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Here’s the breakdown of what happens in your body to get the blood flowing again:1
Stimulation increases blood flow
Arousal triggers cGMP, a molecule that boosts blood flow to the penis and helps you get an erection.
Limited blood flow stops an erection
In people with ED, an enzyme called PDE5 breaks down cGMP too quickly, reducing blood flow and causing the erection to fade.
Medication promotes a firmer erection
ED treatments block PDE5, helping more blood reach the penis. This leads to firmer, longer-lasting erections.
You’ll be assessed by our UK-based clinicians via a simple consultation.
Your medication will be delivered swiftly in unmarked packaging. Repeat prescriptions keep you topped up, and you can switch any time if you wish to try alternative treatments.
We’re with you throughout your journey, helping you navigate, understand, and treat the root cause of your ED.
That awkward moment in bed? It’s not just performance anxiety. It could be your first warning sign. Heart disease. Diabetes. Low testosterone. All hiding in plain sight.
This isn’t just about sex. It’s about your health. Call it what it is: the canary in your boxers.
Erectile dysfunction is the ongoing inability to get or keep an erection firm enough for sex. It can be caused by physical issues (like poor blood flow, nerve damage, or low testosterone), psychological factors (such as stress or anxiety), or lifestyle habits (like smoking or alcohol use).
The primary symptom of ED is:17
Inability to achieve or maintain an erection sufficient for penetrative sex.
This may present in various ways, including:
Difficulty achieving an erection at all
Erections that are not firm enough for intercourse
Erections that do not last long enough to complete sexual activity
Loss of erection during foreplay or penetration
Decreased frequency or absence of morning or spontaneous erections
In some men, erection problems come on slowly over time, while for others, they happen quite suddenly. If you’re still getting erections during sleep or when masturbating, it might point to stress or anxiety as the cause. But if things have gradually declined, it could be linked to an underlying health issue like diabetes, heart problems, or hormone changes.17
1. Dhaliwal A, Gupta M. PDE5 inhibitors. In: StatPearls. Treasure Island (FL): StatPearls Publishing; 2025.
2. Hackett G, Kirby M, the British Society for Sexual Medicine (BSSM). A practical guide to the assessment and management of testosterone deficiency in adult men. Trends in Urology & Men s Health. 2023;14(3): 21–25.
3. Andre B. Araujo, Gretchen R. Esche, et al. Prevalence of Symptomatic Androgen Deficiency in Men, The Journal of Clinical Endocrinology & Metabolism, Volume 92, Issue 11, 1 November 2007, Pages 4241–4247
4. Panuganti KK, Nguyen M, Kshirsagar RK. Obesity. In: StatPearls. Treasure Island (FL): StatPearls Publishing; 2025.
5. Liu Y, Hu X, Xiong M, Li J, Jiang X, Wan Y, et al. Association of BMI with erectile dysfunction: A cross-sectional study of men from an andrology clinic. Frontiers in endocrinology.
6. Olinic DM, Stanek A. Vascular diseases: Etiologic, diagnostic, prognostic, and therapeutic research. Life (Basel, Switzerland). 2023;13(5).
7. Tsujimura A, Hiramatsu I, Aoki Y, Shimoyama H, Mizuno T, Nozaki T, et al. Atherosclerosis is associated with erectile function and lower urinary tract symptoms, especially nocturia, in middle-aged men. Prostate international. 2017;5(2): 65–69. https://doi.org/10.1016/j.prnil.2017.01.006.
8. Sapra A, Bhandari P. Diabetes. In: StatPearls. Treasure Island (FL): StatPearls Publishing; 2025.
9. Kitaw TA, Abate BB, Tilahun BD, Yilak G, Rede MB, Getie A, et al. The global burden of erectile dysfunction and its associated risk factors in diabetic patients: an umbrella reviews. BMC Public Health. 2024;24(1).
10. Defeudis G, Mazzilli R, Tenuta M, Rossini G, Zamponi V, Olana S, et al. Erectile dysfunction and diabetes: A melting pot of circumstances and treatments. Diabetes/metabolism research and reviews. 2022;38(2): e3494.
11. Diabetes and sexual problems – in men. Diabetes UK. https://www.diabetes.org.uk/about-diabetes/looking-after-diabetes/complications/sexual-problems-men [Accessed 17th July 2025].
12. Gessl A, Lemmens-Gruber R, Kautzky-Willer A. Thyroid disorders. Handbook of experimental pharmacology. 2012;(214): 361–386.
13. Salari N, Fattahi N, Abdolmaleki A, Heidarian P, Shohaimi S, Mohammadi M. The global prevalence of sexual dysfunction in men with thyroid gland disorders: a systematic review and meta-analysis. Journal of diabetes and metabolic disorders. 2024;23(1): 395–403.
14. Seidman SN. Exploring the relationship between depression and erectile dysfunction in aging men. The journal of clinical psychiatry. 2002;63 Suppl 5: 5–12; discussion 23-5.
15. Velurajah R, Brunckhorst O, Waqar M, McMullen I, Ahmed K. Erectile dysfunction in patients with anxiety disorders: a systematic review. International journal of impotence research. 2022;34(2): 177–186.
16. Men admit to avoiding sex due to performance anxiety. Onebright. https://onebright.com/advice-hub/news/almost-60-of-men-avoid-sex-due-to-performance-anxiety/ [Accessed 17th July 2025]
17. Leslie SW, Sooriyamoorthy T. Erectile dysfunction. In: StatPearls. Treasure Island (FL): StatPearls Publishing; 2025.
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