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.
|Narrowing of penis blood vessels, high blood pressure, high cholesterol||medicine to lower blood pressure, statins to lower cholesterol|
|Hormone problems||hormone replacement – for example, testosterone|
|Side effects of prescribed medication||change to medicine following discussion with GP|
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
- do not cycle for a while (if you cycle for more than 3 hours a week)
- do not drink more than 14 units of alcohol a week
Medicine such as sildenafil ↗ (sold as Viagra) is often used by doctors to treat erectile dysfunction. It is also available from chemists.
Because of changes in regulations, you no longer need a prescription to get sildenafil. But you will have to have a consultation with the pharmacist to make sure it's safe for you to take it.
There are other similar medicines called tadalafil (Cialis), vardenafil (Levitra) and avanafil (Spedra) that work in a similar way. You will still need a prescription to get these medicines.
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 ↗.