The Most Common ED Questions, Answered By An Expert

Although erectile dysfunction (ED) can sometimes feel embarrassing to talk about, it's incredibly common where approximately 1 in 5 men in the UK experience the condition ^[2]. It’s important to understand that ED is easily treatable - so there's no reason to feel like you cannot discuss it to help identify the best way of minimising its impact on your sex life.

Many men turn to the internet for advice and guidance on this topic but the answers aren’t always accurate or verified, with some guidance contributing to unnecessary worry. That’s why our Superintendent Pharmacist, Ana Carolina Osorio De Faria Goncalves, is here to provide clarity and insight by answering some of the most frequently asked questions about ED.

1. What is ED?

ED, or erectile dysfunction, is a common health condition involving the persistent or recurrent inability to achieve or maintain an erection that is sufficient for satisfactory sexual intercourse. ED is usually caused by either a physical or psychological condition.

2. How do I know if I have ED?

It is normal to experience problems in achieving or maintaining erections from time to time; however, if these are repeating occurrences, you should seek further medical advice as these could be caused by ED.

3. What causes ED?

In order to maintain an erection, the body requires healthy circulation, a well-functioning nervous system and sexual desire. If you are having issues maintaining an erection, it is likely that there is an underlying physical cause or psychological cause. Physical causes of ED can stem from the effects of a prescribed medication, other underlying health conditions or lifestyle choices. The psychological causes can include mental health issues, stress or relationship issues.

The majority of ED cases are known as ‘secondary’ – this is when erectile function has been normal in the past, but poses a problem later in life.

4. Can ED be caused by watching too much pornography?

There is some evidence to suggest that watching a lot of pornography can have a negative effect on your sex life, including your ability to maintain an erection. According to a European study, people who spent over 300 minutes a week watching pornography rate their sex life as lower quality, and 45% of those under 35 years old were diagnosed with erectile dysfunction - proving to be above the national rate for this age group ^[2]. However, there is currently insufficient evidence to determine whether or not consuming too much pornography can directly cause ED.

5. Can ED be genetic?

ED is not believed to be a genetic condition, but certain factors that contribute to ED may run in the family, such as medical conditions like diabetes, cardiovascular disease or multiple sclerosis. If you are experiencing ED and have family members who are coping with any of these conditions, it may be worthwhile to speak to your GP about your family history. There are currently ongoing studies attempting to establish whether genetics play a role in making you more susceptible to ED.

6. Do smoking and alcohol have an impact on ED?

ED and smoking:

Research shows that ED is more likely to occur if you are a heavy smoker than if you are a non-smoker. Heavy smoking can cause damage to the functioning of your blood vessels, which makes experiencing ED much more likely. However, research shows that circulation can improve within 2-12 weeks of stopping smoking, which means quitting the habit could potentially relieve some symptoms of ED, as well as provide other health benefits.

ED and alcohol:

Studies have shown that men who heavily consume alcohol have a 60-70% chance of suffering sexual problems ^[3]. There are links between overconsumption of alcohol and the risk of long-term ED as it can damage blood vessels, leading to hypertension and heart disease, which can both contribute to ED.

7. Can ED be cured?

Currently there is no cure for ED, but that’s not to say that the condition isn’t highly treatable. In some cases, normal erectile function can return without needing treatment - making lifestyle changes can sometimes be enough to lower your chances of experiencing ED:

• Exercising regularly
• Adopting a healthier diet
• Pelvic floor exercises
• Lowering your alcohol intake
• Stopping smoking
• Reducing stress

These are just some of the potential lifestyle changes that may improve your ability to maintain erections, but it is best to consult a GP for treatment if the problem persists.

8. Is ED treatable?

ED is highly treatable and there are a number of ways that you can get treated. You should first consult with your GP so they can examine any pre-existing health conditions you may have and find the treatment that best suits you.

The most commonly used treatments are oral medications in tablet form. These pills are usually taken 15-60 minutes before sex. These include:

• Sildenafil (branded treatments: Viagra and Viagra Connect)
• Tadalafil (branded treatment: Cialis)
• Vardenafil (branded treatment: Levitra)
• Avanafil (branded treatment: Spedra)

9. What ED medication is the most effective?

Each medication mentioned above has its own advantage, onset of action and duration of drug action, but their effectiveness in treating ED symptoms depend on the individual. See below for how popular ED treatments compare:

10. Can ED cause premature ejaculation (PE)?

ED and PE are often linked to each other as they are both sexual disorders experienced by men. They can have similar psychological causes, but it is important to note that ED is not necessarily a direct cause of PE. Men who are more anxious about maintaining an erection during sexual intercourse are more likely to form a habit of premature ejaculation. The fear of losing an erection could cause you to rush through sexual encounters therefore at risk of PE. Pelvic floor exercises, relaxing to reduce your anxiety and opening up and talking about it with your partner can all be useful in reducing PE.