Guides > Erectile Dysfunction

Erection problems – everything you need to know about symptoms, diagnosis and treatment

Symptoms

What is erectile dysfunction?

Erectile dysfunction (ED) is the persistent trouble getting or keeping an erection firm enough for sexual intercourse.

How common is ED?

About 1 in 10 men experience ED at some point. In the US alone, roughly 30 million men are affected.

How does age affect ED?

Around 5% of men in their 40s and 15% of men in their 70s experience complete ED. It is increasingly affecting younger men as well.

Who is most likely to suffer?

Men with chronic conditions such as diabetes or heart disease, those with unhealthy lifestyle factors, and those dealing with mental health issues are most at risk.

Why does ED occur?

ED can stem from physical causes including impaired blood flow, hormonal imbalances, and nerve damage, as well as psychological causes like stress and anxiety.

Why is maintaining an erection important?

Erectile function is an important indicator of overall cardiovascular health. It also supports mental wellbeing and healthy intimate relationships.

Psychological impact?

ED can significantly affect self-image, confidence, mood, and intimate relationships, often creating a cycle of anxiety that worsens the condition.

Is ED serious?

While not life-threatening on its own, ED frequently signals deeper health problems such as cardiovascular disease or diabetes that require attention.

Can ED affect fertility?

ED does not directly affect sperm production or quality, but it can interfere with the ability to have intercourse and therefore conceive naturally.

Low testosterone linked?

Low testosterone can reduce sex drive and make ED worse, though it is rarely the sole cause.

Prostate linked?

Between 60% and 80% of men experience ED after prostate surgery due to nerve damage in the area.

What causes ED?

Excess body fat negatively affects vascular, hormonal, and psychological health, all of which contribute to erectile dysfunction.

Diabetes linked?

Type 2 diabetes is strongly associated with ED because it causes nerve damage and impairs blood vessel function over time.

Always psychological?

No. Physical causes account for roughly 70% of ED cases, though psychological factors often coexist.

Normal vs dysfunctional?

A normal erection depends on a precise sequence of blood flow events; disruptions at any point in this process can result in dysfunction.

What should I do?

Speak to your GP or a specialist for a proper assessment. Early intervention leads to better outcomes.

Can ED be cured?

ED is treatable in nearly all cases, especially when the underlying cause is identified and addressed.

Long-term untreated?

Left untreated, ED may worsen and can be associated with progression of heart disease, diabetes, and other conditions.

Diagnosis

How diagnosed?

Diagnosis typically involves a detailed medical history, physical examination, and blood tests to identify underlying causes.

Need a doctor?

Seeing a doctor is not compulsory but is strongly advised to rule out serious underlying health conditions.

Heracles protocol?

Heracles uses the IIEF-5 questionnaire for initial assessment, plus optional blood tests for a more comprehensive evaluation.

What is IIEF5?

The IIEF-5 is a standardised, clinically validated tool used worldwide to assess the severity of erectile dysfunction.

Why blood tests?

ED can signal underlying conditions such as diabetes or hormonal imbalances that blood tests can detect early.

What's in blood tests?

Tests typically include total testosterone, free testosterone, albumin, SHBG, HbA1c, and a full lipid profile.

Why consultation?

A consultation helps get to the root cause of your ED rather than just treating the symptoms.

What's in consultation?

The consultation includes targeted questions about your medical history, lifestyle, and symptoms to build a complete picture.

Treatment

Best treatment?

The best approach combines lifestyle changes, PDE5 inhibitor medication, and therapy where psychological factors are involved.

Options at Heracles?

Heracles offers Sildenafil (as-needed), Tadalafil (as-needed), and Tadalafil daily for continuous coverage.

How long for results?

Standard on-demand tablets work within 60 minutes. Daily Tadalafil takes several days to reach full effectiveness.

How safe?

PDE5 inhibitors are generally safe and well-tolerated when used under medical supervision.

Side effects?

Common mild side effects include headache, facial flushing, and nasal congestion. These usually pass quickly.

Who cannot take?

Men taking nitrate medications or those with severe heart or liver disease should not use PDE5 inhibitors.

With heart problems?

It depends on the specific condition. PDE5 inhibitors must never be combined with nitrate medications.

Long-term solution?

Medication should be part of a broader treatment strategy that includes lifestyle changes and addressing root causes.

What to expect?

Best results come from combining medication with lifestyle changes such as improved diet, exercise, and stress management.

Can PDE5 cure ED?

PDE5 inhibitors manage symptoms rather than cure ED. However, the condition may resolve if the underlying cause is addressed.

Which PDE5?

The best choice depends on how frequently you need it and your timing preferences. Your clinician will help you decide.

Addictive?

No. PDE5 inhibitors do not cause physical dependence or addiction.

Adverse reactions?

Serious but rare reactions include chest pain and vision loss — seek immediate medical help. Mild effects like headache are more common.