Erectile dysfunction (ED) can have many causes — often a combination of physical, psychological, and lifestyle factors. Common causes include:

Physical Causes:

• Heart disease and poor circulation – reduced blood flow to the penis

• High blood pressure or high cholesterol

• Diabetes – damages nerves and blood vessels needed for erections

• Obesity – linked to hormonal changes and reduced blood flow

• Low testosterone (androgen deficiency)

• Certain medications – including blood pressure drugs, antidepressants, or prostate treatments

• Smoking, alcohol, or drug use

• Neurological conditions – such as Parkinson’s disease or multiple sclerosis

• Pelvic surgery or injury – particularly prostate surgery

Psychological Causes:

• Stress or anxiety – including performance anxiety

• Depression

• Relationship issues

ED is often a sign of another underlying health issue, especially related to blood vessels or hormones. Addressing the root cause not only improves sexual health but also overall wellbeing.

Diagnosing erectile dysfunction (ED) begins with a thorough discussion about your symptoms, medical history, lifestyle, and any emotional or relationship factors that may be involved. From there, we may recommend:

1. Physical Examination

   • Checks for signs of hormonal imbalance, nerve problems, or circulation issues.

2. Blood Tests

   • Used to assess levels of testosterone, blood sugar (for diabetes), cholesterol, and other key health markers.

3. Urine Tests

   • To check for diabetes or other underlying conditions.

4. Nocturnal Penile Tumescence Test

   • Measures erections that occur during sleep to help determine if the cause is physical or psychological.

5. Penile Doppler Ultrasound

   • A specialised test to evaluate blood flow in the penis, often used when vascular issues are suspected.

6. Psychological Evaluation

   • If emotional or mental health factors are contributing, a brief psychological assessment may be helpful.

Treatment for erectile dysfunction (ED) is highly effective and tailored to the underlying cause, severity of symptoms, and your personal preferences. Common treatment options include:

1. Lifestyle Changes

Improving overall health can have a big impact on ED. This includes:

• Quitting smoking

• Reducing alcohol

• Exercising regularly

• Losing excess weight

• Managing stress

2. Medications

Oral medications known as PDE5 inhibitors (like Viagra, Cialis, or Levitra) help increase blood flow to the penis. These are often the first line of treatment and work well for many men.

3. Hormone Therapy

If low testosterone is contributing to ED, testosterone replacement therapy (TRT) may be recommended.

4. Penile Devices

• Vacuum erection devices (pumps) draw blood into the penis and help maintain an erection with a tension ring.

• Penile injections or suppositories deliver medication directly into the penis for more immediate results.

5. Surgical Options

For severe or long-term ED that hasn’t responded to other treatments, penile implants (prostheses) may be considered. These are safe, discreet, and offer a permanent solution.

6. Psychological Support

Counselling or sex therapy can be helpful if emotional or relationship factors are contributing.