Understanding erectile dysfunction
Erectile dysfunction (ED) is difficulty getting or keeping an erection firm enough for sex. It is common, becomes more frequent with age, and can be treated in most men.
Because erections depend on healthy blood vessels, ED can be an early sign of heart disease or diabetes.
Causes
- Blood vessel problems linked to high blood pressure, high cholesterol, diabetes and smoking
- Nerve damage, for example from diabetes or pelvic surgery
- Low testosterone
- Side effects of some medicines
- Stress, anxiety and relationship difficulties
- Heavy alcohol use
Assessment
- A private conversation about your symptoms and health
- Examination
- Blood tests for sugar, cholesterol and testosterone
- A review of your medicines
- Specialised tests, such as penile Doppler ultrasound, when needed
Treatment options
Treatment is matched to the cause and to what suits you and your partner.
Tablets
Medicines such as sildenafil and tadalafil help many men. They work with sexual stimulation and are prescribed after checking they are safe for you.
Lifestyle and health
Exercise, weight loss, stopping smoking, and controlling blood sugar and blood pressure improve erections and general health.
Injections and vacuum devices
Options for men who do not respond to tablets or cannot take them.
Penile implant
A surgical option when other treatments do not work, with high satisfaction among patients and partners.
When to see a urologist
See a urologist if erection problems last more than a few weeks, affect your confidence or relationship, or come with other symptoms such as pain or curvature.
Frequently asked questions
This page is general information and does not replace a medical consultation.