Erectile Dysfunction Knowledge Base
Reliable information about erectile dysfunction, treatment options, medicine safety and when to seek medical advice.
Erectile dysfunction (ED) means regularly having difficulty getting or maintaining an erection firm enough for sexual activity. It is common, but persistent erection problems can sometimes be associated with underlying health conditions such as diabetes, cardiovascular disease, high blood pressure, hormonal problems, stress or anxiety. The NHS advises speaking to a GP or sexual health clinic if erection problems keep happening. nhs.uk
This Knowledge Base is designed to provide clear general information about ED and commonly used treatment approaches. It is not a substitute for diagnosis or personalised advice from a doctor, pharmacist or other qualified healthcare professional.
Understanding erectile dysfunction
An occasional difficulty getting an erection is not unusual. Tiredness, stress, alcohol and anxiety can all affect sexual performance.
When the problem becomes persistent or repeatedly interferes with sexual activity, it is worth discussing it with a healthcare professional.
A medical assessment may include questions about general health, lifestyle, medicines, relationships and symptoms. Basic checks such as blood pressure may also be appropriate. nhs.uk
Common factors associated with ED
Erection problems may be connected with:
- cardiovascular or circulation problems;
- diabetes;
- high blood pressure;
- high cholesterol;
- hormonal conditions;
- some prescription medicines;
- smoking;
- excessive alcohol;
- stress or anxiety;
- depression;
- relationship difficulties;
- neurological conditions; or
- previous pelvic or prostate treatment.
Finding the underlying cause can be as important as treating the erection problem itself.
Treatment options
Treatment depends on the cause and the individual’s general health.
Lifestyle changes can sometimes improve erectile function. The NHS recommends measures including stopping smoking, maintaining a healthy weight, exercising regularly, eating a healthy diet and reducing stress and anxiety. nhs.uk
Medical treatment may also be appropriate.
PDE-5 inhibitors
The principal oral medicines used for erectile dysfunction are known as PDE-5 inhibitors.
They include:
- sildenafil;
- tadalafil;
- vardenafil; and
- avanafil.
These medicines increase blood flow to the penis when sexual stimulation occurs. They do not automatically produce an erection without sexual stimulation. nhs.uk
Different medicines vary in how quickly they begin working, how long their effects can remain available and how they interact with food or other medicines.
A pharmacist or doctor can advise which treatment, if any, is appropriate for an individual.
Sildenafil information
Sildenafil is widely used to treat erectile dysfunction.
It is not suitable for everybody. In particular, sildenafil should not normally be taken with nitrate medicines, such as glyceryl trinitrate (GTN) used for angina, because the combination can cause a dangerous fall in blood pressure. nhs.uk
A doctor or pharmacist should also be told about other medicines, supplements and medical conditions before sildenafil is used.
Potential side effects can include headache, flushing, indigestion, nasal congestion and visual disturbances. Serious reactions are uncommon but require medical attention.
Tadalafil information
Tadalafil is another PDE-5 inhibitor used for erectile dysfunction.
Its effects may remain available for considerably longer than those of some other ED medicines; NHS guidance states that tadalafil can remain effective for up to approximately 36 hours in some people. nhs.uk
This does not mean that an erection lasts for 36 hours. Sexual stimulation is still required.
Like sildenafil, tadalafil is generally unsuitable for use with nitrate medicines. People with certain cardiovascular conditions, low blood pressure, recent heart attack or stroke, or particular kidney or liver problems should seek professional advice before using it. nhs.uk
ED medicines and nitrates
One of the most important ED medicine safety rules concerns nitrates.
Do not take sildenafil, tadalafil or similar ED medicines without professional advice if you use nitrate medicines for chest pain or heart disease.
Examples include:
- GTN spray;
- glyceryl trinitrate tablets;
- isosorbide mononitrate; and
- isosorbide dinitrate.
Using a PDE-5 inhibitor together with nitrates can cause a potentially dangerous drop in blood pressure. nhs.uk
Recreational nitrites commonly known as “poppers” can create a similar risk and should not be combined with these medicines. nhs.uk
When ED should be medically checked
If erection difficulties continue to happen, do not simply assume that they are only a sexual-performance problem.
The NHS notes that persistent ED can sometimes be an indicator of conditions such as diabetes or cardiovascular disease. nhs.uk
You should particularly consider seeking professional advice if:
- ED has developed suddenly;
- the problem continues for several weeks or months;
- you have diabetes or cardiovascular disease;
- you experience chest pain or breathlessness;
- you have noticed changes in libido;
- erections are painful;
- your penis has developed a significant curvature;
- ED began after surgery or injury; or
- a medicine you take may be contributing to the problem.
Do not stop prescribed medication without discussing it with your doctor.
Emergency symptoms
Most ED medicine side effects are not emergencies, but some symptoms require urgent medical attention.
Prolonged erection
A prolonged or painful erection is called priapism.
An erection lasting around 4 hours or longer requires urgent medical treatment, because delaying treatment can result in permanent injury. UCL Hospitals
Chest pain or severe reactions
Seek urgent medical assistance if you develop symptoms suggestive of a heart attack, a severe allergic reaction, seizure or another serious reaction after taking a medicine. nhs.uk
If you experience chest pain after using an ED medicine, tell the healthcare professionals treating you what medicine you have taken.
Alcohol, food and ED medicines
Excessive alcohol can itself make it more difficult to achieve an erection.
Food can also affect some medicines differently. For example, a large meal may delay the effect of sildenafil, while tadalafil is less affected by food. nhs.uk
Always follow the patient information leaflet supplied with a medicine and advice from a pharmacist or doctor.
Buying medicines online safely
Extra caution is needed when medicines are offered online.
The MHRA has warned about unlicensed and illegally supplied erectile-dysfunction medicines sold through websites, noting that such products may present significant health risks. GOV.UK
Before obtaining a medicine online, consumers should check that the seller is legally permitted to supply the medicine concerned and that appropriate professional safeguards apply.
Prescription-only and pharmacy medicines are subject to specific UK requirements. The fact that a medicine is advertised online does not by itself establish that its sale or supply is lawful. Medicine Seller Register
Lifestyle and erectile health
Healthy lifestyle changes can contribute to both general cardiovascular health and erectile function.
Useful measures can include:
- stopping smoking;
- regular exercise;
- maintaining a healthy weight;
- eating a balanced diet;
- limiting excessive alcohol consumption;
- reducing stress;
- getting adequate sleep; and
- managing conditions such as diabetes and high blood pressure appropriately.
Because erectile function depends partly on healthy circulation, measures that support cardiovascular health may also support sexual health.
Mental health and sexual performance
ED does not always have a purely physical cause.
Stress, performance anxiety, depression, relationship difficulties and other psychological factors can contribute to erection problems.
In some cases, counselling, psychological therapy or addressing relationship difficulties may form part of treatment.
Physical and psychological factors can also occur together.
Our Knowledge Base
We are developing this section to provide straightforward information about subjects such as:
Erectile Dysfunction
- What causes erectile dysfunction?
- When should ED be investigated?
- ED and cardiovascular health
- ED and diabetes
- Stress, anxiety and erection problems
Medicines
- Sildenafil explained
- Tadalafil explained
- Sildenafil vs tadalafil
- ED medicines and food
- ED medicines and alcohol
- ED medicines and other medications
- Understanding common side effects
Safety
- Why nitrates and ED medicines should not be combined
- What is priapism?
- When to seek urgent medical help
- How to recognise unsafe online medicine sellers
Lifestyle
- Exercise and erectile health
- Smoking and ED
- Alcohol and erectile function
- Weight and cardiovascular health
- Stress management and sexual health
Important medical disclaimer
Information in the KamagraDeal.UK ED Knowledge Base is provided for general educational purposes only.
It does not:
- diagnose a medical condition;
- replace consultation with a doctor or pharmacist;
- recommend a particular medicine for an individual;
- establish that a product is suitable for you; or
- replace the patient information leaflet supplied with a medicine.
Always seek appropriate professional advice if you are unsure whether a treatment is suitable for you.
For continuing or unexplained erectile dysfunction, contact your GP, pharmacist or sexual health service.