Defined as ‘the inability to get or keep an erection sufficient for sexual intercourse or another chosen sexual activity’, Erectile Dysfunction is estimated to affect 50% of men aged between 40 and 70. The condition is generally categorised as physical or psychological with it being possible to be effected by either or both. Usually, it is nothing to worry about however you should see a GP if the issue is reoccurring.

Despite being an extremely common condition only a small percentage of sufferers actually seek help and receive treatment. Due to embarrassment, ignoring the condition, or simply hoping it will disappear men tend not to seek help. However, it is important to remember that addressing the problem when it is first noticed could lead to a simple solution or an early diagnosis of a more underlying issue.

Physical causes of erection problems.

With erectile dysfunction occurring more often in people who smoke, drinking alcohol excessively, are overweight, or not active enough it is clear that there is a correlation between the condition and your physical health.

Other triggers could be;

  • Physical injury to the penis
  • Conditions which affect blood flow; disease of the heart or blood vessels high blood pressure, diabetes and raised cholesterol.
  • Hormonal conditions; an overactive/underactive thyroid gland, low testosterone level, Cushing’s syndrome, or a head/brain injury.
  • Conditions affecting the nervous system; multiple sclerosis, diabetes, stroke, Parkinson’s disease, and spinal injuries.
  • Anatomical conditions (which affect the structure of the penis); Peyronie’s disease
  • Surgery and radiation therapy for bladder, prostate or rectal cancer
  • Side effects of prescribed drugs or recreational drug use.

Psychological causes of erectile problems

Often issues with erections can be as much to do with your mental health as your physical health. An indication that your erectile problems are psychological and not physical would be that your erection is fine except with your partner or your erection occurs at other times but not during intercourse. It is important to reflect on whether these issues are triggered by psychological concerns such as;

  • Anxiety
  • Stress
  • Mental tiredness
  • Potential fear of erectile dysfunction if it has occurred previously
  • Processing prior sexual suffering such as abuse or rape


To diagnose the cause or causes of your erectile dysfunction and take the steps towards fixing the issue you should speak to your GP or visit a GUM (Genitourinary Medicine Clinic).

In order to get a diagnosis your sexual history, diet and lifestyle will be discussed. Alongside this an assessment will be carried out. The assessment entails;

  • Height, weight, and waist measurement
  • Heart, lungs, and blood pressure check
  • Genital check
  • Cholesterol check
  • Diabetes test
  • A morning check of your testosterone


The vital thing to remember about erectile dysfunction is that it can be treated extremely successfully. Treatment involves tackling the cause of the problem, whether this is physical, psychological or a mixture of both.

Recommended lifestyle changes

  • Lose weight
  • Keep fit
  • Eat a healthier diet
  • Reduce/stop smoking
  • Reduce alcohol intake
  • If you cycle more than three times a week GP’s often recommend taking time off and seeing if the condition improves. Some bicycle seats are actually specifically designed to relieve pressure on the blood vessels and nerves supplying the penis.
  • Consider therapy to discuss the pressing psychological issues that may be manifesting themselves in your erectile dysfunction

Sex therapy: Sex therapy is often used in conjunction with other treatments.It is a talking therapy where an individual or couple work with an experienced therapist to assess and treat their sexual and/or relationship problems.

The therapist will identify factors that trigger the sexual problems and then design a specific treatment programme to resolve or reduce their impact. This type of therapy is considered highly effective in addressing the main causes and contributing factors of sexual difficulties. Your GP may be able to refer you for sex therapy or you can contact a therapist directly and pay privately.

Medical Options

Tablets:  This is normally the first line of treatment for erectile dysfunction. The tablets are called Phosphodiesterase Inhibitors Tablets or are more commonly known as PDE5i. These include;

  • Tadalafil (Cialis®)
  • Vardenafil (Levitra®)
  • Sildenafil (Viagra®)
  • Avanafil (Spedra®).

Prescriptions are required for every medicine listed except Sildenafil. This drug is available over the counter but still requires a consultation with a pharmacist to ensure it is safe to take.

Injection Therapy: Injection therapy is made available to those who have not achieved success with tablets. There are two main ways this therapy is used;

  • Alprostadil; this is the same chemical that the penis produces naturally when it becomes erect. This can be injected into the shaft of the penis allowing greater blood flow. Alternatively, a pellet that contains Alprostadil can be inserted into the urethra after urinating. The pellet then dissolves and gives you an erection.
  • Invicorp; this contains two active ingredients, one which increases the blood flow to the penis and the other which ensures the blood remains there.

Vacuum Pumps: Vacuum pumps encourage blood to flow to the penis, causing an erection. They work for most men and can be used if medicine isn’t suitable. However, they are not always available on the NHS.

Hormones: If your testosterone levels are low, Testosterone replacement therapy may be an option.

Physiotherapy: Research has suggested that a small number of men may benefit from exercises to strengthen the pelvic floor muscles. These muscles lie underneath the bladder and back passage, and at the base of the penis. If your doctor thinks this approach may benefit you, they will refer you to a physiotherapist.

What is your experience with erectile dysfunction? Have you suffered with the problem? Did you seek treatment? Is it something you worry about? Join or start the conversation below.