- Erectile dysfunction (ED), or problems with getting and keeping an erection, can act as a warning sign for a number of health problems, including:
- Hidden disease of the heart and blood vessels (cardiovascular disease (CVD))
- Raised cholesterol
- High blood pressure
If you have ED, you should also be checked for these other conditions (see our factsheet ‘Erectile dysfunction’)
- A raised cholesterol, unless treated and reduced, can damage the blood vessels (arteries) that supply blood to the heart and the penis. If the penis is affected, this can lead to ED
- High blood pressure is a major risk factor for CVD
- Around two-thirds of men with high blood pressure also have some form of ED
- ED can be an early warning sign of future heart problems, appearing some 3-5 years before a heart complaint (see our factsheet ‘Erectile dysfunction and the heart’)
- If you are under the age of 30, and otherwise fit and healthy, difficulty getting an erection is usually due to psychological causes (in the mind), such as stress. In this age group erectile problems are rarely due to physical causes (in the body)
- A phosphodiesterase (pronounced phos- pho- di- es- ter- ase) inhibitor (PDE5i), such as Viagra®, will not give a man an erection unless he is mentally AND physically stimulated. This becomes more important as he get older (see our factsheet ‘Oral treatment for erectile dysfunction’)
- Older men with ED that does not improve with PDE5i treatment often have low testosterone levels. Low testosterone can be easily corrected with testosterone replacement therapy (TRT) (see our factsheet ‘Testosterone deficiency’)
- You should not take a PDE5i if you are already taking nitrates (in the form of a spray for angina, some tablets for the heart, or the recreational drugs known as ‘poppers’ (Amyl nitrite)). As this combination can make the blood pressure drop too low
- Compared with younger men, those aged 55 years and over tend to have less firm erections, produce smaller amounts of semen and have less intense ejaculations. They also have a longer recovery period after ejaculation (see our factsheet ‘Sex and aging – Men’s issues’)
- Many sexual problems are caused by a combination of physical issues (in the body) and psychological issues (in the mind). These require very different treatments
- Lifestyle changes can help improve ED AND general health. These include:
- Stopping smoking (see our booklet ‘Sex and smoking’)
- Taking regular physical activity
- Losing weight if you are overweight (see our factsheet ‘Body Mass Index (BMI)’)
- Eating a healthy Mediterranean-style diet (including large amounts of plant foods, moderate amounts of fish and wine, and small amounts of animal products and sweets) (see our factsheet ‘The Mediterranean diet’)
- Limiting alcohol intake (Government guidelines recommend that men and women do not regularly drink more than 14 units of alcohol per week
- Don’t forget that women can have sexual problems too (see our factsheet ‘Women’s sexual problems’)
- It is helpful if men with ED are assessed with their partners. This way, the partner can be involved in any treatment decisions, and if they have any sexual problems themselves, these can be identified and addressed
Where can you get more information?
The Sexual Advice Association is here to help. We cannot give individual medical advice, but we can answer your questions on any sexual problems and put you in touch with local specialist practitioners. We also have a number of factsheets and booklets on sexual problems and related issues for men and women that can be downloaded from our website or requested. Please feel free to email us or phone our Helpline (our contact details are at the bottom of this page).
You can also visit the NHS Choices website at www.nhs.uk for information and advice on many different health and lifestyle topics.
What is the take home message?
Download or request our booklet ‘Sex and the heart’ and/or our factsheet ‘Explaining sexual problems to your GP’.
By donating to the Sexual Advice Association, you will know that you are helping improve the lives of people living with sexual problems. If you are interested in donating, please click here or contact us for more information (details at the bottom of this page).
Thinking About Sex Day: February 14th
Launched by the Sexual Advice Association, Thinking About Sex Day (TASD) is designed to encourage everyone to think about the physical and psychological issues surrounding sexual activity.