Erection Problems: A Part of Life

If you can’t get or keep an erection hard enough for sex, you may be experiencing erection problems. Doctors often refer to this as erectile dysfunction (ED). Erection problems and erectile dysfunction mean the same thing.

Erection problems can happen in different ways

Some men:

Don't get an erection at all
Get an erection that isn't firm enough for sex
Get an erection, but can't keep it long enough for sex

For some men, erection problems happen every time they try to have sex. For others, erectile dysfunction only happens occasionally.

An estimated 15 million men in the UK experience erection problems¹, but many men stay silent and avoid talking about it, sometimes for years. The good news is that erectile dysfunction is common and treatment can be successful in most cases.

How does an erection happen?

An erection starts in the brain. When you become sexually aroused, your brain sends signals through your nervous system to the blood vessels in your penis. These signals cause the smooth muscle tissue in the penis to relax, allowing blood to flow into two spongy chambers called the corpora cavernosa. As these chambers fill with blood, the penis becomes firm and erect.

To get and maintain an erection, several things need to work together properly, including:

Healthy blood flow
Functioning nerves
Balanced hormone levels
A mind that is not overwhelmed by stress or anxiety

If any part of this process is disrupted, erection problems or erectile dysfunction can happen.

What causes erectile dysfunction?

Erectile dysfunction is not a single condition with one specific cause. Erection problems can happen for physical reasons, psychological reasons or a combination of both.

Physical causes of erection problems

Physical causes are the most common reason for erectile dysfunction. Common causes include:

Heart disease and narrowed arteries - Reduced blood flow can make it harder to get or keep an erection.
High blood pressure - Damage to blood vessels over time can restrict blood flow to the penis.
Diabetes - High blood sugar levels can damage nerves and blood vessels involved in erections
Hormone imbalances - Low testosterone may affect sex drive and erections.

Certain medications - Some antidepressants, beta-blockers and some H2 blockers such as ranitidine and cimetidine may cause erection problems as a side effect.

Psychological factors cause erection problems image

Can psychological factors cause erection problems?

Yes. Psychological factors can cause erectile dysfunction or make existing erection problems worse.

Anxiety is one of the most common causes. After experiencing erection problems once, it is natural to worry about it happening again. This is known as performance anxiety, and it can make erections more difficult.

Stress from work, finances, relationships or everyday life can also affect the signals between the brain and body that are needed for an erection.

Depression can reduce sexual desire and affect physical function. Some antidepressant medications may also contribute to erectile dysfunction. Relationship difficulties, communication problems and low confidence can all play a role in erectile problems too.

Is erectile dysfunction permanent?

In many cases, erectile dysfunction is treatable, and improvement is possible. The right treatment depends on the underlying cause of the erection problems.

Treatment options may include:

Erectile dysfunction treatments such as Viagra Connect^® tablets, Viagra Connect^® Melts or Avarante^®
Lifestyle changes, including stopping smoking, exercising more and maintaining a healthy weight
Managing underlying health conditions such as diabetes or high blood pressure
Support for stress, anxiety or relationship difficulties

These treatments help support the blood flow needed to achieve and maintain an erection when sexually aroused.

When should you speak to a doctor about erection problems?

You should speak to your GP if your erection problems are persistent, becoming more frequent or are accompanied by other symptoms such as pain, changes in urination or reduced sexual desire.

Erectile dysfunction can sometimes be an early sign of other health conditions, including cardiovascular disease, so it is important to get checked even if you otherwise feel well.

¹Based on 45% of UK men self-identifying as having an erection problem (Toluna, Viagra Connect research UK, July 2025; n=3000), applied to UK male population (~33.1 million; ONS)

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