Overview
Erectile dysfunction is difficulty getting or keeping an erection firm enough for sex. Occasional problems are normal; persistent problems deserve a medical check, because they can be an early sign of heart and blood-vessel disease.
Symptoms
- Trouble getting an erection
- Trouble keeping an erection
- Reduced sexual desire
When to see a doctor
- Chest pain or breathlessness on exertion
- Erection problems with diabetes or high blood pressure
Causes
- Reduced blood flow from diabetes, high blood pressure, high cholesterol or smoking
- Hormonal problems
- Nerve damage
- Side effects of some medicines
- Stress, anxiety and relationship issues
Risk factors
- Diabetes
- Heart disease
- Smoking and alcohol
- Obesity
- Age
Diagnosis
- Medical and sexual history
- Examination
- Blood sugar, cholesterol and testosterone tests
- Penile Doppler ultrasound in selected men
Treatment
- Lifestyle changes and control of diabetes, blood pressure and cholesterol.
- Oral medicines, prescribed after checking they are safe for your heart.
- Counselling where stress or anxiety plays a part.
- Penile implant surgery when other treatments have not worked.
FAQs
Is it safe to buy tablets without a prescription?
No. These medicines can be dangerous with some heart conditions and heart medicines, especially nitrates. See a doctor first.
Is erectile dysfunction a sign of heart disease?
It can be. The blood vessels of the penis are small, so problems can show there first. A check-up is worthwhile.
What is a penile implant?
A device placed surgically inside the penis that allows an erection when needed. It is fully concealed. Your urologist will discuss whether it suits you.
Medical review: pending — Dr. Abhishek M. Shah · Content prepared October 2026. This guide is general information and does not replace a consultation.