suddenly. Chronic health conditions that affect nerves or blood flow, such as diabetes or multiple sclerosis, can also cause ED, as well as any damage to the penis or low testosterone levels, however these are less common.

Some medications can cause or make erectile dysfunction worse. These include some of the medications used to treat depression, high blood pressure, and prostate problems. It is best to discuss this with your doctor if you think this might be the case. Don't stop taking the medication before speaking with your doctor.

Does Viagra (sildenafil) always help?

The most likely cause of the symptoms will define the best treatment to try. It could be treating the mental health condition, high blood pressure, or high cholesterol that could help.

Sildenafil (Viagra) can be used to treat erectile dysfunction in some situations and is a tablet that is taken before you want to have sex, and it increases the blood flow to the penis resulting in an erection. You can get it on prescription via your doctor.

Healthwords pharmacists' top tips

Eating a healthy diet, getting enough good quality sleep, avoiding smoking or excessive alcohol, and exercising can help improve ED, along with lowering any stress if you can.

When should I see my doctor?

You should book a routine doctor's appointment if you have had multiple episodes of erectile dysfunction, if it's affecting your relationship or how you feel about yourself, if you're experiencing other symptoms alongside erectile dysfunction, or if you think it is a side effect of your medication.

What will my doctor do?

Your doctor will discuss your current symptoms and any current medication, along with your past medical history and current mental health. Your doctor will likely take your blood pressure and heart rate and may examine your genital area. Depending on what your doctor thinks is the potential cause, they may offer to arrange further tests such as blood tests. Some solutions that may help could be a referral for talking therapy (counseling) or looking at starting or adjusting medication.

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This article has been written by UK-based doctors and pharmacists, so some advice may not apply to US users and some suggested treatments may not be available. For more information, please see our T&Cs.
Dr Karen Martin
Reviewed by Dr Karen Martin
Reviewed on 19.10.2023
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