ED is the inability to attain and/or maintain an erection sufficient for sexual performance2

Projected 8 million 

men in the UK experienced ED in 20213

What causes ED?

The incidence and severity of ED both increase with age and the presence of comorbidities.4 In fact, 90% of people with ED have at least one underlying physical cause.5 However, ED can also be caused by psychological problems, substance abuse, or even some medications.5,6


• Cardiovascular disease (CVD)5
• Diabetes5,6
• Hormone problems5,6
• Hypertension2

Psychological causes


Medical and recreational drugs

• Some medicines (e.g. antihypertensives, antipsychotics, antidepressants)5
• Substance abuse (e.g. heroin, cocaine, methadone)5
• Excessive alcohol consumption6

Erections aren’t the only things affected by ED1

Some helpful lifestyle changes

ED can be an early warning sign of a serious health condition, such as CVD, hypertension or diabetes.2,12

The presentation of ED is an opportunity to address modifiable risk factors, which can not only reduce the risk of these associated conditions, but also improve erectile function.2,12

So, alongside ED treatment, you may want to recommend some lifestyle changes to your patients,2 which could include:

All men seeking ED treatment in your pharmacy should be advised to see their GP within 6 months for a clinical review of potential underlying conditions and risk factors associated with ED.

The British Society for Sexual Medicine recommend examining testosterone levels, HbA1c, lipid profile and blood pressure, which their GP should be able to perform.2

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    CVD, cardiovascular disease; ED, erectile dysfunction; GP, general practitioner; HbA1c, glycated haemoglobin.


    1. Elterman DS et al. Res Rep Urol 2021; 13: 79–86.
    2. Hackett G et al. J Sex Med 2018; 15(4): 430–457.
    3. Estimated from the Office for National Statistics (ONS) 2021 UK population data and Irrational quantitative survey 2021, where 3,445 (i.e. 34%) of 10,197 adult men qualified or identified as suffering from Erectile Dysfunction.
    4. Li HJ et al. Asian J Androl 2016; 18(5): 773–779.
    5. The British Association of Urological Surgeons. Patients: I think I might have… Erectile Dysfunction (impotence). Available at https://www.baus.org.uk/patients/conditions/3/erectile_dysfunction_impotence. Accessed: May 2023.
    6. NHS. Erectile dysfunction (impotence). July 2023. Available at https://www.nhs.uk/conditions/erection-problems-erectile-dysfunction/. Accessed: May 2023.
    7. Gil N. Erectile dysfunction: two women on what it did to their sex lives. 2019. Available at www.refinery29.com/en-gb/2019/04/227131/partner-has-erectile-dysfunction. Accessed: May 2023.
    8. Liu Q et al. J Sex Med 2018; 15(8): 1073–1082.
    9. Wagner G et al. Int J Impot Res 2000; 12(Suppl 4): S144–146.
    10. Goldstein I et al. Int J Clin Med 2021; 73(11): e13384.
    11. Pyke R. Sex Med Rev 2020; 8(2): 183–190.
    12. Yannas D et al. J Clin Med 2021; 10(10): 2221.
    13. Sahin MO et al. Int Braz J Urol 2020; 46(4): 642–648.
    14. Gerbild H et al. Sex Med 2018; 6(2): 75–89.
    15. Esposito K et al. JAMA 2004; 291(24): 2978–2982.
    16. Del Río F, Cabello F and Fernández I. Int J Health Psychol 2015; 15(1): 37–43.

    Reporting suspected adverse reactions after authorisation of the medicinal product is important. It allows continued monitoring of the benefit/risk balance of the medicinal product. Healthcare professionals are asked to report any suspected adverse reactions via the Yellow Card Scheme website www.mhra.gov.uk/yellowcard or search for MHRA Yellow Card in the Google Play or Apple App Store.