We answer your erectile dysfunction questions

What is erectile dysfunction?

Erectile dysfunction is the term used to describe the difficulty of getting and maintaining an erection hard enough for sex. Although men are more likely to experience erectile dysfunction as they get older, ED can impact men of all ages, with 4.3 million men in the UK alone having experienced erectile dysfunction symptoms. 

What causes erectile dysfunction?

Erectile dysfunction can be caused by physical or psychological factors, or a combination of the two, as they both can impact the ability to get an erection. 

It’s important to understand the difference of what might be a psychological cause of ED and what might be a physical one. For example, if you’re able to get an erection while masturbating or sometimes wake up with an erection – but can’t get an erection when you’re with your partner – this is likely to be a psychological issue. If you’re unable to get an erection at all, the issue is probably physical. 

Although there are treatments available to help with erectile dysfunction symptoms, such as those offered through the Boots Erectile Dysfunction Online Doctor Service*, you still need to go and speak to your GP so they can rule out any underlying health issue which may be causing your erectile dysfunction.

Certain health or medical conditions can cause erectile dysfunction. Examples of the physical causes of erectile dysfunction include: 

• Heart problems
• High blood pressure
• Narrow or blocked blood vessels of the penis
• Diabetes 
• Kidney problems
• Parkinson’s disease
• Multiple sclerosis (MS)
• Peyronie disease, which is the name for a condition in which scar tissue forms around the penis, can also cause erectile dysfunction

Other physical factors that can cause or contribute towards erectile dysfunction include:

• Certain prescription medicines
• Surgery or permanent injury to the pelvic area or spinal cord can also cause erectile dysfunction

If there’s an issue playing on your mind, it can affect the ability to focus or feel happy. Not being in a positive frame of mind can have an impact on sexual performance and enjoyment, so psychological issues can be a cause of erectile dysfunction. 

The most common psychological causes of ED are:

• Depression
• Stress
• Anxiety

Another, more specific type of anxiety that can cause ED is sexual performance anxiety. This is an umbrella term used to describe the psychological fear of not being able to perform sexually or enjoy sex due to a particular worry. Examples of types of issues that can cause sexual performance anxiety are:

• Low self-esteem
• Body confidence
• Previous negative sexual experiences 
• Fear of rejection 

Can health & lifestyle choices cause erectile dysfunction?

Health and lifestyle choices can also affect your ability to get and maintain an erection. Examples of these include:

• Obesity and being overweight have been linked with erectile dysfunction
• High cholesterol can build up in the arteries impacting blood vessels in the penis needed to achieve an erection
• Smoking can cause ED. Cigarettes often contain chemicals such as acetone, nicotine, arsenic and carbon monoxide, which can damage blood vessels, narrow arteries and cause poor blood circulation
• Alcohol can affect the nervous system making it difficult to get or maintain an erection, so it’s advisable to avoid drinking alcohol before sex

How is erectile dysfunction treated?

There are different options available that can be used to help manage erectile dysfunction. 

Making lifestyle changes such as giving up smoking, limiting alcohol intake and eating a healthy, varied and balanced diet could all improve symptoms of ED. Taking up regular exercise has several benefits as not only can it help improve symptoms of ED, it can also help to improve your general health. Your body also releases hormones called endorphins when you exercise, which increase feelings of happiness and positivity. 

Speaking to your partner could have a positive effect on your relationship, as being open and honest about your issues could make you emotionally closer and they might reassure and support you. It could also be a good opportunity for you to both think of solutions to overcome the issue and discuss different approaches to sex that you’ll both enjoy and benefit from.

Oral medication such as Viagra, Spedra, Sildenafil, Cialis, Tadalafil and Levitra can help treat the symptoms of ED. 

The Boots Erectile Dysfunction Online Doctor Service* offers access to advice and treatment for ED symptoms in men aged 18 or over. You’ll be asked to complete a short and simple online questionnaire so one of our clinicians can make sure the treatment is suitable for you. 

Topical creams, which can be applied directly to the penis, are another option to help treat symptoms of erectile dysfunction. You can apply a topical cream five to 30 minutes before you want to have sex and its effects should last for up to two hours. 

Injectable medicines, such medicines can be inserted into the penis, either via pellet or injection. Your doctor will show you (or your partner) how to inject the drug into the shaft of your penis.

Vacuum pump, which is a physical device that works by drawing blood into the penis using air suction, can have a positive effect for most men. You may be able to get one on the NHS, so speak to your doctor for more information.

Counselling can help tackle the root of your psychological problems that may cause symptoms of ED. Psychosexual therapy is an effective form of counselling available for individuals or couples, which involves working with an experienced therapist to figure out what may trigger ED problems. They’ll then be able to create a treatment programme to help resolve or reduce your symptoms.

Before considering the different treatment options, it’s important that you speak to your GP first to make sure that your ED symptoms aren’t linked to any possible underlying health issue.

Is erectile dysfunction a reflection of masculinity?

Erectile dysfunction can be a result of health or lifestyle issues (or both). It has nothing to do with masculinity.

Can erectile dysfunction go away by itself?

There might be some occasions where you aren’t able to get or maintain an erection hard enough for sex. For example, if you’ve been tired or stressed at work for few days, you might be able to get a suitable erection as soon as things have returned to a calmer state. However, if your erection problems don’t go away and become a regular issue, then it would be best to speak to your GP, to make sure it isn't linked to an underlying health condition.

*Treatments provided by Boots Online Doctor are subject to an online consultation with a clinician to assess suitability. Charges and eligibility criteria apply.