Erectile Dysfunction Treatment

Erectile dysfunction, often shortened to ‘ED’, is a sexual health condition. ED happens when you either:

• cannot get an erection
• cannot keep an erection long enough to engage in sex

Although it’s normal to struggle with getting or maintaining an erection occasionally, if it happens often, this could be a sign you have erectile dysfunction.

Is it possible to cure ED?

It depends on what’s causing it. You might be able to if you can cure or manage the underlying condition that might be causing it.

In some cases, ED cannot be cured, but it can be managed with erectile dysfunction treatment when you need it. Luckily, erectile dysfunction treatment is safe to take long-term under the care of a doctor.

How common is erectile dysfunction?

Erectile dysfunction is a common health condition and various studies have been carried out on people of different ages:

• One study found that around 52% of men aged between 40 and 70 have ED. The chance of having ED also increased with age, with 40% of men aged 40 affected and 70% of men aged 70 affected.
• ED doesn’t just affect men who are 40 or older. Another study found that 2.3% of men aged 30 have ED.
• A further study found that at least 150 million men around the world have ED.

These findings may be underestimated, as many men do not come forward about their symptoms or seek medical help for many reasons, such as embarrassment, anxiety, or cultural reasons.

The symptoms of erectile dysfunction include:

• only being able to get an erection sometimes
• being able to get an erection but not being able to maintain it long enough to have sex
• not being able to get an erection at all
• requiring a lot more stimulation than you needed before to get and maintain an erection
• not getting fully hard when you get an erection

ED can also be linked to a low sex drive. In some cases, this may be part of the reason for your ED.

How long can erectile dysfunction last?

Erectile dysfunction can last several months or years, depending on the cause and whether you try any treatment. Speak to your doctor if you can’t get hard often, as they can help you look into what may be causing it. You can also get medication so you can still have a normal sex life.

Who does erectile dysfunction affect?

ED can affect any man, but it’s more likely if you:

• are over 40 years old
• cycle more than 3 hours a week
• have diabetes, high blood pressure or another medical condition that can cause ED
• have a high body mass index (BMI)
• smoke
• are physically inactive
• are stressed
• have depression or anxiety
• take certain medications
• don’t eat a healthy, balanced diet
• drink more than 14 units of alcohol every week
• are having problems with your relationship (especially if you only have symptoms with your partner but can get an erection alone)
• take recreational drugs often

If you’re having trouble getting and staying hard regularly and this isn’t getting better, you should speak with your doctor. They can diagnose ED based on your symptoms. They can also check for underlying health conditions that could be causing it, such as high blood pressure.

How do I know if I have ED?

If you cannot get and keep an erection and this happens often, you’ve probably got ED. Write down a list of your symptoms and consider keeping a habits diary to see if anything makes it worse or better. You can get diagnosed by speaking with your GP, but you don’t need a formal diagnosis to request treatment now.

Can I test for ED?

Yes, you can use an ED test to check what could be causing your symptoms. Our at-home erectile dysfunction test kit checks for conditions like diabetes or thyroid problems, and checks important levels like your cholesterol and testosterone. The results of your test can be discussed with one of our doctors.

Erectile dysfunction has 4 main causes:

• a physical condition
• a psychological condition
• medication
• lifestyle and age

Knowing the cause of your ED can help you manage and treat it.

Physical conditions that can cause ED

Some common physical conditions that may cause erectile dysfunction include:

• diabetes
• high blood pressure
• hormone problems, such as increased prolactin
• heart disease
• multiple sclerosis
• spinal cord or nerve injuries
• heavy metal poisoning
• nerve damage from a pelvic operation
• thyroid problems
• high cholesterol
• chronic sleep disorders
• conditions affecting the structure of your penis
• penis injuries
• stroke
• Parkinson’s disease

Why these conditions cause ED depends on the condition. It might affect the blood flow to your penis or cause hormonal changes that make it harder to get and maintain an erection. For example, people with diabetes are 3 times more likely to have erectile dysfunction. It may be more likely to happen when your blood sugar levels are too high.

If you have a physical condition you think might be causing your ED, speak with your doctor.

Psychological conditions that can cause ED

Common psychological conditions that may cause ED include:

• depression
• anxiety
• high levels of stress
• ongoing relationship problems
• sexual performance anxiety

Stress and other psychological conditions can affect your hormones, increasing the stress hormones cortisol and adrenaline. This can restrict blood flow and make it harder to get an erection. They also affect your brain, making it more difficult to get ‘in the mood’ for sex or cause a decrease in sex drive.

If you experience difficulties with your mental or psychological health and feel that this is impacting your sex life, speak with your doctor.

Medications that can cause ED

Some medications cause erectile dysfunction as a side effect because of how they work in your body. According to research, the most common medications that cause ED (in order of likelihood) are:

• 5-α reductase inhibitors – these treat male pattern hair loss and benign prostatic hypertrophy and include finasteride (Propecia) and dutasteride
• neuropsychiatric medications – used to treat mental disorders such as anxiety and depression, seizures, or diseases of the central nervous system. This includes selective serotonin reuptake inhibitors (SSRIs) like fluoxetine, as well as pregabalin and gabapentin
• some cardiovascular medications – these help prevent or treat conditions such as heart attack, angina, or high blood pressure and include beta-blockers like propranolol and diuretics like indapamide
• acne medication – specifically a medication called isotretinoin

Other medications linked to ED:

• fibrates (for lowering cholesterol levels)
• corticosteroids (used in lots of conditions, including asthma and arthritis)
• H2-antagonists (for treating stomach ulcers)
• antihistamines (for allergic conditions like hay fever)
• cytotoxics (cancer therapy)

Check with your doctor or read the patient information leaflet included with any medications to see if a side effect is ED, ‘erection problems’ or ‘impotence’.

Lifestyle and age

Age is a factor that can cause or make ED more likely. Other lifestyle choices that may cause ED include:

• chronic alcoholism
• taking recreational drugs, including illegal steroids
• being overweight or obese
• smoking cigarettes or cannabis
• not exercising regularly
• riding a bicycle for more than 3 hours every week
• not eating a healthy, balanced diet
• frequently watching porn

Alcohol, drugs, and cigarettes can all affect how your body works, including how well your blood flows and the ability to get sexually aroused. Not following a healthy lifestyle can also make it more likely that you’ll get ED.

How do I know what causes my ED?

The only way to know what causes your ED is to:

• check for any underlying health conditions – you may need to do some blood tests or other diagnostic screening to rule out certain causes
• have a medication review with your doctor to check if this could be causing your symptoms
• look at your lifestyle to see if anything you’re doing or not doing regularly could be causing ED
• consider losing weight if you have a high BMI

Erectile dysfunction treatments include prescription or over-the-counter medications, and non-medical alternatives. You can request ED tablets with our quick and easy online service after our doctors have provided a prescription.

Prescription erectile dysfunction tablets

Prescription ED pills belong to a group of medicines called PDE-5 inhibitors. PDE-5 inhibitors work by relaxing your blood vessels, increasing blood flow to your penis so you get an erection when aroused.

We prescribe all of the most popular prescription ED tablets, including:

• Viagra: Also known as the ‘little blue pill’, Viagra was one of the first ED treatments available. It’s a branded tablet that contains sildenafil, works in about 30 minutes to 1 hour and lasts for around 4 to 6 hours.
• Sildenafil: A generic Viagra tablet that also works in 30 minutes to 1 hour and lasts around 4 to 6 hours. As it’s a generic treatment, it’s usually cheaper.
• Cialis: Also known as the ‘weekend pill’. Cialis is a branded tablet that contains tadalafil, works in around 30 minutes and lasts for up to 36 hours.
• Tadalafil: The generic version of Cialis, but cheaper because it’s unbranded. Also works in around 30 minutes and can last up to 36 hours.
• Cialis Daily: Like Cialis, but taken at a lower dose of 2.5mg or 5mg every day, so you’re always ready. This means there’s no minimum wait time and as you take it every day, it’ll continue to last. Cialis Daily tablets are recommended if you regularly have sex three or more times a week on different days.
• Vardenafil: A generic tablet that used to be found under the brand name Levitra (now discontinued). Similar to Viagra, it works in around 30 minutes and lasts about 4 hours but can be slightly better to take if you have eye problems.
• Spedra: A branded tablet containing avanafil, which isn’t currently available in generic form. Spedra works in as little as 15 minutes, making it preferable for some people. It lasts for 4 to 6 hours after you take it.

We’ve also got 2 different ED trial packs available, one containing generic treatments and the other containing well-known branded treatments. This gives you the option to try 3 different medications and find which works best for you and your sex life.

Prescription erectile dysfunction cream

We also prescribe a branded ED cream called Vitaros. This is applied directly into the opening of your penis (urethra) and contains alprostadil. It relaxes the blood vessels so blood can flow into your penis, making it easier to get and maintain your erection.

Vitaros works within 5 to 30 minutes and lasts around 1 to 2 hours after application and should only be used once in 24 hours. Although we don’t prescribe it, alprostadil can also be taken as an injection or a pellet that you insert into your urethra.

Over-the-counter erectile dysfunction treatments

Over-the-counter ED treatments also contain PDE-5 inhibitors. You can get these treatments at your local pharmacy or online through Superdrug Online Doctor but you’ll need to answer a few questions first. These include:

• Viagra Connect: Viagra tablets with 50mg of sildenafil per tablet. Works in 30 minutes to 1 hour and lasts about 4 to 6 hours.
• Cialis Together: A lower-dose Cialis tablet (10mg), available without a prescription. Takes around 30 minutes to work and lasts up to 36 hours.
• Superdrug Sildenafil: Our generic version of Viagra Connect that contains 50mg of sildenafil. Works in about 30 minutes to 1 hour and lasts around 4 to 6 hours.

If you’re taking over-the-counter ED tablets regularly, speak to a doctor.

Non-medical erectile dysfunction treatments

Non-medical treatment options for ED include:

• lifestyle changes
• erectile dysfunction exercises, such as Kegels (these target the pelvic floor muscles)
• counselling
• penis pumps give you harder erections when used with a penis ring by creating pressure to increase blood flow

Counselling can help if you are getting erectile dysfunction because you’re anxious about sex. It can also help you manage how your erectile dysfunction symptoms make you feel.

You can combine lifestyle changes and erectile dysfunction exercises with medications for even better results.

Penile implants

Penile implants involve inserting an implant into the penis which can then support an erection. Penile implants are usually used as a last resort when other treatment options don’t work or aren’t safe because it involves having invasive surgery.

Will ED go away on its own?

ED can go away on its own, but it’s not likely. Most treatments can help you get and maintain an erection when you need it, but won’t treat the underlying cause. You’ll need to see a doctor to check for this.

Will I need to take ED treatment forever?

Some people need to take ED treatment long-term. You and your doctor can create a treatment plan that might involve taking medication when you need it and investigating the cause. Even if you cure ED and no longer need treatment, this doesn’t mean it can’t come back in the future for a different reason.

It might be possible to prevent ED but not always. Some things you can do to prevent erectile dysfunction include:

• quitting smoking – smokers are twice as likely to develop ED than non-smokers
• eating a healthy, balanced diet – this can decrease your risk of high cholesterol, obesity, diabetes, high blood pressure, heart disease and stroke, which are risk factors for ED
• exercising regularly – this reduces your risk of obesity and other conditions that could cause ED
• reducing stress – stress can cause many conditions, including those that cause ED or it may cause ED itself
• avoid or limit substances – certain substances can cause ED, such as excessive alcohol consumption or illegal drugs

What is the latest treatment for erectile dysfunction?

The latest treatment for erectile dysfunction that contains a PDE-5 inhibitor is Spedra (avanafil). There have also been studies into new ED treatments, such as low-intensity shockwave therapy on the penis to improve its function. Results are limited but do show improvements in men with mild to moderate ED. You can only get this procedure in private clinics in the UK.

Which high blood pressure medication can cause erectile dysfunction?

High blood pressure medications that can cause erectile dysfunction include certain beta-blockers, like atenolol and diuretics (water pills) like hydrochlorothiazide. If you’re taking a high blood pressure medication, read the patient information leaflet to check whether impotence or erection problems are listed as a side effect.

Stopping your medication could help with your erection problems but may not be suitable if you need it to manage your blood pressure. Talk to your doctor if you’re concerned or have any questions about this.

Do I need a prescription for erectile dysfunction tablets?

No, you don’t need a prescription for every erectile dysfunction tablet but stronger dose medications require a prescription. ED tablets that don’t require a prescription include Viagra Connect (50mg), Superdrug Sildenafil (50mg) and Cialis Together (10mg). If these don’t work, you might need a higher-dose prescription tablet instead.

What is the most effective ED treatment?

PDE-5 inhibitors are the most effective ED treatment. In clinical trials, the effectiveness of each PDE-5 inhibitor was as follows:

• sildenafil (Viagra, Viagra Connect): Up to 82%
• tadalafil (Cialis, Cialis Daily, Cialis Together): Up to 86%
• vardenafil (Levitra): Up to 80%
• avanafil (Spedra): Up to 59%

Each treatment can be effective but results depend on: suitability for the medication, the severity of your ED symptoms, and what dose you need.

Is there a link between erectile dysfunction and premature ejaculation?

Yes, there is a link between erectile dysfunction and premature ejaculation (PE). Studies show 30% to 60% of men with ED will also get PE.

Premature ejaculation is where you ejaculate quickly, usually 2 to 3 minutes into sex or before sex. ED doesn’t cause you to ejaculate quicker, but it can cause or worsen PE. Getting treated for ED may treat premature ejaculation, or you may need to get treatment separately. Speak to your doctor if you think you may have premature ejaculation.

Can ED be caused by using condoms?

Yes, ED can be caused by using condoms. However, we do not recommend you avoid using condoms to solve erectile dysfunction as the risk of STIs and unwanted pregnancy is not worth it.

Studies show between 14% and 28% of men lose their erection when putting on a condom and 10% to 20% of men lose their erection during sex with a condom. This could be caused by several things, like not using the right size condom, not wearing it correctly, the loss of sensation or confidence/anxiety issues with putting on and wearing a condom.

If you only have ED symptoms when applying or using a condom, speak to your sexual partner, if you can. They may be able to use an internal condom in their vagina or anus instead. This still offers protection from STIs.

Is erectile dysfunction the same as impotence?

Yes, erectile dysfunction is the same as impotence; they are just two different medical terms for the same condition. Impotence was more widely used in the past, but because it has other non-medical meanings, ED is now used instead.