Erectile Dysfunction: Causes, Treatment & UK Online Doctor
Educational information — not medical advice.
This article was prepared by the OnlineDoctor24 editorial team and reviewed for factual accuracy against UK clinical guidance (NHS and NICE). It is not written by a doctor and does not replace personal medical advice. For symptoms specific to you, book an online doctor consultation.
Key points
- Erectile dysfunction (ED) affects roughly half of UK men aged 40–70.
- Causes are physical (cardiovascular, diabetes, low testosterone), psychological or both.
- PDE5 inhibitors (sildenafil, tadalafil) work for most men and are safe with appropriate screening.
- ED can be the first warning sign of heart disease — a proper assessment matters.
- An online GP can review your history, screen for risk factors and prescribe discreetly.
What is erectile dysfunction?
ED is the persistent inability to get or maintain an erection sufficient for satisfactory sex. Occasional difficulty is normal — ED is when it happens regularly and causes distress.
Common causes
- Vascular: high blood pressure, high cholesterol, atherosclerosis.
- Metabolic: diabetes, obesity, metabolic syndrome.
- Hormonal: low testosterone, thyroid problems.
- Neurological: after pelvic surgery, MS, spinal injury.
- Medication: antidepressants, blood pressure tablets, finasteride.
- Psychological: anxiety, depression, relationship stress.
- Lifestyle: smoking, excess alcohol, lack of exercise.
Lifestyle measures (proven to help)
- Stop smoking — biggest single factor.
- Lose excess weight — even 5–10% improves erections.
- Aerobic exercise 150 min/week.
- Limit alcohol to ≤14 units/week.
- Treat sleep apnoea if present.
Prescription treatments
- Sildenafil (Viagra): works in 30–60 min, lasts ~4 hours.
- Tadalafil (Cialis): longer-acting (up to 36 hours); also available daily low-dose.
- Vardenafil, avanafil: alternatives.
- All require sexual stimulation to work.
- Should NOT be combined with nitrates (chest-pain medication) — can cause dangerous BP drop.
When to investigate further
New ED in men under 40, sudden onset, or ED with chest pain on exertion warrants cardiovascular assessment. Low libido with fatigue suggests checking testosterone.
Online doctor service
An online GP will review your medical history, current medications, blood pressure and any cardiovascular risk before prescribing — usually delivered discreetly to your address or local pharmacy.
Red flags — when to seek urgent help
Call 999 or go to A&E if you experience any of the following:
- Chest pain or breathlessness on exertion
- Sudden ED after pelvic injury
- ED with severe headaches or vision changes
- Painful, prolonged erection (>4 hours) — A&E
Frequently asked questions
Common questions UK patients ask about erectile dysfunction.
How an online doctor can help
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This article is for general information only and does not replace personal medical advice from a qualified doctor. Content is reviewed against UK NHS and NICE guidance by the OnlineDoctor24 editorial team and is not authored by a medical doctor. If your symptoms worsen or you are unsure, please book a consultation with a GMC-registered GP.
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