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Erectile dysfunction (impotence)

Erection problems (impotence) are very common, particularly in men over 40. It's usually nothing to worry about, but you should see your GP if it keeps happening.

Causes of erection problems

Most men occasionally fail to get or keep an erection.

It can be caused by:

  • stress
  • tiredness
  • anxiety
  • drinking too much alcohol

If it happens more often, it may be caused by some physical diseases, for example diabetes or some mental health problems.

See your GP or go to a sexual health clinic if erection problems keep happening. It could be a sign of an underlying health condition.

Diagnosing erectile dysfunction

Speak to your GP if you are having erection problems. They will carry out checks and tests.

What happens at your appointment

The doctor or nurse will ask about your lifestyle and relationships, and any problems you might be having.

They'll carry out basic health checks, such as taking your blood pressure.

They'll also examine your genitals to rule out any obvious physical cause.

If you have symptoms like needing to pee more often, your GP may also need to examine your prostate.

They might have to examine your bottom (rectal examination).

Treatment for erection problems

There are specific treatments for some of the causes of erectile dysfunction.

Possible cause Treatment
Possible cause Narrowing of penis blood vessels, high blood pressure, high cholesterol Treatment Medicine to lower blood pressure, statins to lower cholesterol
Possible cause Hormone problems Treatment Hormone replacement (for example, testosterone)
Possible cause Side effects of prescribed medication Treatment Change to medicine after discussion with GP

Medicine called PDE5 inhibitors are often used to treat erectile dysfunction.

Things you can do to help with erectile dysfunction

Healthy lifestyle changes can sometimes help erectile dysfunction.



  • do not cycle for a while  – cycling can damage nerves and compress arteries in the penis if you cycle for more than 3 hours a week

  • do not drink more than 17 standard drinks a week

Vacuum pumps

Vacuum pumps encourage blood to flow to the penis, causing an erection.

They work for most men and can be used if medicine is not suitable.

Speak to your GP about where to get one.

Emotional (psychological) problems

It's more likely to be an emotional problem if you only have erection problems some of the time. For example, you still get erections in the mornings, but not during sexual activity.

Anxiety and depression can be treated with counselling and cognitive behavioural therapy (CBT).

A GP might recommend sex therapy. This could be on its own or in combination with other psychotherapy.

Read more about talking therapies

Content supplied by the NHS and adapted for Ireland by the HSE

Page last reviewed: 22 March 2021
Next review due: 22 March 2024

This project has received funding from the Government of Ireland’s Sláintecare Integration Fund 2019 under Grant Agreement Number 123.