Difficulty getting an erection is a common problem, but it’s usually temporary, caused by either stress, tiredness, or too much alcohol. If it keeps happening, then it could be a sign of an underlying health condition – physical or psychological. In this blog, we look at some of the causes of erectile dysfunction (ED) and consider how to treat it.   

The physical conditions that cause ED

When you are aroused, your brain sends a signal to the base of your penis to tell the blood vessels to relax – this increases blood flow and causes the penis to expand. 

Anything that interferes with this process can cause erectile dysfunction. The physical causes of ED can be broken down into four types. Conditions that affect:  

  • Blood flow to the penis 
  • The nervous system 
  • Hormone levels (hormonal) 
  • The physical structure of the penis 

Vasculogenic problems are the most common cause of erectile dysfunction. This is anything that affects the flow of blood around the body, such as high blood pressure and cardiovascular disease. Atherosclerosis, associated with high cholesterol, also contributes to ED because it narrows the arteries, which restricts blood supply.  

Erectile dysfunction is a common symptom of type 2 diabetes. This condition doesn’t just restrict blood flow to your penis, but it also impacts on hormone levels and affects the nervous system. Other neurological conditions associated with ED include: 

  • Multiple sclerosis (MS) 
  • Parkinson’s disease
  • Alzheimer’s disease 
  • Brain or spinal tumors 
  • A stroke 
  • Temporal lobe epilepsy 

Physical injury and surgery can also lead to ED. Between 15 and 25% of people with a severe head injury are believed to suffer from erectile dysfunction¹. And, it’s a common complaint among bicycle riders because of the pressure it puts on nerve endings in the buttocks and the genitals. 

The emotional reasons behind ED

If you’re able to get an erection some of the time, i.e., when you’re masturbating or first thing in the morning, but not when you’re with your partner, then the problem is unlikely to be physical. In this case, there may be a psychological reason behind your ED. 

It’s quite common for relationship problems, stress at work, or money troubles to find their way into the bedroom and impact how you feel about sex with a partner.

Stress, anxiety, and depression can all cause erectile dysfunction. This can turn into a self-perpetuating problem – one bad night can lead to performance anxiety, which can impact on your sex life long-term and consequently affect your mental health.    

Some medications used to treat depression, such as selective serotonin reuptake inhibitors (SSRIs), can also cause low libido and erectile dysfunction. The good news is that you should see a return to normal when you stop taking the medication.  

How to treat erectile dysfunction 

Treatments for erectile dysfunction are focused on tackling the root cause of the problem. As a starting point, your GP will consider the following: 

  • Statins for high cholesterol and medicine for high blood pressure
  • Hormone therapy for hormonal problems e.g. testosterone   
  • An alternative treatment if ED is a side effect of any medication you’re taking
  • Cognitive behavioural therapy (CBT) or counselling for emotional problems  

More complex health conditions, such as heart disease, will require a multifaceted approach, but making changes to your lifestyle and diet is a good place to start. 

Medicines, such as Viagra (sildenafil citrate), are also effective at treating erectile dysfunction and they offer a quick result in the short-term. 

How do ED tablets work? 

Viagra (and Sildenafil – its unbranded alternative) is part of a group of drugs, known as PDE5 inhibitors. They work by dilating the blood vessels at the base of the penis to improve blood flow, which leads to a firm, long-lasting erection.  

Taken on an empty stomach one hour before sex, you can expect Viagra to take effect within 30 to 60 minutes. For it to work you must be aroused; it’s a common misconception that Viagra can cause an erection without sexual excitement

At least two thirds of men have an erection after taking Viagra², but if you find that it doesn’t work then you may need to try an alternative brand of ED tablets. 

At Post My Meds, other ED treatments we also stock include: 

For those who anticipate having sex regularly there is also a daily tablet (Cialis Daily) that stays active in your system, so it’s ready when you are.  

You can buy erectile dysfunction tablets online from a registered pharmacy without a prescription, but you will have to complete an online consultation first for your condition and to ensure treatment is suitable for you to use.  

Other things you can do to help ED 

If you’re having problems getting and maintaining an erection, then changing your diet and adopting a healthier lifestyle can all help. The NHS recommends: 

  • Losing weight 
  • Exercising more 
  • Reducing your alcohol intake 
  • Quitting smoking
  • Reducing stress and anxiety

If you cycle for more than three hours a week, you could try taking a break for a while to see if that makes a difference. 

You might also benefit from using a vacuum pump – a simple-to-use device that works in 90% of cases³. It forms an erection by creating a vacuum around the penis that increases blood flow and causes the penile tissue to expand and harden.  

How to buy treatments for ED safely 

If you’re considering buying erectile dysfunction medication online, look for a pharmacy registered with the General Pharmaceutical Council (GPhC). 

The pharmacy should have the GPhC logo or a registration number on its home page. 

Sites that claim to be selling genuine ED tablets may not be safe. The products could be out-of-date, diluted, or even fake. Moreover, an unregistered retailer is not qualified to check that it is safe for you to take the medication before they sell it to you.

You can expect a registered pharmacist to ask you questions about your health and any other prescription drugs you are taking. This reduces the risk of you suffering dangerous side effects and ensures you get the most out of your tablets. 

Post My Meds is registered with the GPhC and is led by experienced healthcare professionals trained in sexual health treatments.

Although all of our content is written and reviewed by healthcare professionals, it should not be substituted for or used as medical advice. If you have any questions about your health, please speak to your doctor.

Authored Dec 09, 2021 by Joseph Issac, MPharm
Reviewed Dec 08, 2021 by Prabjeet Saundh, MPharm