Men's Health
Expert advice and care

Erectile dysfunction (ED) can also be referred to as impotence. ED is a condition that affects men and is the inability to achieve and maintain a satisfactory erection for sexual intercourse, or in response to sexual stimulation.

Erectile dysfunction is a very common condition that can affect any man at any age, although it becomes increasingly common with advancing years. It is estimated that around 50% of men between the ages of 40 and 70 will experience ED at some point.

Erections are caused when a man becomes sexually excited. This arousal causes the brain to send signals to the nerves in the penis. Upon receiving these signals the nerves increase the blood flow to the penis, causing it to enlarge and harden. If anything interrupts this process then erectile dysfunction can occur. This interruption may be physical, psychological or medicinal.

Physical causes of ED include:

• Vascular conditions - such as diabetes, high blood pressure and cardiovascular disease, all of which can affect the flow of blood to the penis.
• Hormonal conditions - such as over or underactive thyroid, hypogonadism and Cushing’s syndrome, all affect the hormonal levels of the body and can lead to impotence
• Neurogenic conditions - such as multiple sclerosis and Parkinson’s disease will affect the body’s nervous system and can interfere with the process of achieving an erection
• Anatomical conditions - like Peyronie’s disease that affect the tissue in the penis and can result in erectile dysfunction

Psychological causes of ED include:

• Mental conditions - such as stress, anxiety and depression can lead to erectile dysfunction
• Emotional problems can affect your physical ability to achieve or maintain an erection too. Examples of which include; lack of sexual knowledge or past sexual abuse, being in a new relationship.

Medicinal causes of ED include:

• Certain medicines can lead to erectile dysfunction in some men. Examples of these include; beta blockers, diuretics, corticosteroids, antidepressants, antihistamines, and cytotoxics.

Erectile dysfunction will present itself as an inability to achieve or maintain a satisfactory erection during sexual intercourse. When dealing with ED it is very important to understand and identify the underlying cause. For example if you’re able to achieve and maintain an erection while you masturbate but find you are unable to get an erection with your sexual partner, this would suggest the cause is psychological. However, if achieving and/or maintaining an erection isn’t possible under any circumstance, it would be safe to assume the problem is primarily physical or potentially medicinal.

Erectile dysfunction is most commonly caused by reduced blood flow to the penis. In a large proportion of cases this can be due to narrowing of the blood vessels flowing into the penis, meaning that there is insufficient blood flow to produce an erection. Some causes of reduced blood flow are; weight gain, high blood pressure, high cholesterol, smoking and diabetes. For this reason erectile dysfunction can be an early indicator of heart disease and it is important to have a full health check with your GP.

In general, symptoms of erectile dysfunction that occur slowly are more likely to indicate a physical cause (e.g. narrowing of the blood vessels to the penis) whereas symptoms that are sudden in onset may suggest psychological causes.

Other causes of erectile dysfunction can include: injury to, or diseases that affect, the nerves going to the penis, hormonal causes (e.g. low testosterone), side effects of medicines, excess alcohol, drug abuse, and psychological causes such as anxiety, depression, stress or relationship issues.

If you feel like you have the symptoms, our guide can help you learn how to complete a discreet online ED consultation.