Common Causes

Occasional erectile dysfunction is usually caused by stress, tiredness, or drinking too much alcohol, and can also be a side effect of certain medicines. If it happens often, it may be linked to an underlying condition, such as high blood pressure, high cholesterol, diabetes, depression or anxiety, or hormone problems.

Lifestyle Changes That Can Help

Healthy changes can sometimes improve erectile dysfunction, including losing weight if you're overweight, stopping smoking, eating a healthy diet, exercising daily, and reducing stress and anxiety. It's also worth keeping alcohol to no more than 14 units a week, and cutting back on cycling for a while if you cycle more than 3 hours a week, since this can sometimes contribute to the problem.

Getting Help

Sexual health clinics can offer the same treatment as a GP surgery for erection problems, often with a walk-in service that doesn't need an appointment, and test results are frequently available more quickly than through a GP. At your appointment, a doctor or nurse may ask about your lifestyle and relationships, carry out basic checks such as blood pressure, and examine your genitals to rule out an obvious physical cause — if you have symptoms like needing to pee more often, they may also examine your prostate.

Medicines

The main treatments for erectile dysfunction are medicines called PDE-5 inhibitors, which increase blood flow to the penis. These include sildenafil (Viagra), tadalafil (Cialis), vardenafil (Levitra), and avanafil (Spedra). Sildenafil can be bought from a pharmacy or obtained on prescription, while the others need a prescription.

If buying sildenafil online, it's important to be cautious, since many websites sell fake medicines with unregulated or inconsistent ingredients that could cause unwanted side effects or simply not be suitable for you. It's best to see a doctor before buying medicine online, since they know your medical history and can advise on whether treatment is likely to help. If you do buy online, check that the pharmacy is registered with the General Pharmaceutical Council, and that any online doctor service is registered with the Care Quality Commission, with doctors registered with the General Medical Council.

Vacuum Pumps

Vacuum pumps encourage blood flow into the penis to create an erection, and work for most men — they can be a useful option if medicine isn't suitable or hasn't worked. They're not always available on the NHS, so it's worth asking a doctor for advice on where to get one.

Treating the Underlying Cause

Sometimes treating the cause helps resolve erectile dysfunction directly — for example, switching to a different medicine if the current one is responsible, or treating high blood pressure, high cholesterol, or hormone problems with appropriate medicine. If erection problems are linked to emotional or mental health difficulties, counselling or therapy can help, though NHS waiting times for these services can be long. Private counsellors or sex therapists are also an option — counsellors and psychotherapists should be registered with the British Association of Counselling and Psychotherapy, and sex therapists with the College of Sexual and Relationship Therapists or the Institute of Psychosexual Medicine; Relate also offers paid sex therapy.