Erectile Dysfunction: Causes, Symptoms and Treatment Options

Erectile dysfunction concerns difficulty obtaining or maintaining an erection firm enough for sex. It is a health question, not a verdict on masculinity or a partner's attractiveness. [1]

Understanding the possible causes and the assessment process is a better starting point than choosing a tablet from an advertisement. This overview explains the main routes through care without providing a prescription or a self-treatment plan.

What can contribute

Blood-vessel, nerve and hormone problems, some medicines and psychological factors can contribute to ED. More than one factor may be involved. [2]

Describe what happens in your own words: difficulty starting an erection, losing it before you want to, or a change that occurs only in some situations. Note when it began. Do not turn occasional observations into a home diagnostic test or repeatedly test yourself to prove a cause.

When recurring difficulties deserve attention

The NHS advises seeing a GP when erection problems keep happening. [3]

You can begin with primary care and ask whether specialist assessment is appropriate. Bring a list of medicines and relevant health history. If you have already tried a product, give its exact name and describe the experience honestly rather than simply saying that nothing worked.

What the consultation is for

An assessment may involve discussion, examination and targeted testing; it is not necessarily a standard package of every available test. [4]

Ask what each proposed investigation is intended to clarify. You should leave understanding the next step, who will arrange it and how the result will reach you. A consultation is still useful if the outcome is further assessment rather than an immediate prescription.

Treatment options are individual

Options include prescribed medicines, counselling, vacuum devices and, for selected cases, surgery. Suitability and risks need clinical discussion. [4]

Compare the whole plan

Ask about the aim of treatment, practical use, adverse effects, follow-up and alternatives. Consider privacy, comfort and what you and a partner want from intimacy. A technically available option is not automatically the right one for your circumstances.

Do not copy another person's treatment. An online advertisement cannot review your complete history, and a treatment name alone does not describe the monitoring or support that should accompany it.

Symptoms that should not wait

Seek emergency care for an erection lasting 3–4 hours; with sickle cell disease, a painful erection over 1 hour. [5]

Questions to take away

Write down the questions most relevant to you: What might explain this? Are other health issues being considered? What are the alternatives? How do I report a problem with treatment? Who handles follow-up? Keep the answers with your own health records, rather than relying on a checkout confirmation.

Further reading

• How online ED care works.
• Weight loss and sexual health.
• Choosing when to seek care.

Men’s Sexual Health