Erection problems and seeing a GP

What counts as an erection problem?

Erectile dysfunction, also called impotence, means having trouble getting or keeping an erection. Many men have occasional difficulty, and the NHS describes this as common. It also says occasional problems are often harmless and can resolve by themselves.

What matters is whether the problem keeps happening. The NHS advises seeing a GP or going to a sexual health clinic if erection problems keep happening, rather than simply waiting for them to pass. The sections below describe the usual causes, the links with other conditions, what a GP may offer and how to avoid risky online products.

What causes erection problems?

The NHS links occasional erection problems to stress, tiredness, anxiety and drinking too much alcohol. These tend to come and go, and they are different from a problem that persists.

Physical causes are also described. NHS sources name diabetes, operations on the bowel, bladder or prostate, and a lack of testosterone, which is a male hormone. One NHS page says hormone problems may be treated with hormone replacement, for example testosterone. Erection problems can also be a side effect of some medicines, including some of those used to treat high blood pressure or depression. Prostate surgery can also cause retrograde ejaculation, which is a separate problem from erectile dysfunction.

The NHS advises talking to a GP before stopping any prescribed medicine, so a suspected medicine side effect is something to raise at an appointment.

Is there a link with heart disease and diabetes?

NICE says erectile dysfunction shares risk factors with cardiovascular disease, which is disease of the heart and blood vessels. Examples it gives include lack of exercise, obesity, smoking, high cholesterol and metabolic syndrome.

MedlinePlus says erectile dysfunction is an early warning sign that a man may be at higher risk of atherosclerosis, which is a build-up of fatty plaque in the arteries, and its complications. The British Heart Foundation explains that the arteries supplying the penis are narrow, so erection problems can be one of the first warning signs. A large Australian cohort study of 95,038 men found that more severe erectile dysfunction was linked with a higher risk of cardiovascular disease.

An NHS diabetes resource says erectile dysfunction is more common in people with diabetes, especially when diabetes is poorly controlled. It adds that diabetes can damage the blood supply and nerves to the penis. High blood pressure is another link, because the British Heart Foundation notes that high blood pressure and some of its treatments, including beta-blockers and diuretics, can cause erection problems.

When should I see a GP?

The NHS advises seeing a GP or a sexual health clinic if erection problems keep happening. NHS inform Scotland gives more detail, suggesting that people seek help when the symptoms have lasted for more than a few months, things they can do themselves have not helped and they are bothered by the symptoms.

NHS sources describe the GP as the usual first point of contact. The GP can discuss treatment options, may start treatment and can refer on to a hospital or sexual function service if tablets are not suitable. Because erectile dysfunction can sometimes be an early sign of cardiovascular disease, high blood pressure or diabetes, getting it checked is more useful than waiting it out. One NHS trust guideline lists blood tests such as HbA1c and cholesterol among the checks that may be done before a referral.

The British Heart Foundation says erection tablets such as Viagra cannot be used with nitrates or nicorandil, which are medicines used to treat angina. This is one reason clinicians ask about heart medicines before treating erection problems.

What treatments are there?

NHS trusts describe tablets as the usual first treatment for most men. These include sildenafil, tadalafil, vardenafil and avanafil, and the GP usually prescribes them first. One trust leaflet says medicines of this kind work for up to 70% of men, and the same leaflet notes that most men with erectile dysfunction have an underlying physical cause.

Lifestyle changes are also listed as ways to improve erections, including weight loss, more exercise, stopping smoking and cutting back on alcohol and drugs. Some sources note that these changes can also reduce cardiovascular risk factors.

Psychosexual counselling is one of the offered treatments in primary care guidance, and sexual function clinics can support individuals and couples. Psychological causes are described as more common in younger men.

Vacuum devices are another option, and in some cases the NHS can supply them. Injections into the penis, urethral alprostadil and penile implants are used if tablets fail or are not suitable. A GP or specialist can explain which of these apply in a particular case.

What about buying erection medicines online?

The MHRA, which regulates medicines in the UK, warns against buying erection pills from unlicensed online sellers. It says such products are unauthorised, so their contents are unknown, and they may contain no active ingredient, too much of it or toxic ingredients.

The MHRA says its enforcement unit seized about 19.5 million doses of erectile dysfunction medicines between 2021 and 2025, and that many of these were sold illegally online. They contained active ingredients such as sildenafil, tadalafil, vardenafil and avanafil.

It adds that unlicensed erection medicines can be especially dangerous for people with heart disease or high blood pressure, or who take other medicines, and can raise the risk of heart attack, stroke and dangerously low blood pressure. The MHRA says these medicines can only be supplied through a UK-registered pharmacy. Suspected fake products can be reported through the Yellow Card scheme.