In short: Erectile dysfunction (ED) means regularly finding it hard to get or keep an erection firm enough for sex. It is common, especially with age, and usually has a physical cause such as reduced blood flow, often combined with stress or anxiety. Because ED can be an early sign of heart disease or diabetes, it is worth a health check. Lifestyle changes, talking therapies and several medical treatments can help, and a clinician will advise which is suitable.

This guide, written by a Ready Health prescribing pharmacist, explains the causes of ED, the checks you can expect, and the treatment options used in the UK.

What is erectile dysfunction?

ED is when you are often unable to get an erection, or keep one long enough, for satisfying sex. Most men have occasional problems, for example when tired, stressed or after drinking alcohol. That is normal. It becomes worth discussing with a clinician when it happens regularly or is affecting your confidence or relationship.

What causes erectile dysfunction?

An erection depends on healthy blood vessels, nerves, hormones and mood all working together. ED often has more than one cause.

Physical causes

narrowed blood vessels, linked to high blood pressure, high cholesterol, smoking and heart disease
type 2 diabetes, which can affect both blood vessels and nerves
being overweight and inactive
low testosterone, which can also lower sex drive
nerve problems, such as after prostate surgery or with multiple sclerosis
side effects of some medicines, including certain blood pressure tablets, antidepressants and prostate treatments
drinking too much alcohol or using recreational drugs

Psychological causes

stress, anxiety and performance worries
depression
relationship difficulties

A useful clue: if you still get erections in the morning or when masturbating, a psychological cause is more likely. If erections have faded gradually in all situations, a physical cause is more likely.

Why is ED linked to heart health?

The blood vessels in the penis are smaller than those supplying the heart, so they can show the effects of narrowing earlier. ED can appear a few years before symptoms of heart disease. That is why UK guidance recommends that men with ED have their cardiovascular risk checked, including blood pressure, cholesterol and blood sugar.

What happens at an ED consultation?

A consultation is confidential and straightforward. A clinician will usually:

ask about your symptoms, sex drive, general health, medicines, alcohol and smoking
check your blood pressure, weight and, where appropriate, examine you
suggest blood tests, such as HbA1c (for diabetes), cholesterol and, if indicated, a morning testosterone level
discuss which treatment options may suit you

What are the treatment options for erectile dysfunction?

Approach	What it involves	Good to know
Lifestyle changes	Stopping smoking, more exercise, losing excess weight, cutting down alcohol	Improves ED for many men and lowers heart risk
Reviewing current medicines	Checking whether a medicine could be contributing	Never stop a prescribed medicine without advice
Talking therapies	Psychosexual counselling or CBT, alone or with a partner	Helpful where anxiety or relationship issues play a part
PDE5 inhibitor tablets (such as sildenafil or tadalafil)	Increase blood flow to the penis when sexually aroused	Usual first-line medical treatment. Not safe with nitrate medicines (such as GTN spray) or some other heart medicines
Treating low testosterone	Only if blood tests confirm low levels	Requires specialist assessment and monitoring
Vacuum pumps, injections or specialist treatment	Used when tablets do not work or are unsuitable	Usually via a urology or specialist service

Some lower-strength ED tablets can be supplied by a pharmacist after a consultation, but they are not suitable for everyone. Whatever the route, a prescriber or pharmacist must check your health and other medicines first, and will decide whether a treatment is safe for you.

When should I get urgent help?

Seek urgent medical advice if:

you have an erection lasting more than 4 hours (priapism), which needs emergency treatment
you get chest pain during or after sex
ED followed an injury to the pelvis or penis

Frequently asked questions

Is erectile dysfunction common?

Yes. It becomes more common with age, but it can affect men of any age. It is a medical issue like any other, and clinicians discuss it every day.

Can ED be cured?

Often. If there is a treatable cause, such as a medicine side effect, smoking, stress or low testosterone, dealing with it can improve or resolve ED. Where it cannot be cured, it can usually be managed.

Is it safe to buy ED tablets online?

Only use a UK-registered pharmacy or service. Medicines bought from unregulated websites may be fake or contain undeclared ingredients. You can check a pharmacy on the General Pharmaceutical Council register.

Should I worry about my heart if I have ED?

Not necessarily, but it is a good reason to have your blood pressure, cholesterol and blood sugar checked.

Key takeaways

ED is common and usually treatable.
It can be an early warning sign of heart disease or diabetes, so a health check is sensible.
Lifestyle changes help many men and protect long-term health.
Tablets are the usual first-line medical treatment, but a clinician must confirm they are safe for you.
Psychological support is effective when stress, anxiety or relationship problems play a role.

Sources and further reading

Last reviewed: October 2026 by Shamir Patel, Independent Prescribing Pharmacist, Ready Health. This article is general information and does not replace advice from your own clinician.

If erection problems are affecting you, you can book a confidential men's health consultation at Ready Health in Standish, Wigan. A clinician will assess your health, arrange any tests needed and talk you through the options.

Erectile Dysfunction: Causes, Health Checks and Treatment Options