Erectile dysfunction | The signs, symptoms, and treatments

Erectile dysfunction (ED) is a common condition that affects men of all ages. ED is characterised by an inability or difficulty achieving or maintaining an erection that’s firm enough for sex. It can affect confidence levels, reduce libido (sex drive), and make sexual intercourse with a partner difficult.

Keep reading to see General Practitioner Asif Naseem explore what erectile dysfunction is, how the symptoms can affect your sex life, and the treatment options that can help minimise the impact of ED.

Key takeaways

What is erectile dysfunction?

Erectile dysfunction is any difficulty getting or maintaining an erection. It can be caused by your overall health and lifestyle, a health condition, psychological factor, or medication.

It’s very common and can come and go depending on changes to your overall health, mood, and lifestyle.

How common is it?

Erectile dysfunction is very common. Some studies estimate it’s the most common sexual dysfunction affecting men.

The stigma and potential for embarrassment mean that it’s also a heavily underreported condition. This means that many men will not admit to having ED out of shame or embarrassment.

Whilst studies on how common the condition is vary in their findings, it’s widely acknowledged that men over 40 are more likely to experience ED.

That doesn’t mean that younger men are exempt. One study estimates that 26% of men under 40 have been affected by some form of erectile dysfunction.

How to know if you have erectile dysfunction

A good way to tell if you’re experiencing erectile dysfunction is to assess whether your penis remains hard enough for sex when you’re aroused.

Some men are able to get an erection but not maintain it during sex despite being aroused. You may find that the penis never becomes fully firm, or that you’re unable to have penetrative sex because you cannot maintain a strong erection.

The facts and figures

Symptoms of erectile dysfunction

Erectile dysfunction can present a range of symptoms that come and go at different times.

Some of the most common symptoms of ED are: 

  • Difficulty getting an erection
  • Difficulty maintaining an erection
  • Reduced firmness of erections
  • Premature ejaculation
  • Delayed ejaculation
  • Reduced sexual desire or libido

What causes erectile dysfunction?

Physical causes

It’s estimated that around 80% of ED cases are caused by a physical ailment or symptom.

This includes:

  • Reduced blood flow to the penis
  • Other circulation issues
  • High blood pressure
  • Diabetes
  • Low testosterone
  • Side-effects from medication
  • Alcohol or drug abuse
  • Nerve damage in the pelvic area
  • Cancer treatment

Psychological causes

Psychological issues can also cause or contribute to ED. 

Whilst the primary cause may be physical, many men do experience psychological symptoms that then further contribute to their ED.

These symptoms include:

  • Stress
  • Anxiety
  • Relationship problems
  • Embarrassment
  • Shame
  • Guilt
  • Depression
  • Low self-esteem

You may find that your ED arises during a particularly difficult time at home or at work because of higher levels of stress or anxiety. 

This can mean your ability to get and maintain an erection improves when the situation resolves itself and your mood and mental state improve.

Can masturbation cause erectile dysfunction?

Research indicates that there is currently no established link between masturbation and erectile dysfunction. Other studies indicate that watching pornography can desensitize you to certain stimulating imagery, however there is no current physical link between masturbation and ED.

In some cases, masturbating can actually help with ED. If you find you’re able to maintain an erection whilst masturbating, you may start to feel more confident that you can do the same with your partner during intercourse.

Is there a cure for ED?

Thankfully, erectile dysfunction is a highly treatable condition. Treatment generally focuses on addressing the underlying cause of the dysfunction. 

For example, if you have poor circulation or high blood pressure, your GP may advise improving your diet or managing your weight to improve blood flow to the penis. For men with anxiety or high stress levels, talking with a therapist can help address the root cause of these feelings and normalise your experience.

Ultimately, the treatment for ED will depend on the underlying cause. If ED is bothering you, talk to a GP and learn more about the lifestyle factors that may be contributing to your erectile dysfunction.

Treatments for erectile dysfunction

The latest treatment for erectile dysfunction involves treating the underlying symptoms that may be causing you to have difficulty getting or maintaining an erection.

This includes maintaining a healthy weight, making sure you're in overall good health, identifying and treating any mental health problems you may be experiencing, and understanding the value of transparent communication with your partner.


Exercise helps by getting our heart rate up and improving circulation and blood flow to the penis. It’s associated with maintaining a healthy weight, which is a leading factor in slowing the development of ED.

Research indicates that an exercise routine in line with the NHS guidance on movement (150 minutes per week) can help reduce symptoms of ED significantly. 

Another long-term study estimates that men who ran for 90 minutes or did 3 hours of rigorous outdoor work per week were 20% less likely to develop ED.

Lifestyle adjustments

The following lifestyle factors have all been linked with an increased risk of developing erectile dysfunction:

  • Diet
  • Smoking
  • Alcohol consumption
  • Drug usage
  • Sitting still for long periods
  • Exercise routine
  • Pelvic health
  • Blood pressure
  • Sleep quality

Communicating with your partner

Unfortunately, there is still a stigma around erectile dysfunction that can make talking about the condition difficult.

If you’re in a relationship, talking openly with your partner can help normalise your experience and get some valuable emotional support if you’re struggling.

If you’re struggling with intimacy or worrying that your condition will never improve, sharing these feelings with your partner can help them better understand how ED is affecting you.

  • Emotional support: talking about your thoughts, feelings, and emotions can help unburden some of the underlying stress and anxiety that might be contributing to your ED
  • Normalise the experience: if you’re helping a partner with ED, reassuring them that it’s incredibly common can help normalise their experience and reduce stress and anxiety around erectile dysfunction
  • Improve intimacy: open and honest discussion about how your sexual desire and libido has been affected can help re-establish physical and emotional connections that may have been impacted by ED
  • Seek reassurance: communicating can help reduce insecurities and any feelings of inferiority. Reassurance is a great way to make someone feel like they’re not alone and that ED isn’t the be all and end all of your relationship


Oral medications for erectile dysfunction have become increasingly popular in recent years.

The NHS currently prescribes a class of medicines called ‘PDE-5 inhibitors’ that work by increasing blood flow to your penis.

The drugs currently prescribed by GPs are:

Avoid taking supplements or stimulants that suggest they may help with erectile dysfunction. If you have ED and want help, always speak with a GP or consult a Pharmacist about treatment.

Last updated Tuesday 14 May 2024

First published on Tuesday 14 May 2024