PrivateDoc doctor

Erectile Dysfunction

Erectile Dysfunction (ED) or Impotence, is a common health problem affecting up to one in five males. In the UK alone it is estimated that up to 4.3 million men suffer from some level of ED or will experience some level of erectile dysfunction at some point in their life.

Erectile Dysfunction can affect men of all ages but is most common later in life (over the age of 40). Younger men suffering from impotence can usually be as a result of anxiety, tiredness, stress, drinking too much alcohol or the pressures to perform when with a sexual partner.

Erectile Dysfunction/Impotence however are not usually a long term problem and effective treatment can range from changes to the lifestyle of the patient and/or through the use of certain medicines such as Viagra (sildenafil), Cialis (tadalafil)Levitra (vardenafil) and Spedra (avanafil) (all of which are taken orally).

Referring yourself for counselling or therapy can also be an alternative and quite effective treatment option.  Do not allow Erectile Dysfunction (ED) to have a negative impact on your sex life.  Taking control of your condition and getting the right treatment will mean you continue to enjoy a happy and healthy sex life.

The definition of Erectile Dysfunction

Erectile Dysfunction is when a male is unable to achieve an erection (or maintain an erection during sexual intercourse with a partner).

This usually means that a male is unable to get an erection following arousal or he achieves an erection but is unable to maintain it prior to or during sexual intercourse.  If this occurs on multiple occasions especially over a short period of time, then the patient should speak to a healthcare professional to ascertain the cause(s) and to discuss suitable treatment options.

How does an erection occur?

For a person to understand the cause of their erectile dysfunction, they must first understand the complicated processes involved in achieving an erection.  The brain needs to interact with nerves, hormones and blood vessels for the process to be successful.  The involvement of multiple components means this pathway can be disrupted at numerous points resulting in the a failure to achieve an erection.

The penis consists of twin chambers called the corpus cavernosa and during arousal the walls of the corpus cavernosa are instructed to relax by a nucleotide called cGMP, which enables the chambers to accommodate increased blood flow. In addition to this the veins leaving the penis are instructed to reduce the flow of blood away, increasing the blood pressure in the penis, creating an erection. PDE-5 is an enzyme that naturally breaks down cGMP, therefore erection problems can occur when there is an in balance between the PDE-5 enzyme and the cGMP nucleotide.

Why does erectile dysfunction happen?

There are many physical and psychological causes which can lead to impotence.  It is important to identify the cause so the most appropriate treatment can be selected.


  • Any condition which affects blood flow (hypertension, hypercholesteremia, atherosclerosis)
  • Diabetes (both type 1 and type 2)
  • Changes in levels of certain hormones (testosterone, prolactin, thyroid, etc.)
  • A BMI of greater than 40
  • An injury which results in damage to the nervous system linking the brain to the penis.  
  • Surgery, MS (multiple sclerosis), chemotherapy, radiotherapy, local trauma, etc.
  • Illicit drug use, smoking and drinking excessive levels of alcohol.


  • Stress
  • Anxiety (especially if you have suffered erectile dysfunction in the past or are likely to suffer from performance anxiety).
  • Depression 
  • Lack of interest in sex (usually due to depression)

A simple test to establish if you are suffering from erectile dysfunction is to see if you have an erection in the morning following sleep, this is when testosterone is at its highest. If you have an erection at this time it is not a physical issue. Similarly, if you can achieve a satisfactory erection for masturbation your problems again are not physical but likely psychological in nature.

Take control of Erectile Dysfunction now

The most important thing to do is discuss the situation with your partner and your doctor to get the appropriate treatment.  If you feel uncomfortable discussing this with your GP, PrivateDoc can help by arranging a consultation with a specialist either over the phone or through this website.

Making lifestyle changes can have a positive impact on erectile dysfunction.  Stop smoking measures should be considered, dietary changes considered specifically if weight is an issue and alcohol consumption should be limited to no more than 14 units per week.

For psychological problems you may benefit from counselling or therapy.  If your problem is physical in nature, then a doctor will be able to perform an examination and prescribe suitable treatment through medication.

Prescription only medication

The most commonly used drugs for erectile dysfunction are the PDE-5 inhibitors.  This group of treatments increases the blood flow to the penis allowing the patient achieving an erection and the ability to maintain it.  The most common drugs in this category are Viagra, Cialis, Levitra and Spedra.  Some treatments are better suited to patients and during the consultation PrivateDoc will recommend the most appropriate treatment for you.

Treatment Options
Recommended Starting Strength
100mg 20mg200mg
When to take the tablet
60 mins30 mins25-60mins15-30mins
Effect of food
All food may slow down the effectsNot affected by foodHigh fat foods can slow down the tablets actionNot affected by food
Duration of Action
4-5 hrsup to 36 hrs4-5 hrs6 hrs