Erectile Dysfunction: When to See a Private GP in Birmingham
Erectile difficulties are far more common than many men realise. Having difficulty getting or maintaining an erection occasionally does not necessarily mean something is wrong. Stress, tiredness, alcohol, anxiety or simply having an off day can all temporarily affect sexual performance.
Persistent erectile dysfunction can sometimes be associated with underlying issues such as high blood pressure, high cholesterol, diabetes, hormonal changes, medication or mental health. For that reason, speaking to a doctor is not simply about improving your sex life. It can also provide an opportunity to check your wider health.
The NHS recommends seeing a GP or sexual health clinician when erection problems repeatedly occur, because an underlying health condition may be contributing.
At Complete Clinical Care in Edgbaston, Birmingham, men can discuss erectile difficulties confidentially as part of a private men's health consultation. Your clinician can review your symptoms, medication, lifestyle and wider health before deciding whether blood testing, treatment or specialist referral is appropriate.
This guide explains what erectile dysfunction is, when occasional problems become worth investigating, what your GP may check and what treatment options may be available.
Key Takeaways
Occasional erection difficulties are common and can be caused by stress, tiredness or alcohol.
If erectile problems keep happening, it is worth discussing them with a GP.
Erectile dysfunction can have physical, psychological or mixed causes.
Conditions such as diabetes, high blood pressure and high cholesterol can contribute to erectile difficulties.
Persistent erectile dysfunction can sometimes be associated with increased cardiovascular risk.
Low testosterone can contribute in some men, but erectile dysfunction does not automatically mean your testosterone is low.
Your assessment may include blood pressure, cardiovascular risk factors, medication review and personalised blood testing.
Effective treatments are available, but the right treatment depends on the underlying cause.
Medicines such as sildenafil are not suitable for everybody and must not be combined with nitrate medication.
A painful erection lasting more than three to four hours requires emergency medical treatment.
What Is Erectile Dysfunction?
Erectile dysfunction — often shortened to ED — means repeatedly having difficulty getting an erection or maintaining one for long enough to have satisfactory sexual activity.
It used to be commonly referred to as impotence, although erectile dysfunction is now the preferred medical term.
The British Association of Urological Surgeons defines erectile dysfunction as an inability to obtain or maintain an erection sufficient for satisfactory sexual activity.
That does not mean every occasion when an erection does not happen represents erectile dysfunction and most men will experience erection difficulties at some point.
There is an important difference between:
“It happened once after a stressful week.”
and:
“This has been happening repeatedly for the last few months.”
The second scenario is where a medical assessment can help get to the route of the problem.
Erectile Dysfunction Can Look Different for Different Men
You may be able to get an erection but struggle to maintain it.
You may find erections are less firm than they previously were.
You may have no difficulty during masturbation but experience problems during partnered sex.
You may still wake with normal morning erections.
Or you may notice erections have become more difficult in every situation.
The time, frequency and surrounding circumstances can give your doctor clues about possible physical and psychological contributors.
When Should You See a Doctor?
The NHS advises speaking to a GP or sexual health clinic when erection problems keep happening. You absolutely do not need to wait until you are completely unable to achieve an erection to get checked out.
Consider making an appointment if:
Erectile difficulties have become recurrent
Erections are consistently less firm
You repeatedly lose your erection during sexual activity
The problem has continued for several weeks or months
Your sex drive has also changed
You are experiencing fatigue or other hormonal symptoms
You have noticed changes in your morning erections
You have diabetes or cardiovascular risk factors
You recently started a new medication
The problem is affecting your confidence or relationship
You are worried about what might be causing it
There is also no minimum age at which erectile dysfunction becomes worth discussing - although ED becomes more common as men get older, persistent erection problems should not simply be dismissed as an inevitable part of ageing.
You Do Not Need to Be Embarrassed
For many men, the hardest part of the appointment is booking it. Sexual-health concerns can feel awkward to discuss, particularly if you have never spoken to a doctor about them before.
But from a clinician's perspective, erectile dysfunction is a common medical problem.
You are not being judged and do not feel you need to provide graphic detail of your symptoms. The doctor simply needs enough information to understand what is happening and whether there may be an underlying cause.
What Can Cause Erectile Dysfunction?
An erection depends on several systems working together. The brain, hormones, nerves, blood vessels and emotional state all play a role, so erectile dysfunction can have many different causes.
Cardiovascular and Metabolic Causes
Conditions affecting blood vessels can make it more difficult for sufficient blood to reach the penis.
These include:
High blood pressure
High cholesterol
Diabetes
Cardiovascular disease
Obesity
Smoking
The NHS specifically identifies high blood pressure, high cholesterol and diabetes among health conditions that can cause recurrent erectile dysfunction.
Hormonal Causes
Hormone problems can also contribute.
Low testosterone may be associated with:
Reduced libido
Lower energy
Fewer morning erections
Erectile difficulties
Reduced strength
Changes in mood
However, erectile dysfunction on its own does not prove that testosterone is low.
Thyroid problems and other hormonal conditions can also sometimes affect sexual function.
Medication
Certain medicines can contribute to erectile difficulties.
Examples can include some treatments for:
High blood pressure
Depression
Anxiety
Prostate conditions
Hormonal disorders
Do not stop prescribed medication yourself because you think it may be responsible. Your doctor can review your medicines and decide whether an alternative could be appropriate.
Psychological Factors
Sexual function is extremely sensitive to what is happening psychologically.
Potential contributors include:
Stress
Performance anxiety
Depression
Relationship difficulties
Low confidence
Previous negative sexual experiences
Sometimes an initial physical problem creates anxiety about whether it will happen again.
That anxiety then makes the next erection more difficult, which can cause a frustrating cycle to develop surprisingly quickly.
Lifestyle Factors
Erectile function can also be affected by:
Poor sleep
Heavy alcohol consumption
Smoking
Recreational drugs
Physical inactivity
Chronic stress
Often there is not one single cause - you may have mild cardiovascular risk factors, poor sleep and increasing performance anxiety all contributing at the same time.
Can Erectile Dysfunction Be a Sign of Heart Disease?
Problems affecting vascular health can sometimes become apparent through erectile difficulties as the strength of an erection is affected by the health of the blood vessels in the penis.
The British Association of Urological Surgeons notes that erectile dysfunction can be associated with illnesses including heart disease and diabetes and recommends seeking medical advice rather than simply ignoring persistent symptoms.
NICE cardiovascular guidance also specifically includes erectile dysfunction as a factor within the QRISK3 cardiovascular risk calculator.
That does not mean:
“Erectile dysfunction means you have heart disease.”
It means:
“Persistent erectile dysfunction can provide a useful reason to check your cardiovascular risk.”
What Might Your Doctor Check?
Depending on your age and medical history, this could include:
Blood pressure
Cholesterol
Smoking history
Diabetes risk
Weight and waist measurement
Family history
Physical activity
Cardiovascular symptoms
For some men, an appointment originally booked because of erectile difficulties becomes a valuable opportunity to identify cardiovascular or metabolic risk factors earlier.
Is Low Testosterone Causing Your Erectile Problems?
Possibly — but not necessarily.
There is a tendency online to treat erectile dysfunction as evidence of low testosterone, but the correlation between testosterone, your overall hormone balance and erections.
Testosterone plays an important role in sexual desire but is not the only factor involved. Men with genuine testosterone deficiency may experience reduced libido, fewer spontaneous erections and erectile difficulties, however, it is also true that many men with erectile dysfunction have normal testosterone levels. So low testosterone is not an automatic cause of ED.
A testosterone test is more likely to be useful when erectile problems occur alongside symptoms such as:
Reduced sex drive
Persistent fatigue
Fewer morning erections
Reduced strength
Changes in muscle mass
Low mood
Reduced motivation
Complete Clinical Care's men's health service assesses erectile difficulties alongside symptoms, medical history and wider health rather than assuming hormone deficiency is responsible.
Where hormone testing is clinically appropriate, your doctor may look at testosterone alongside related markers rather than interpreting one number in isolation.
What Happens at a Private GP Appointment?
The first part of the appointment is usually a conversation.
Your doctor may ask:
When did the problem start?
Did it begin suddenly or gradually?
Does it happen every time?
Can you achieve an erection during masturbation?
Do you still have morning erections?
Has your libido changed?
Are you experiencing urinary symptoms?
Are there any relationship or psychological factors?
What medication do you take?
How much alcohol do you drink?
Do you smoke?
Do you have diabetes, high blood pressure or high cholesterol?
Some questions can feel personal but there is always a clinical reason for asking them.
For example, being able to achieve normal morning erections but experiencing difficulty specifically during sexual activity may lead the clinician to consider a different mix of possible causes than if erections have disappeared in every situation.
Basic Health Checks
The NHS notes that an erectile-dysfunction consultation can include checks such as blood pressure alongside assessment of lifestyle and relationship factors.
Depending on your history, a private GP may therefore check:
Blood pressure
Heart rate
Weight
BMI
Cardiovascular risk
A genital examination is not required in every case.
If one is clinically appropriate, your doctor should explain why beforehand.
What Tests Might Your Doctor Recommend?
Not every man with erectile dysfunction requires an extensive blood panel. Testing is selected and advised based on your symptoms, age and medical history.
Possible investigations include:
Diabetes Testing
Diabetes can damage both blood vessels and nerves involved in erections.
Your clinician may therefore consider:
HbA1c
Blood glucose
This can be particularly relevant if you also have symptoms such as increased thirst, frequent urination or a family history of diabetes.
Cholesterol
Because erectile dysfunction can be associated with vascular health, cholesterol testing may form part of a cardiovascular risk assessment.
This may include:
Total cholesterol
LDL cholesterol
HDL cholesterol
Triglycerides
Non-HDL cholesterol
Testosterone
If your symptoms suggest hormone deficiency, a morning testosterone test may be recommended.
Testing might include:
Total testosterone
SHBG
Calculated free testosterone
LH
FSH
Prolactin
Not every man requires all of these markers.
The appropriate tests depend on your clinical picture.
Other Blood Tests
Depending on your symptoms, your clinician might also consider:
Thyroid function
Full blood count
Liver function
Kidney function
Iron or ferritin
Other metabolic markers
Complete Clinical Care provides personalised blood testing, allowing biomarkers to be selected around the symptoms being investigated rather than automatically using the same panel for every patient.
How Is Erectile Dysfunction Treated?
Addressing Underlying Health Problems
The most important treatment may sometimes be improving the condition contributing to the erectile dysfunction.
That could mean improving:
Blood pressure
Diabetes control
Cholesterol
Weight
Sleep
Physical activity
Smoking cessation and reducing excessive alcohol can also benefit overall cardiovascular and sexual health.
The NHS recommends measures including regular exercise, stopping smoking, a healthy diet, reducing stress and managing excess weight where relevant.
Reviewing Medication
If a medicine could be contributing to your symptoms, your clinician can review whether another option is appropriate.
Do not stop treatment without discussing it first.
PDE-5 Inhibitors
The main medicines used for erectile dysfunction are called PDE-5 inhibitors.
These include:
Sildenafil
Tadalafil
Vardenafil
Avanafil
They work by improving blood flow to the penis when sexual stimulation occurs.
The NHS identifies PDE-5 inhibitors as the main medicines used to treat erectile dysfunction.
However, they are not appropriate for everyone.
Why Your Medication History Matters
Sildenafil and similar medicines must not be combined with nitrate medicines or nitric-oxide donors because the combination can cause a potentially dangerous fall in blood pressure.
That is one reason why getting erectile-dysfunction medication through a proper clinical assessment is safer than simply buying tablets from an unknown website.
Your doctor needs to know about your cardiovascular history and existing medication before deciding whether treatment is appropriate.
Other Treatment Options
If tablets are unsuitable or ineffective, specialist treatments can include:
Vacuum erection devices
Alprostadil preparations
Penile injections
Specialist psychological or psychosexual therapy
Urological treatment
The appropriate option depends on the underlying cause and how you respond to first-line treatment.
What If Anxiety or Stress Is Part of the Problem?
Psychological causes are extremely common. Anxiety activates the body's stress response — almost the opposite physiological state required for relaxed sexual arousal. As erections depend heavily on your nervous system, anxiety can inhibit them from occurring. Over time this can develop into a cycle of performance induced anxiety.
For example:
You experience difficulty once.
↓
You worry it will happen again.
↓
You monitor whether you are becoming erect.
↓
Anxiety increases.
↓
Achieving an erection becomes more difficult.
↓
The next sexual encounter carries even more pressure.
If anxiety, depression, relationship problems or stress appear to be significant contributors, your doctor may discuss psychological or psychosexual support alongside medical treatment.
When Might You Need a Specialist Referral?
Many cases of erectile dysfunction can initially be assessed and managed by a GP.
However, specialist input may be useful when:
First-line treatments do not work
The diagnosis is unclear
There are abnormalities on examination
You have significant penile curvature or pain
Hormonal abnormalities require specialist assessment
There are fertility concerns
You have significant urinary symptoms
A neurological cause is suspected
You require treatment beyond oral medication
A urologist or andrologist specialises in male reproductive and sexual-health problems.
Here at Complete Clinical Care, appropriate investigations can be arranged following your assessment, and we can refer patients onward when specialist assessment or treatment is needed.
When Is an Erection Problem an Emergency?
Ordinary erectile dysfunction is not normally an emergency, but there is one important condition to recognise:
Priapism
Priapism is a prolonged erection that does not go away and is often painful.
This is different from erectile dysfunction.
An erection lasting more than three to four hours requires emergency medical attention because prolonged priapism can permanently damage penile tissue.
The NHS advises calling 999 or attending A&E for an erection lasting more than three to four hours. Do not book a routine GP appointment and wait. You need to seek emergency care immediately.
Private Erectile Dysfunction Assessment at Complete Clinical Care
Complete Clinical Care provides private men's health consultations from its clinic at 38 Harborne Road, Edgbaston, Birmingham, B15 3EB.
The men's health service includes confidential support for:
Erectile difficulties
Changes in libido
Hormone concerns
Low energy
Urinary symptoms
Preventative men's health
Personalised blood testing
Men's health consultations currently cost £99.
What Happens During Your Appointment?
Discussing your symptoms
When the problem started, how frequently it happens and whether anything appears to trigger it.
Reviewing your medical history
Including cardiovascular health, diabetes, previous diagnoses and relevant family history.
Reviewing medication and lifestyle
Including prescription medicines, smoking, alcohol, sleep, exercise and stress.
Considering hormone health
Particularly when erectile problems are accompanied by reduced libido, fatigue or other symptoms that could justify testosterone testing.
Checking wider health risks
Blood pressure, diabetes, cholesterol and cardiovascular risk may be relevant depending on your circumstances.
Arranging investigations
Personalised blood tests or other investigations can be organised when clinically appropriate.
Agreeing treatment or referral
Your GP can discuss appropriate treatment and refer you for specialist assessment when required.
At Complete Clinical Care, our men's health service is discreet and supportive. We provide an environment where erectile, libido and urinary concerns can be discussed confidentially and assessed alongside a patient's wider health.
Erectile Dysfunction Is Worth Talking About
Erectile problems can feel incredibly personal which can make them very easy to hide.
But persistent erectile dysfunction deserves the same approach as any other ongoing health symptom: work out why it is happening and decide what to do next.
If erection difficulties keep happening or are beginning to affect your confidence, relationship or wellbeing, booking a private GP appointment in Birmingham can be a straightforward first step towards getting answers.
Frequently Asked Questions
When should I see a doctor about erectile dysfunction?
You should consider seeing a GP if difficulty getting or maintaining an erection keeps happening. Occasional erection problems associated with tiredness, stress or alcohol are common, but recurring ED can sometimes be associated with an underlying health condition.
Is erectile dysfunction normal as you get older?
Erectile dysfunction becomes more common with age, but persistent problems should not automatically be dismissed as normal ageing. Treatable cardiovascular, metabolic, hormonal, psychological and medication-related factors may be contributing.
Can erectile dysfunction be a sign of heart problems?
It can sometimes be associated with cardiovascular disease because erection quality depends partly on healthy blood vessels. NICE's QRISK3 cardiovascular assessment specifically includes erectile dysfunction as a risk factor.
Does erectile dysfunction mean I have low testosterone?
No. Low testosterone can contribute to erectile problems, particularly when there is also reduced libido, fatigue or fewer spontaneous erections, but many men with erectile dysfunction have normal testosterone levels.
What blood tests are used for erectile dysfunction?
Testing depends on your symptoms and medical history. Your GP may consider HbA1c or glucose for diabetes, cholesterol for cardiovascular risk, testosterone where hormone deficiency is suspected, and other tests such as thyroid function where clinically appropriate.
Can stress cause erectile dysfunction?
Yes. Stress, anxiety, depression and relationship difficulties can all affect erections. Physical and psychological causes can also occur together.
Can a private GP prescribe Viagra or sildenafil?
A private GP can prescribe erectile-dysfunction medication when it is clinically appropriate and safe for you. Sildenafil is one of the PDE-5 inhibitors commonly used to treat erectile dysfunction.
Is sildenafil safe for everyone?
No. Your medical history and medication need to be reviewed first. Sildenafil must not be combined with nitrate medicines or nitric-oxide donors because this can cause a dangerous reduction in blood pressure.
What if sildenafil does not work?
Your clinician can review whether the medicine was used correctly, consider alternative PDE-5 inhibitors and reassess the underlying cause. If oral treatment remains ineffective, specialist options such as vacuum devices, alprostadil or other treatments may be considered.
Is erectile dysfunction confidential?
Yes. Erectile and sexual-health concerns can be discussed confidentially with your healthcare professional. We specifically provides discreet support for intimate men's health concerns including erectile difficulties and libido changes.
How much is a men's health consultation at Complete Clinical Care?
Our private men's health consultation at £99. Additional investigations such as blood testing may carry separate fees depending on what your clinician recommends.
Where can I see a private GP about erectile dysfunction in Birmingham?
The Complete Clinical Care clinic is based at 38 Harborne Road, Edgbaston, Birmingham, B15 3EB. Erectile difficulties can be discussed as part of our men’s health consultations.
Interested in booking an appointment? You can book with us here
