Erectile Dysfunction

Erectile dysfunction, otherwise known as ED, or impotence is a condition where a man is unable to get or keep an erection long enough to have sex. This happens to most men on occasion, but if it happens often it may be a sign of an underlying health problem. 

ED is common, particularly in men over 40, and affects around 1 in 10 men at some time in their lives. 

Occasional ED is normally nothing to worry about and is usually due to stress, tiredness, or drinking too much alcohol, but if it happens a lot it needs investigation and treatment. ED can be a sign of another health problem such as diabetes or heart disease. Long-term ED can cause problems in your relationship and lead to depression and low self-esteem.

ED is a complex condition with a variety of causes including physical, psychological, and lifestyle related. It may also be a side effect of some medications. 

Physical causes of ED include: 

• • diabetes
  • heart disease
  • hormonal problems like low testosterone or thyroid disease
  • high blood pressure
  • high levels of fats (triglycerides) in the blood

• conditions affecting the brain and nerves such as multiple sclerosis, spinal cord injury, and stroke

• injury to the penis or testicles due to trauma or surgery 
• obesity
• Peyronie’s disease— a condition where a build-up of scar tissue causes the penis to curve

Psychological causes of ED include:

• depression 
• stress
• relationship problems
• history of sexual abuse

Lifestyle-related causes of ED include:

• smoking
• drinking too much alcohol
• not getting enough exercise
• using recreational drugs

Some medications that can cause ED include some types of: 

• antidepressants 
• blood pressure medications
• epilepsy medications
• antihistamines
• medications to treat Parkinson’s disease
• hormones
• psychiatric medications
• heart medications
• drugs that suppress your immune system
• sleeping tablets 

If you think your medication may be causing your ED, don’t stop taking your medication without first speaking to your GP.

Treatment for ED depends on the cause. If your ED is due to an underlying health issue like a hormonal problem, or diabetes, your ED may improve when you get treatment for these conditions. In some cases, lifestyle changes such as stopping smoking or losing weight can help. 

Other treatments for ED include medication, devices such as vacuum pumps, talking therapies, and surgery. 

Some lifestyle changes you can make to help with ED include: 

• stopping smoking
• losing weight if needed
• reducing stress
• taking regular exercise
• eating a healthy diet
• not drinking more than the recommended limit of alcohol (14 units a week). 

Medications for ED work by increasing the blood supply to the penis. They include sildenafil (Viagra), tadalafil (Cialis), vardenafil (Levitra), and avanafil (Spedra). 

Medications for ED are normally highly effective but may not be suitable for everyone and can cause side effects in some people. Talk to your doctor about which medication may be best for you. 

Emotional or psychological issues such as anxiety, depression, and problems in your relationship are common causes of ED. 

Talking therapies such as psychotherapy, sex therapy, couples therapy, or cognitive behavioural therapy (CBD), are effective treatments if your ED has a psychological or emotional cause. Your GP can refer you to a therapist, or you can find a private therapist yourself. 

Devices such as vacuum pumps, and penile rings work by pumping air into a cylinder that fits around the penis. This creates a vacuum and increases blood flow to the penis which causes an erection. A constriction ring around the base of the penis prevents the blood from escaping and the erection normally lasts around 30 minutes. These devices may be recommended if you can’t take medication. 

Penile injection therapy (intracavernosal injection therapy) is a type of treatment where you inject a small amount of medication into your penis (your doctor will show you how to do this correctly). The medication relaxes the blood vessels inside the penis and increases blood flow enabling you to get an erection. 

Surgery such as penile implant surgery is an effective treatment for long-term ED and is usually used when other treatments haven’t worked. A pair of inflatable cylinders are implanted into the shaft of the penis and inflated manually using a hand pump inside the scrotum.

Many men feel embarrassed when talking about erection problems, but if you frequently have problems getting or keeping an erection, it’s important to see a doctor. Our NHS-trained GPs can help diagnose ED by asking you some questions about your general health, symptoms, and any medications you are taking. They can advise you on how to manage your ED, prescribe suitable medication, and recommend further investigations if necessary. You can have a consultation with a doctor from the privacy of your home via video link at a time that suits you.

In the UK, sildenafil (Viagra) is now available to buy from pharmacies without a prescription. Your pharmacist will check that it is safe for you to take by asking you some questions about your general health, any allergies you have, and other medications you are taking. A pharmacist can also advise you about lifestyle changes and possible underlying health problems that could be causing your ED. 

Find a Pharmacy Near Me 

Erectile dysfunction is a common, but complex condition with a variety of possible causes. Untreated ED can have long-term implications for your mental health and relationships and may be a sign of another health issue. The good news is, there are many treatments for ED available and most men with the condition are able to enjoy healthy, fulfilled lives. If you think you may have ED and would like to talk to a doctor, make an appointment today. 

References 

NHS: Erectile Dysfunction August 26th 2020 (Accessed October 15th 2022) 

Cleveland Clinic: Erectile Dysfunction October 14th 2019 (Accessed October 15th 2022)

PubMed: Erectile Dysfunction February 4th 2017 (Accessed October 15th 2022)

NIH: Erectile Dysfunction May 27th 2022 (Accessed October 15th 2022)

Harvard Health Publishing: 5 natural ways to overcome erectile dysfunction July 7th 2020 (Accessed October 15th 2022)

BMJ Journals: Recent advances in the treatment of erectile dysfunction  November 2017 (Accessed October 15th 2022)

American Family Physician: Erectile Dysfunction November 15th 2016  (Accessed October 15th 2022)

 Viagra Connect: The role of a pharmacist December 2020 (Accessed October 15th 2022)