Erectile Dysfunction - Causes and Treatment

Erectile Dysfunction - Causes and 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.


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.

Alexandra Moses - Medical Content Writer
James O'Loan - CEO & Superintendent Pharmacist
James O'Loan , CEO & Superintendent Pharmacist on 23 January 2023
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