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Frequently Asked Questions
Problems with blood vessels
Factors which increase the risk of heart disease (obesity, smoking, high cholesterol, age, diabetes) also contribute to ED, however the blood vessels of the penis are much smaller than those in the heart, so ED may be an early warning sign of heart disease. If you are over the age of 40 a cardiovascular review with your GP should be requested.
Problems with nervous system
Diseases that affect the transmission of nerve signals from the brain to the penis can cause erectile dysfunction. For example: multiple sclerosis, spinal cord injury, damage due to diabetes. Cycling for more than 3 hours per week has been associated with ED due to pressure on the nerves. This is usually reversible (the nerves recover) over a few weeks after stopping cycling.
Problems with the penis itself
Deformities of the penis such as a very tight foreskin, or a condition called Peyronie’s disease can cause ED.
Psychological problems and relationship issues
Anxiety, depression and stress can all cause ED. Relationship issues – performance anxiety with an unfamiliar partner, no longer being attracted to your partner, tiredness can all affect sexual desire, performance and the ability to get an erection. If a man is getting early morning erections as normal and is able to get an erection for masturbation, psychological or relationship issues are a more likely cause of the ED. For more advice on psychological or relationship issues leading to problems with sex, see here (https://www.relate.org.uk/relationship-help/help-sex/sex-common-problems/i-have-problems-getting-or-keeping-erection).
Sometimes, even when performance anxiety or stress is the root cause of the ED, it may be appropriate to use medication to achieve an erection as this can allow men to regain their confidence and feel better about themselves.
Low levels of the male hormone testosterone along with other hormone imbalances can cause ED, often along with other symptoms such as a reduced sex-drive.
Some medications affect sex drive and the ability to get an erection. If you are experiencing ED while taking any of these medications, we recommend speaking to your doctor.
- Anti-Histamines (Hay Fever Medication & some Antacids)
- Blood Pressure Medications
- Heart Drugs
- Cancer Drugs
Excessive consumption of alcohol can cause difficulty getting an erection. This may be a one-off related to a bout of heavy drinking. However, regular consumption of high levels of alcohol has a range of effects on the body that includes altering hormone levels, which can cause persistent ED.
Lifestyle measures: Losing weight, stopping smoking and increasing exercise can be enough to improve ED alone with the added benefits of improving general health and reducing your risk of heart disease, cancer and diabetes. If cycling has contributed to your ED, switching to an alternative form of exercise may be worthwhile.
Psychological treatment: If psychological causes are at the root of your ED, it makes sense to address these in order to improve your sex life as well as your overall well-being. Identifying the problem, whether its stress at work, personal or relationship issues, is the first step to tackling them. Self-help books and various forms of counselling are available to help you work through these issues either alone or with a partner.
Medication: Millions of men worldwide have used medication to help them achieve an erection. The medication works by helping to relax the blood vessels of the penis to increase blood flow. The medicines differ in the time it takes for them to work, how long their effects last and their side effects. Our doctors can help advise which one may be right for you and see our table comparing the main features of each medicine (here). These medicines will not cause an erection on their own, they work together with the body’s normal processes. When you become sexually aroused these medicines temporarily boost the normal increase in blood flow to the penis so that a more satisfactory erection is achieved and maintained. These medicines are unlikely to work without sexual arousal.
Medicines for injection: Medicines are available that need to be injected into the penis to cause erection. These are not available to purchase from this website.
Devices: Specially designed vacuum pumps can be placed over the penis to generate an erection, which is then maintained by a constriction ring around the base. They cannot be used in men with bleeding disorders or on anticoagulant medication.
Surgery: If deformities of the penis such as a tight foreskin or Peyronie’s disease are contributing to ED, these may be corrected by surgery.
Some people are eligible for free prescriptions for ED treatment on the NHS. Reasons for NHS prescriptions include:
- Having diabetes, multiple sclerosis, Parkinson’s disease, poliomyelitis, prostate cancer, severe pelvic injury, single gene neurological disease, spina bifida or spinal cord injury
- If you are receiving dialysis for renal failure