What should you know about sexual impotence?

Erections depend on blood flow, nerves, hormones, medicines, emotions and sexual stimulation. Problems may be occasional or persistent. Hypertension, type 2 diabetes, obesity, depression, smoking, alcohol and some prescriptions can contribute. Loss of libido may occur at the same time, but erectile difficulty and low desire are different concerns.

A change in erections can be an early reason to review cardiovascular and metabolic health. It does not establish a diagnosis on its own, and it is not a measure of masculinity or relationship commitment.

Book a GP consultation if the problem keeps happening, causes distress or appeared suddenly. The clinician may ask about erections during sleep or masturbation, desire, mood, relationships, medicines and alcohol, then check blood pressure and general health. A blood test or diabetes screening may be suggested when the history indicates it.

Treatment can include lifestyle changes, counselling when anxiety or depression is involved, and prescription medicines that improve penile blood flow. Do not buy unregulated tablets or combine erection medicines with nitrate medicines; tell the clinician about every prescription and supplement.

Seek urgent help for an erection that is painful or does not settle, chest pain during sexual activity, sudden neurological symptoms, or a serious allergic reaction after taking an erection medicine. Arrange prompt review for a sudden change after injury, severe pelvic pain, or symptoms of diabetes or vascular disease.

Ask what might be contributing, whether blood pressure or blood tests are appropriate, which treatments are safe with your medicines, and whether counselling could help. Mention depression, hypertension, obesity, type 2 diabetes, loss of libido and any recent prescription change.