Cardiovascular conditions
Reduced blood flow from high blood pressure, high cholesterol or atherosclerosis is the most common physical cause.
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Erectile dysfunction — symptoms, causes and treatment
Erectile dysfunction (ED) is the inability to get or keep an erection firm enough for sex. It affects roughly half of men over 40 and is treatable in most cases
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Overview
ED can have physical, psychological, or lifestyle causes. Most men experience it occasionally — it only becomes a clinical concern when it persists.
An erection is the result of nerves, blood vessels, hormones, and emotions working together. When any link in that chain is disrupted, getting or maintaining an erection becomes difficult.
The good news: most cases respond well to treatment, lifestyle changes, or both.
Symptoms
Speak to a clinician if you regularly experience any of the following:
Difficulty getting an erection
Trouble achieving an erection on most attempts over a period of weeks.
Difficulty keeping an erection
An erection that fades before or during intercourse on a regular basis.
Reduced sexual desire
A noticeable drop in libido lasting more than a few weeks.
Common causes
ED is typically caused by a combination of physical and psychological factors.
Diabetes
Diabetes can damage the nerves and blood vessels that control erections, particularly when poorly managed.
Stress and anxiety
Performance anxiety, work stress and depression are leading psychological causes — especially in younger men.
Lifestyle factors
Smoking, heavy alcohol use, lack of exercise and obesity all contribute to ED.
Recommended treatments
Our clinicians may recommend one of the following, depending on your medical history.
Sildenafil (generic Viagra)
Most popularGenericFast acting
The original ED treatment in its generic form. Taken on demand and effective for the majority of men.
- From £14.99
- Take 30–60 minutes before sex
- Lasts up to 4 hours
From £14.99
View SildenafilTadalafil (generic Cialis)
GenericLong-lasting
Often called the 'weekend pill' because of its long duration — useful when timing matters less.
- From £19.99
- Effective in 30 minutes
- Lasts up to 36 hours
From £19.99
View TadalafilAvanafil (Spedra)
BrandedFewest side effects
The newest ED tablet, designed to act quickly while keeping side effects to a minimum.
- From £29.99
- Take 15–30 minutes before sex
- Lasts up to 6 hours
From £29.99
View AvanafilHow they compare
| Treatment | Onset | Duration | Notes |
|---|---|---|---|
| Sildenafil | 30–60 min | 4 hours | Generic Viagra |
| Tadalafil | 30 min | Up to 36 hours | Best for spontaneity |
| Avanafil | 15–30 min | 6 hours | Newest, fewer side effects |
Not sure which is right for you?
How it works
Three steps from questionnaire to treatment at your door.
1
Complete the medical questionnaire
Takes about two minutes. Your answers stay confidential.
2
Clinician review
A registered UK prescriber reviews your answers and recommends a treatment if appropriate.
3
Discreet delivery
Plain packaging dispatched the same day with tracked delivery.
Myths and misconceptions
ED only affects older men
False. Around 26% of men under 40 experience ED, often linked to stress or lifestyle factors.
ED is always psychological
False. The majority of cases have a physical component, often cardiovascular.
Treatment is a permanent commitment
False. Most men only take ED treatments on demand, before sex — there's no need to take them daily unless prescribed otherwise.
When to see a doctor in person
Most ED cases can be treated remotely, but seek in-person medical advice if you experience any of the following:
- Severe chest pain or shortness of breath
- An erection lasting more than 4 hours (priapism)
- Sudden change in vision or hearing after taking ED medication
- Painful or curved erection
Related guides
Related reading from our health guide library.
Frequently asked questions about ED
Common questions our clinicians hear from patients.
Is erectile dysfunction reversible?
In many cases, yes. Treating the underlying cause — high blood pressure, anxiety, lifestyle factors — often restores normal function.
Are these treatments safe?
When prescribed by a clinician for the right patient, ED treatments have an excellent safety record. Side effects are usually mild.
Will my GP see this?
Only if you ask us to share. Your treatment with us is private by default.
Ready to get help with ED?
Our consultation takes two minutes and is reviewed by a UK clinician — no commitment required.
