Erectile dysfunction: what you need to know
Erectile dysfunction (ED) is a common but often misunderstood condition that can have a significant impact on a man's quality of life and self-esteem. If you're experiencing difficulties achieving or maintaining an erection, you're not alone. Erectile dysfunction often first surfaces as a concern for partners of the male experiencing ED, because they notice changes in their partner’s confidence or intimacy patterns, so having clear information can be just as important for partners as for the men affected. Let’s explore what you need to know about ED, its causes, risk factors, and available solutions.
What is erectile dysfunction?
Erectile dysfunction, sometimes referred to as impotence, is the inability to achieve or sustain an erection firm enough for sexual intercourse. While occasional difficulties with erections are normal, persistent problems can indicate underlying health issues that require attention. Importantly, ED is considered a “sentinel symptom” for cardiovascular disease, meaning it can appear up to three years before more obvious heart-related problems. Recognising it early and seeking help can therefore benefit overall health, not just sexual wellbeing.
Causes and risk factors
Several factors can contribute to the development of erectile dysfunction, including:
- Physical health conditions: chronic illnesses such as diabetes, hypertension, heart disease, and obesity can impair blood flow and nerve function, leading to ED. High cholesterol and metabolic syndrome also reduce blood-vessel flexibility, making erections harder to achieve.
- Psychological factors: stress, anxiety, depression, and relationship problems can all impact sexual performance and contribute to erectile difficulties. Performance anxiety - worrying about “letting a partner down” - is particularly common in long-term relationships.
- Lifestyle choices: smoking, excessive alcohol consumption, drug use, and lack of exercise can all increase the risk of erectile dysfunction. Even modest weight loss and 150 minutes of moderate exercise per week have been shown to improve erectile quality.
- Medications: certain medications, including those for high blood pressure, depression, and prostate conditions, may cause or exacerbate ED as a side effect. Do not stop any prescription without talking to your GP first - sometimes a simple dose adjustment helps.
- Hormonal changes: Falling testosterone levels with age, thyroid disorders, or raised prolactin can undermine libido and erection firmness.
Recognising the signs and symptoms
The primary symptom of erectile dysfunction is the inability to achieve or maintain an erection sufficient for sexual activity. However, other signs may accompany ED, including reduced sexual desire, difficulty ejaculating, and feelings of embarrassment or frustration. Partners might notice withdrawal from intimacy, avoidance of situations that might lead to sex, or talk of feeling “less masculine.” If you observe these shifts, open, non-judgmental conversation can help reduce pressure and encourage medical review.
Treatment options
Fortunately, there are several treatment options available for erectile dysfunction, depending on the underlying cause and individual circumstances:
- Lifestyle modifications: making healthy lifestyle choices such as quitting smoking, reducing alcohol consumption, exercising regularly, and managing stress can help improve erectile function. A Mediterranean-style diet - rich in oily fish, colourful fruit and vegetables, whole grains, nuts, and olive oil - supports vascular health and can enhance erections. Supplements like L-arginine or ginseng are sometimes tried, but quality and dosing vary; seek professional advice before starting.
- Medications: oral medications such as Viagra (sildenafil), Cialis (tadalafil), and Levitra (vardenafil) are commonly prescribed to treat ED by enhancing blood flow to the penis. Notably, tadalafil can be taken daily at a lower dose, allowing for more spontaneous activity and providing greater flexibility and convenience. This represents a significant advancement in ED treatment. Avanafil, a newer PDE-5 inhibitor, may work faster for some men, while topical alprostadil cream can be an option when tablets are unsuitable. Before starting treatment a consultation with a medical professional should be undertaken.
- Therapies: psychological counselling, couples therapy, and sex therapy can help address underlying psychological factors contributing to erectile dysfunction. For partners, attending a therapy session together can demystify ED and distribute responsibility more fairly, reducing the pressure on the man.
- Medical interventions: in some cases, medical interventions such as penile implants, vacuum erection devices, or injections may be recommended for men who do not respond to other treatments. Vacuum devices can also be used alongside tablets for stronger rigidity, and modern slim-line models are quieter and easier to use than older pumps.
The importance of testing
Early detection and diagnosis are key to effectively managing erectile dysfunction. Because ED is often an early indicator, checking cardiovascular and metabolic markers is now standard advice in UK primary care. MyHealthChecked's Erectile Dysfunction Blood Test offers a convenient and confidential way to assess your sexual health from the comfort of your own home. It measures:
- HbA1c (to screen for diabetes or pre-diabetes)
- Total cholesterol and triglycerides (to flag cardiovascular risk)
- Free and total testosterone (to assess hormonal influence)
- Thyroid-stimulating hormone (TSH) (for hidden thyroid issues)
ED can be an early indicator of cardiovascular disease or diabetes mellitus, making regular blood testing essential. By measuring important biomarkers related to erectile function, this test can provide valuable insights into your health status and guide treatment decisions. For women supporting a partner with ED, encouraging at-home testing can feel less intimidating than a face-to-face appointment, and the results provide a good starting point for GP discussions.
In summary
Erectile dysfunction is a common and treatable condition that affects millions of men worldwide. By understanding the causes, symptoms, and available treatment options, you can take proactive steps towards improving your sexual health and overall wellbeing. If you are a partner, remember that empathetic support, shared lifestyle goals, and open communication can play a powerful role in recovery. Don’t let ED hold you back - take control of your health today with MyHealthChecked's Erectile Dysfunction Blood Test.
References
1. NICE Clinical Knowledge Summaries. Erectile dysfunction. London: National Institute for Health and Care Excellence; 2023. Available from: https://cks.nice.org.uk/topics/erectile-dysfunction/
2. GPnotebook. Erectile dysfunction. Leeds: Oxbridge Solutions Ltd; 2025. Available from: https://gpnotebook.com/pages/urology/erectile-dysfunction
3. GPnotebook. Treatment - male impotence. Leeds: Oxbridge Solutions Ltd; 2023. Available from: https://gpnotebook.com/en-GB/pages/urology/male-impotence/treatment
4. GPnotebook. Erectile dysfunction (ED) and coronary artery disease. Leeds: Oxbridge Solutions Ltd; 2018. Available from: https://gpnotebook.com/pages/urology/erectile-dysfunction-ed-and-coronary-artery-disease
5. British Society for Sexual Medicine. A practical guide on managing erectile dysfunction. BSSM; 2024. Available from: https://bssm.org.uk/wp-content/uploads/2024/05/ED-Practical-Guide-v3-for-BSSM.pdf
6. National Institute for Health and Care Excellence (NICE). IND106 - Diabetes: advice for erectile dysfunction. London: NICE; 2022. Available from: https://www.nice.org.uk/indicators/ind106-diabetes-advice-for-erectile-dysfunction
7. Omotosho YB, Zahra F. Erectile dysfunction. In: StatPearls. Treasure Island (FL): StatPearls Publishing; 2025. Available from: https://www.ncbi.nlm.nih.gov/books/NBK562253/