Erectile Dysfunction

Physical, psychological or lifestyle-related factors can cause erectile dysfunction (ED), and in many cases, a combination of these. Physical causes include cardiovascular disease, diabetes, high blood pressure, high cholesterol, hormonal imbalances and neurological conditions such as multiple sclerosis or Parkinson's disease. Psychological causes include stress, anxiety, depression and relationship difficulties. Lifestyle factors such as smoking, excessive alcohol consumption, lack of exercise and being overweight can also contribute. In some cases, ED can be an early warning sign of an underlying health condition, particularly cardiovascular disease, which is why a consultation with a qualified doctor is recommended.

The most commonly prescribed ED treatments are PDE-5 inhibitors, which include sildenafil (the active ingredient in Viagra), tadalafil (Cialis), vardenafil (Levitra) and avanafil (Spedra). These medications work by relaxing the blood vessels in the penis, increasing blood flow and making it easier to achieve and maintain an erection during sexual stimulation. They do not cause an erection on their own, sexual arousal is still required. Sildenafil, vardenafil and avanafil typically work within 30 to 60 minutes and last for around four to eight hours. Tadalafil can last for up to 36 hours, making it a popular choice for men who prefer not to plan around a specific time window.

Yes. Through Peak Pharmacy's regulated online doctor service, you can buy ED medication safely and discreetly. Each order is reviewed by a qualified clinician to ensure the medication is suitable for you based on your medical history, current medications and any existing health conditions. Your treatment is dispensed by our pharmacy team and delivered in discreet, unmarked packaging. All prescribing follows UK clinical guidelines, and our service is fully regulated by the General Pharmaceutical Council (GPhC).

Like all medications, ED treatments can cause side effects. The most commonly reported include headaches, facial flushing, nasal congestion, dizziness and indigestion. Some men experience visual disturbances or muscle aches, particularly with higher doses. These side effects are usually mild and tend to pass within a few hours. Approximately 12% of men experience noticeable side effects, though only around 3% find them significant enough to stop treatment. A prescriber will discuss potential risks during your consultation and recommend the safest option for your individual needs.

Erectile dysfunction, sometimes called impotence, is the persistent inability to get or maintain an erection firm enough for satisfactory sexual intercourse. Occasional difficulty with erections is common and not usually a cause for concern, but if it happens regularly it may be worth seeking medical advice. ED is a very common condition; it is estimated to affect around half of all men between the ages of 40 and 70 to some degree. It is a treatable condition, and most men can find an effective solution with the right support.

The main symptom of ED is difficulty getting or keeping an erection that is firm enough for sex. You may also notice reduced sexual desire or find that erections are less firm than they used to be. ED should not be confused with premature ejaculation or a loss of libido, which are separate conditions with different causes and treatments. If you experience persistent erection difficulties, it is worth consulting a doctor, as ED can sometimes indicate an underlying health issue that may benefit from treatment.

ED can affect men at any age, though it becomes more common with age. Mild or occasional ED can begin in the 30s or 40s, and it becomes increasingly prevalent from the age of 50 onwards. However, age alone does not cause ED; it is usually linked to underlying health conditions, lifestyle factors or medications that become more common as men get older. Younger men who experience ED often find that psychological factors such as performance anxiety, stress or relationship issues play a significant role. Regardless of age, effective treatments are available.

Yes. High blood pressure (hypertension) is one of the most common physical causes of ED. It damages blood vessels throughout the body, including those that supply the penis, reducing blood flow and making it harder to achieve an erection. Some medications used to treat high blood pressure, particularly beta-blockers and thiazide diuretics, can also contribute to ED as a side effect. If you have high blood pressure and are experiencing erection problems, speak with a doctor. There are often alternative medications that are less likely to affect sexual function, and ED treatments such as PDE-5 inhibitors may still be suitable.

Yes. While small amounts of alcohol may reduce inhibitions, excessive or regular alcohol consumption is a well-established cause of erectile dysfunction. Alcohol is a depressant that affects the nervous system, reducing the signals between the brain and the body that are needed to achieve an erection. Long-term heavy drinking can also cause liver damage, hormonal changes and nerve damage, all of which contribute to ED. Reducing alcohol intake is one of the most effective lifestyle changes a man can make to improve erectile function.

Yes. Smoking is a significant risk factor for erectile dysfunction. The chemicals in tobacco damage the lining of blood vessels and restrict blood flow throughout the body, including to the penis. Men who smoke are approximately twice as likely to experience ED compared to non-smokers. The good news is that quitting smoking can improve erectile function, sometimes noticeably within a few months. If you are a smoker experiencing ED, stopping smoking is one of the most impactful things you can do alongside medical treatment.

Yes. Diabetes is one of the leading causes of erectile dysfunction. Both type 1 and type 2 diabetes can damage blood vessels and nerves over time, reducing blood flow to the penis and affecting the nerve signals needed for an erection. Men with diabetes are estimated to be two to three times more likely to develop ED, and symptoms often appear 10 to 15 years earlier than in men without diabetes. Managing blood sugar levels through medication, diet and exercise can help reduce the risk. PDE-5 inhibitors are effective for many men with diabetes-related ED, though a consultation is needed to determine the most suitable treatment.

Yes. Lifestyle changes can have a meaningful impact on erectile function, particularly when ED is linked to cardiovascular health, weight or fitness. Regular physical exercise improves blood flow and cardiovascular health, both of which are directly linked to erectile function. Maintaining a healthy weight, eating a balanced diet rich in fruits, vegetables, whole grains and lean protein, and reducing processed foods and sugar can all contribute to improved sexual health. Reducing alcohol intake and stopping smoking are two of the most effective single changes. While lifestyle changes alone may not resolve all cases of ED, they can significantly improve the effectiveness of medication and overall well-being.

The main ED tablets available through Peak Pharmacy's online doctor service are sildenafil (generic Viagra), tadalafil (generic Cialis) and their branded equivalents. Sildenafil is taken as needed, usually 30 to 60 minutes before sexual activity, and lasts for around four to six hours. Tadalafil can be taken either as needed or as a daily low-dose tablet (2.5mg or 5mg), offering flexibility for men who prefer spontaneous sexual activity without planning around a dose. Both are PDE-5 inhibitors and are clinically proven to be effective in the majority of men with ED. A prescriber will recommend the most suitable option based on your health, lifestyle and preferences.

It can be. Psychological factors are a common cause of ED, particularly in younger men. Performance anxiety, stress, depression, relationship problems and low self-confidence can all interfere with the ability to get or maintain an erection. In many cases, psychological and physical causes overlap; for example, a man with mild physical ED may develop anxiety about his performance, which then makes the problem worse. Cognitive behavioural therapy (CBT) and sex therapy can be effective for psychologically driven ED, and PDE-5 inhibitors may also help by providing reassurance and breaking the cycle of anxiety.

Generic sildenafil is available on NHS prescription for most men with erectile dysfunction. Tadalafil may be prescribed on the NHS in certain circumstances, such as for men with specific conditions including diabetes, multiple sclerosis, Parkinson's disease, prostate cancer or spinal cord injuries. NHS prescriptions for ED are typically limited to a certain quantity per month. If you do not meet NHS criteria or prefer quicker access without GP waiting times, Peak Pharmacy's online doctor service offers a convenient and discreet private prescription alternative with home delivery.