Erectile dysfunction (impotence)
Erection problems (impotence) are very common, particularly in men over 40. It’s usually nothing to worry about, but you should see a GP if it keeps happening.
Causes of erection problems.
Most men occasionally fail to get or keep an erection.
This is usually due to stress, tiredness, anxiety or drinking too much alcohol, and it’s nothing to worry about.
If it happens more often, it may be caused by physical or emotional problems.
See a GP or go to a sexual health clinic if:
erection problems keep happening.
It could be a sign of an underlying health condition.
How sexual health clinics can help with erection problems.
Sexual health clinics treat genital problems. They can provide the same treatment you would get at your GP surgery.
Many sexual health clinics offer a walk-in service, where you don’t need an appointment. They’ll often get test results quicker than GP practices.
What happens at your appointment.
The doctor or nurse will ask about your lifestyle and relationships, and any problems you might be having.
They’ll carry out basic health checks, such as taking your blood pressure. They’ll also examine your genitals to rule out any obvious physical cause.
If you have symptoms like needing to pee more often, your doctor may also need to examine your prostate. They might have to examine your bottom (rectal examination).
Treatment for erection problems depends on the cause.
Treatments for erectile dysfunction are much better than they used to be, and the problem often goes away.
Physical causes.
You may also be asked to make lifestyle changes.
lose weight if you’re overweight stop smoking eat a healthy diet exercise daily try to reduce stress and anxiety.
cycle for a while (if you cycle more than 3 hours a week) drink more than 14 units of alcohol a week.
Viagra should only be prescribed by a doctor.
Medicine such as sildenafil (sold as Viagra) is often used by doctors to treat erectile dysfunction.
There are other similar medicines called tadalafil (Cialis), vardenafil (Levitra) and avanafil (Spedra) that work in a similar way.
Buying Viagra online.
It’s possible to buy Viagra over the internet, but many sites sell fake (counterfeit) medicines. The active ingredients in them can vary, causing side effects.
Check on the website you’re using that:
Never buy off-prescription Viagra tablets online. Make sure they are prescribed by a doctor and come from a UK pharmacy.
The Sexual Advice Association has factsheets on medicines and other treatments, including injections, implants and creams.
Do vacuum pumps work?
Vacuum pumps encourage blood to flow to the penis, causing an erection. They work for most men and can be used if medicine isn’t suitable.
They’re not always available on the NHS. Speak to your doctor about where to get one.
Emotional (psychological) problems.
It’s more likely to be an emotional problem if you only have erection problems some of the time – for example, you still get erections in the mornings but not during sexual activity.
Anxiety and depression can be treated with counselling and cognitive behavioural therapy (CBT).
Your GP might recommend sex therapy, either on its own or in combination with other psychotherapy.
There’s usually a long wait for these services on the NHS.
You can also pay to see someone privately.
Finding private counsellors or sex therapists.
Counsellors and psychotherapists should be a member of the:
Sex therapists should be a member of the:
Relate also offers sex therapy for a fee.
Advice and support is also available from the Sexual Advice Association.
If you can’t speak to your GP or don’t know what to do next.
Erectile dysfunction (impotence)


