Erectile Dysfunction - Causes & Treatment

Erectile dysfunction (ED), sometimes referred to as impotence, is a common problem that many men face, but it’s more prevalent in men over the age of 40. Thankfully, it’s usually nothing to worry about – even so, it can be distressing.

It’s defined by the inability to achieve and maintain an erection long enough to have sex. All men likely experience erection problems at some point, especially if you’ve been drinking alcohol. However, erectile dysfunction can also be caused by a side effect of certain medicines, high blood pressure, high cholesterol, diabetes, and mental health conditions.

There are things you can do yourself to treat ED, like losing weight if you’re overweight, stopping smoking, exercising, eating healthily, and reducing stress and anxiety.

If these aren’t effective in resolving your erectile dysfunction, you may be offered medicine to increase blood flow to the penis such as sildenafil (Viagra). Alternatively, your GP may suggest vacuum pumps or therapy.

Erectile dysfunction statistics

Infographic of key erectile dysfunction statistics

Between 50-55% of men aged 40-70 suffer from ED. That means around 4.3 million men may be affected in the UK alone. To some, this might seem like an alarmingly high number, but the fact is that ED is common, treatable and simply not talked about enough.

As mentioned above, the likelihood of ED rises with age. Only 2% of men report their first experience of ED before age 40, while 40% of first reports occur between the ages of 60-69. When looking at these figures it’s important to take into consideration the fact that only 33% of people who have ED are thought to seek help and advice, and therefore contribute to data.

In 1995 it was predicted that by 2025 there would be 152 million ED sufferers globally, but this figure is now looking much higher - as many as 322 million. Whatever various factors may contribute to this rise, the bottom line remains the same - ED is nothing to be ashamed of and there are things you can do about it should you choose to.


The symptoms of ED include being unable to get an erection, maintain it, and keep it long enough to have sex. Some men also experience a reduced sex drive, or a loss of libido

Depending on what’s causing your erectile dysfunction, you might still be able to have an erection at other times, such as when you wake up.


Erectile dysfunction has a wide range of causes, both physical and psychological. It’s related to the blood supplied to the penis; for example, it could be caused by the narrowing of the blood vessels or reduced blood flow to the penis, preventing an erection from occurring.

The majority of men will struggle to get an erection from time to time, especially if you’ve consumed alcohol or you’re tired and stressed. But if you find that you’re frequently unable to get and maintain an erection, you could have erectile dysfunction.

General erectile dysfunction causes include: 

  • Performance anxiety
  • Being overweight
  • Smoking
  • Side effects of certain medicines
  • Relationship problems
  • Mental health conditions like depression and anxiety

Sometimes, if you can’t get erect, there may be an underlying medical condition at hand. This includes:

  • Heart disease
  • High cholesterol
  • High blood pressure
  • Diabetes
  • Nervous system impairment
  • Hormone problems, like a low level of testosterone (male sex hormone)


There are multiple tests and exams your GP may wish to perform in order to diagnose erectile dysfunction. A physical examination looks at the nerves in your penis and testicles, in addition to a psychological examination to see if there’s any potential psychological causes, like depression or performance anxiety.

Blood and urine tests can also determine whether you have an underlying health condition like a hormone imbalance or diabetes, amongst others. An ultrasound of the penis is useful to see if you have any blood flow problems that could be causing your erectile dysfunction.

When to speak to your doctor

It’s important that you book in to see your GP or visit a sexual health clinic if your erection problems keep happening or they’re causing distress to both yourself and your partner.

You’ll likely get your results quicker at your local sexual health clinic, too, as many offer a walk-in service, meaning you won’t need an appointment. To find a sexual health clinic near you, click here.

At your appointment, the healthcare professional may ask you some simple health, lifestyle and relationship questions, in addition to what problems you’re having. They may also perform some basic health checks, like taking your blood pressure and examining your genitals to rule out an obvious cause.

If you have additional symptoms like needing to pass urine more often, they may also wish to look at your prostate by performing a rectal examination.


Erectile dysfunction treatments range from things you can try yourself like stopping smoking and reducing how much alcohol you drink, to medical treatments your GP or prescribing pharmacist can offer you. This includes medicines like sildenafil (Viagra) and tadalafil (Cialis) to help you achieve and maintain an erection once you’re aroused.

Medical treatments

You’re able to get Viagra Connect without a prescription – all you’ll need to do is answer a few health-related questions and a pharmacist will be able to see if it’s the right option for you. Viagra Connect is different from regular Viagra as it contains a lower dosage (50mg) of the active ingredient sildenafil.

Next there’s prescription-only medicines which must be prescribed to you from your GP or a prescribing pharmacist. They include Viagra (sildenafil, which can be up to 100mg), Spedra (avanafil), Levitra (vardenafil) and Cialis (tadalafil).

These medicines are called PDE-5 inhibitors, and they work by increasing the blood flow to the penis to aid you in getting and maintaining an erection. 

Additionally, there’s non-medicated options available too. Vacuum pumps are a tool that help to increase the size and strength of your erection by encouraging blood flow to the penis. They work for a lot of men and are the ideal choice if medicine cannot be taken or it doesn’t work.

If all other treatments haven’t worked, your doctor may suggest a surgical treatment. One of the main procedures is a penile implant, a device that’s placed inside the penis to allow an erection to form.

However, if your erectile dysfunction is caused by a mental health condition such as depression, it may be the best option to work on managing and treating your symptoms first. It’s probable that once your mental health has improved, so will your ED.

The same applies to health conditions like diabetes, and others which can cause constricted blood vessels.

Home remedies

There’s an opportunity for your erectile dysfunction to improve by simply making a few lifestyle changes. If you’re overweight and smoke and drink excessively, you’re at an increased risk of developing erectile dysfunction, in addition to premature ejaculation.

It’s beneficial to try losing weight and stopping both of these habits to see if you notice a positive change in your symptoms before opting for medical treatments.

Studies suggest that cycling can be another cause of ED. When you’re cycling, the seat puts constant pressure on your perineum (the area between the genitals and the anus) which can damage the nerves and temporarily reduce blood flow. 

This can cause a tingling or numbing sensation in the penis which can eventually lead to erectile problems. If you’re an avid cycler and you’re experiencing ED, take a break to see if your symptoms improve.

The cities purchasing erectile dysfunction treatments

Map of where the most erectile dysfunction products are purchased in the UK

There appears to be a greater demand for ED treatments in certain areas of the UK. When looking at the number of ED treatment purchases per 10,000 people, the coastal town of Llandudno tops the list at 52. There’s a significant drop to the next ED purchase hotspot to Truro, which stands at 28 purchases per 10,000 people, and from there another noteworthy drop to 16 purchases in Canterbury. From there the list evens out a little, with the remaining places in the top 10 (Redhill, Guildford, Inverness, Chelmsford, Motherwell, Llandrindod Wells and Chester) only dropping from 15.5 to 10.5 averages in total.

What can we gather from this? As previously mentioned, because only a third of ED sufferers seek help and advice, we shouldn’t assume that those purchasing ED treatments represent the only people affected in a certain area.

Erectile dysfunction questions: answered

Q1. How can you tell if you have erectile dysfunction?

Answer: If you have difficulty achieving or maintaining an erection.

Q2. How long does erectile dysfunction last?

Answer: This is dependent on the cause. Most cases of ED are caused by physical factors such as heart disease, obesity or diabetes. In these cases, similar to the illnesses that cause it, ED may be long-term. However, 10-20% of erectile dysfunction cases are psychological and can respond to counselling in time.

Q3. Does masturbation cause erectile dysfunction?

Answer: No. This is a common myth.

Q4. Can high blood pressure cause erectile dysfunction?

Answer: Yes, people with high blood pressure are twice as likely to experience erectile dysfunction.

Q5. Can erectile dysfunction be cured?

Answer: By treating the underlying cause you may reverse ED. There are medicines available that can treat erectile dysfunction, such as sildenafil and tadalafil, but these are not cures.

Q6. What is the best cream for erectile dysfunction?

Answer: There is a prescription-only cream containing alprostadil that is used to treat ED. There is also an over-the-counter cream available called Eroxon. This contains GTN, which works by dilating the blood vessels in the penis.

Alexandra Moses - Medical Content Writer
Ian Budd - Prescriber and Clinical Lead
Ian Budd , Prescriber and Clinical Lead on 09 October 2023
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