Erectile dysfunction
Erectile dysfunction treatment, online
Erectile dysfunction (ED) is difficulty getting or keeping an erection firm enough for sex. It is the most common sexual problem reported by men, and for most people it is treatable. It is also, often, the first outward sign of something else going on — which is why a consultation looks at your whole health rather than just the symptom.
Around half of men between 40 and 70 have some degree of erectile dysfunction, and it becomes more common with age. Occasional difficulty is normal and does not mean you have ED.
A consultation does not guarantee a prescription. A prescriber decides what, if anything, is appropriate for you.
What erectile dysfunction looks like
- Difficulty getting an erection
- Difficulty keeping an erection long enough for sex
- Erections that are less firm than they used to be
- Reduced interest in sex alongside the above
- Needing much more stimulation than before
What causes erectile dysfunction
Physical causes
- Narrowing of the blood vessels, often linked to high blood pressure, high cholesterol or smoking
- Diabetes, which can affect both blood supply and the nerves involved
- Hormonal problems, including low testosterone and thyroid disease
- Side effects of medicines, particularly some antidepressants and blood pressure treatments
- Nerve damage after prostate surgery, or from conditions such as multiple sclerosis
- Heavy alcohol use, smoking and recreational drugs
Psychological causes
- Stress, at work or at home
- Anxiety about sexual performance, which can become self-reinforcing
- Depression
- Difficulties within a relationship
Treatment options
This is the full range, including the options we don't provide. Which one is right is a decision for you and a prescriber together — not something to choose from a list.
Addressing the underlying cause
Via your GP or a specialistWhere ED is linked to blood pressure, cholesterol, diabetes or a medicine you take, treating that is the single most effective step. It is also the one most often skipped.
Lifestyle changes
Via your GP or a specialistStopping smoking, reducing alcohol, losing excess weight and regular aerobic exercise all have evidence behind them for improving erectile function.
Psychosexual therapy
Via your GP or a specialistTalking therapy with a specialist therapist is effective where anxiety, depression or relationship factors are involved, and can be used alongside medication.
PDE5 inhibitor tablets
Available through this serviceA class of prescription-only medicines used to treat erectile dysfunction by increasing blood flow to the penis. They are taken either daily or before sex, depending on the medicine and the dose. They do not work without sexual stimulation, and they are not suitable for everyone — in particular, they cannot be taken with nitrates.
Vacuum erection devices
Via your GP or a specialistA pump that draws blood into the penis, held in place with a constriction ring. Useful where tablets are unsuitable or have not worked.
Injections, pellets and surgery
Via your GP or a specialistWhere other options have not worked, a specialist may consider injected or intraurethral treatments, or surgical implants. These are managed by a urology service.
What helps day to day
Move most days
Aerobic exercise improves the health of the blood vessels that supply the penis. Thirty minutes, four or five times a week, is the level studied.
Stop smoking
Smoking narrows blood vessels, and erectile function is one of the earliest things to suffer. It is also one of the earliest things to improve after stopping.
Watch the alcohol
Alcohol depresses the nervous system. A heavy night makes erections harder, and sustained heavy drinking does so over the longer term.
Sleep, and treat sleep apnoea
Poor sleep lowers testosterone. Obstructive sleep apnoea is strongly associated with ED and is very treatable.
When to see a doctor instead
Book an appointment if any of these apply
- Erectile dysfunction that started suddenly, particularly if you still wake with erections
- Chest pain, breathlessness or pain in your legs when you exert yourself
- An erection that is painful, or lasts longer than four hours
- A noticeable bend or lump in the penis
- Symptoms alongside a new diagnosis of diabetes or heart disease
Common questions
Is erectile dysfunction a sign of heart disease?
It can be. The arteries supplying the penis are narrower than the coronary arteries, so they tend to show narrowing earlier. ED can precede a cardiac event by several years, which is why a consultation asks about your heart health and why it is worth having blood pressure and cholesterol checked.
Do I need to see a doctor in person?
Not usually. A prescriber can assess most cases from a detailed set of questions about your symptoms, your general health and your medication. If your answers suggest you need an examination or tests, we will tell you that rather than prescribe.
Will treatment work the first time I take it?
Not always. Guidance is to try a treatment several times, at the right dose and with the right timing, before concluding that it has not worked. Follow-up is included at no extra cost.
Can I get treatment if I take medication for blood pressure?
Often yes, but it depends on which one. Nitrates and nicorandil cannot be combined with ED treatment at all. Alpha-blockers can usually be managed with a lower starting dose. The consultation asks about all of these by name.
Is the packaging discreet?
Yes. Orders arrive in plain packaging with no indication of the contents or of the pharmacy on the outside.
Related conditions
This page is for information and is not a substitute for individual medical advice. Last reviewed October 2026 by the clinical team.
Ready to see where you stand?
The consultation takes about five minutes and costs nothing. You'll only pay if a prescriber decides treatment is right for you.