What is erectile dysfunction? Symptoms, causes and treatment options in the UK

Erectile dysfunction (ED) is the inability to get or keep an erection hard enough for penetrative sex.

It’s very common in men over 40. And the likelihood of experiencing ED increases as you age. This is because of deterioration in the smooth muscle cells of the penis – a natural part of aging.

Many men, even those in their 20s and 30s, also experience occasional difficulties with erections due to stress, fatigue or just not feeling in the mood.

But when you frequently struggle to get or maintain an erection, it’s important to find out what’s causing it – and what you can do about it.

One quick and simple way to tackle the symptoms of erectile dysfunction is to use medically approved treatments.

These medications allow more blood flow to the penis, improving the quality and sustainability of your erections.

This lets you continue enjoying a healthy, active sex life and gives you the space and confidence you need to address the root causes of erectile dysfunction.

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You don’t need an existing prescription. Simply complete your free consultation and medical health questionnaire, and one of our UK-licensed doctors will prescribe a suitable medication to treat your symptoms.

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Erectile dysfunction symptoms

Before we explore causes and treatments, let’s answer the most basic question: what is erectile dysfunction?

Erectile dysfunction is when you’re either:

• Unable to get an erection
• Unable to keep an erection hard enough for sex

Having trouble getting an erection every now and then is common.

But erectile dysfunction is when symptoms continue for a longer period of time, especially if they get worse.

There’s no set time for diagnosing ED. And while doctors can check for other conditions that might be causing it, there’s no specific erectile dysfunction test. Though you can use resources like the International Index of Erectile Function to check your symptoms.

That said, if you’ve been struggling for more than a few weeks, it’s recommended to talk to a doctor.

With medical support, you can uncover the root cause and find an effective solution to help with erectile dysfunction.

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Common causes of erectile dysfunction

Generally speaking, erectile dysfunction is usually a symptom of another underlying health condition.

In most cases, it’s just a sign of aging. But it can also signal other physical or psychological issues that need to be addressed.

Physical causes

• Heart disease: Cardiovascular disease can narrow and harden arteries throughout the body. This can restrict blood flow to the penis, which makes it difficult to achieve or sustain an erection
• High blood pressure: Hypertension can damage or narrow your blood vessels. Without a firm blood supply to the penis, you’re more likely to experience reduced erectile function
• Diabetes: High blood sugar levels can damage the nerves and blood vessels involved in getting an erection. Heart disease and high blood pressure are also more common in men with diabetes
• Low testosterone: Testosterone is a sex hormone that plays a crucial role in arousal and erectile function. Low levels can decrease libido and lead to fewer erections
• Obesity: Excess weight is associated with hormonal imbalances and can contribute to conditions like heart disease, high blood pressure and diabetes. Obesity also lowers testosterone and increases the risk of inflammation and oxidative stress to penile tissues

Psychological causes

• Stress: Chronic stress increases cortisol levels and distracts from sexual arousal, interfering with the brain’s ability to initiate and maintain an erection. It also diverts blood flow away from the penis
• Anxiety: Both generalised anxiety and performance anxiety make it difficult to relax and become aroused. This mental tension disrupts the physiological processes needed for an erection
• Depression: Low mood often reduces libido and affects the brain’s chemical messengers involved in sexual response. It can also cause fatigue and disinterest in intimacy
• Relationship problems: Unresolved conflict, lack of emotional connection and other problems in a couple’s relationship can reduce intimacy and make arousal more difficult. These issues often contribute to psychological stress that worsens ED

Medication-related causes

• Blood pressure drugs: Certain medications like beta-blockers can reduce blood flow to the penis or interfere with nerve signals. This can impair the body’s ability to achieve or maintain an erection
• Antidepressants: Some antidepressants, particularly selective serotonin reuptake inhibitors (SSRIs) and serotonin-norepinephrine reuptake inhibitors (SNRIs), alter neurotransmitter levels, decreasing sexual desire and erectile responsiveness. These effects are often dose dependent
• Hormone blockers: Androgen deprivation therapy or drugs that reduce testosterone are effective in treating prostate conditions. But as a side effect, they can reduce libido and erectile function

Lifestyle factor causes

• Smoking: Cigarettes and vaping products damage blood vessels and impair circulation, including to the penis. They also reduce nitric oxide, a chemical crucial for erections
• Alcohol: Excessive alcohol intake affects your hormone levels, nervous system and circulation. This reduces sexual sensitivity and delays erection or climax
• Lack of exercise: A sedentary lifestyle contributes to poor circulation, weight gain and low testosterone, all of which are linked to ED. Regular physical activity is associated with cardiovascular health, hormone balance and better erectile function
• Poor diet: Diets high in processed foods, sugars and unhealthy fats can lead to obesity, diabetes and vascular disease. These conditions are all risk factors for erectile dysfunction
• Not enough sleep: Inadequate sleep disrupts testosterone production and increases stress hormone levels. Both of these negatively impact sexual performance and interest
• Porn overuse: Excessive pornography consumption desensitises the brain to normal sexual stimuli and arousal patterns, leading to porn-induced erectile dysfunction. As a result, you might experience difficulty becoming aroused during real-life sexual encounters

Erectile dysfunction in younger men

By the time a man is in his 40s, he has about a 40% chance of having some form of ED. This increases by about 10% for every decade after that.

But erectile dysfunction in younger men is increasingly common. And some studies find that ED affects up to 26% of men under the age of 40.

Physical issues like hormonal imbalances, obesity or undiagnosed medical conditions can contribute to erectile dysfunction in 20s and 30s.

But for men in their physical prime, psychological issues like anxiety, stress and relationship problems are more likely the root cause of erectile dysfunction.

There’s also a strong correlation between problematic pornography consumption and erectile dysfunction in younger men.

Excessive porn use is thought to alter arousal patterns, desensitise natural sexual responses and give younger men unrealistic expectations of sex.

These can all lead to performance anxiety and difficulty maintaining erections during real-life sexual encounters.

However, these non-physical issues are also much easier to address through behavioural changes, lifestyle changes and medical treatments.

With support, you can solve the causes of erectile dysfunction in younger men and resume a healthy, active and confident sex life.

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When should I see a doctor about erectile dysfunction?

If you struggle to get or keep an erection for a few weeks or more – especially if behavioural and lifestyle changes haven’t helped – it’s time to consult a doctor.

Erectile dysfunction doesn’t just impact your sex life and mental wellbeing. It can also be the first noticeable symptom of a serious medical condition like heart disease, high blood pressure or diabetes.

Men with known risk factors like obesity, smoking, a sedentary lifestyle or a family history of heart disease or diabetes should also consider erectile dysfunction treatments.

Addressing ED in the context of these risk factors can help prevent more severe health complications down the line.

If you have any concerns about ongoing erectile difficulties, reach out to The Online Clinic today for a free medical consultation.

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Erectile dysfunction treatments

There’s no one simple trick to cure ED – no matter what online ads might tell you.

But with medically approved and supervised treatments tailored to your needs, you can find assistance in achieving and maintaining an erection.

Oral medications

Oral erectile dysfunction treatments relax the muscles in the penis and increase blood flow in response to sexual arousal.

They don’t cause an erection by themselves. But they make it much easier to get one.

Side effects of oral erectile dysfunction treatments can include flushing, nausea, headaches, muscle pains and changes in vision. But these tend to be very mild. And most patients don’t experience side effects at all.

Oral erectile dysfunction treatments are only available on prescription (or from a pharmacist at low doses). But you don’t need an existing prescription to buy erectile dysfunction treatments online.

A UK-licensed doctor at The Online Clinic can prescribe erectile dysfunction treatments following a free consultation. We even offer starter packs so you can try a range of medications to see which one works best for you.

Viagra (sildenafil)

Viagra is one of the most well-known and widely used ED medications. It’s widely accepted as a first-line treatment and has a success rate of 91%. You typically take Viagra 30-60 minutes before sex, and it lasts for about 4-6 hours.

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Cialis (tadalafil)

Evidence from clinical trials show that Cialis has a longer period of effectiveness than Viagra. It can remain effective for around 36 hours. This long-lasting effect allows for greater spontaneity than other erectile dysfunction treatments.

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Levitra (vardenafil)

For most people, Levitra works equally as well as Viagra. But in some difficult-to-treat cases, it’s proven more effective. In patients who don’t respond to Viagra, up to 50% find success with Levitra instead. Please note that the Levitra brand has been discontinued and is now known as Vardenafil.

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Therapy and counselling

When psychological factors contribute to ED, working with a therapist or counsellor can be highly beneficial.

Cognitive behavioural therapy (CBT) can address negative self-image, performance anxiety or excessive porn use. And sex therapy or couple’s counselling can improve intimacy and communication.

Emotional support and a deeper understanding of psychological triggers can reduce pressure during sexual encounters and rebuild sexual confidence over time.

Lifestyle changes

Swapping bad habits for good ones can significantly improve erectile function, especially in men whose ED is related to cardiovascular health or metabolic conditions.

A healthy, balanced diet rich in fruits, vegetables, whole grains and lean proteins supports vascular health and hormonal balance.

Similarly, regular exercise enhances blood circulation, boosts energy and improves mood, all of which contribute to better sexual performance.

Reducing alcohol intake, quitting smoking and achieving a healthy weight can further improve symptoms.

And managing stress, improving sleep quality and cutting back on pornography can help reset natural arousal patterns and soothe performance anxiety.

Erectile dysfunction diagnosis and treatment

The first step to curing impotence is to seek diagnosis and treatment from a trusted and regulated medical healthcare provider.

You could book an appointment with your GP to discuss erectile dysfunction treatment. But you can get a faster, more convenient diagnosis and prescription without a face-to-face consultation with The Online Clinic.

All you need to do is register as a patient and start your free online consultation. After you complete a short medical health questionnaire, one of our UK-licensed doctors will review your request and prescribe a suitable treatment.

During normal business hours (07:30am-10:00pm), we usually respond within just 30-60 minutes. And any orders received on our system before 3:30pm can be dispensed with discreet next-day delivery.

That means you can begin your treatment right away without waiting weeks for an NHS appointment.

Erectile dysfunction treatments are designed for long-term use. So you can get as many repeat prescriptions as appropriate while you address the underlying causes.

You can easily book follow-up consultations and medical supervision through our online patient portal to discuss any side effects or medical concerns. That way, you can access erectile dysfunction treatments that are safe and effective.

Our service fully complies with strict regulations from the Medicines and Healthcare Regulatory Agency (MHRA) and the General Pharmaceutical Council (GPC). And in our latest report from the Care Quality Commission (CQC), we received a rating of Good in all 5 assessed areas – one of the highest possible evaluations.

With over 20 years’ experience, The Online Clinic is one of the most well-established online healthcare providers in the UK. And we have 11,800+ 5-star reviews from satisfied patients. So you can have confidence in an excellent service.

Exceeded my expectations and beyond I'd like to thank the staff at The Online Clinic for paying attention to my needs. I feel they actually read through my enhanced application to try to help and support a long-term erectile dysfunction problem I've had for many years. The medication prescribed is, in one word, wonderful. It does exactly what I'd hoped and wished for – and even more! My confidence and the relationship between me and my long-term partner has genuinely significantly improved thanks to The Online Clinic. So I'd give 6 stars if I could for my overall experience. Fantastic service, amazing prescribed medication and a very happy customer who would recommend The Online Clinic (which I am doing already) to friends and more. Paul Henshaw

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Erectile dysfunction frequently asked questions

Why can’t I stay hard anymore?

You might struggle with erections due to aging, stress, poor blood flow, bad lifestyle habits or side effects from medications. Emotional or relationship issues can also be a factor.

What is erectile dysfunction?

Erectile dysfunction (ED) or impotence is the regular inability to get or keep an erection firm enough for sex.

What are the symptoms of erectile dysfunction?

Erectile dysfunction symptoms include:

• Inability to get an erection
• Inability to keep an erection long enough for sex

How does a man feel when he has ED?

While occasional ED is normal, many men feel embarrassed, frustrated or anxious. It can affect confidence, self-esteem and relationships if not addressed.

What is the main cause of erectile dysfunction?

The most common cause is reduced blood flow. This can be a symptom of heart disease, high blood pressure or diabetes.

Lifestyle and mental health might also play a role. And there are some recreational drugs that cause erectile dysfunction, including alcohol, marijuana, cocaine and nicotine.

Can ED go away on its own?

Yes, if it’s caused by temporary stress, tiredness or substance abuse. But if it continues, you’ll likely need erectile dysfunction treatments or lifestyle changes.

How do I deal with erectile dysfunction?

Speak to a doctor. They’ll help you determine whether your ED is caused by an underlying health problem, psychological issues, lifestyle or medication.

Is erectile dysfunction curable?

Often, yes. Many cases improve with treatment, lifestyle changes or addressing emotional or medical causes.

Is there a permanent cure for erectile dysfunction?

If ED is caused by reversible factors like lifestyle or hormone levels, a permanent fix is often possible.

What age is normal for ED to start?

ED is common after age 40. But younger men can experience it too, often due to stress, lifestyle factors or excessive porn use.

Can I get ED medication online in the UK?

Yes, you can. Licensed and regulated online healthcare providers like The Online Clinic can offer a convenient and discreet prescription following a short consultation.

Useful resources for understanding erectile dysfunction

National Health Service

• Erectile dysfunction (impotence)

Mayo Clinic

• Erectile dysfunction – Symptoms and causes
• Treating erectile dysfunction
• Erectile dysfunction: Viagra and other oral medications
• 8 common erectile dysfunction myths

Cleveland Clinic

• Erectile dysfunction (ED): Causes, diagnosis and treatment

British Association of Urological Surgeons

• Erectile dysfunction (impotence)
• International Index of Erectile Function<

Harvard Health

• 5 natural ways to overcome erectile dysfunction

WebMD

• Myths and facts about erectile dysfunction