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Erectile Dysfunction - Viagra, Sildenafil, Cialis, Tadalafil

Erectile Dysfunction Treatments

Erectile dysfunction (once known as impotence) affects an estimated 20% of British men. The good news is that if you are one of the 4.3 million men in the UK who finds it difficult to achieve or maintain an erection, there is no need to suffer in silence. Erectile dysfunction is an easily treatable condition and (depending on your choice of treatment) you should be able to enjoy a satisfying sex life within a couple of days. 

Prices from £20.99
(incl. prescription + next day delivery)

DoktorABC is the UK’s fastest growing prescription renewal service. We offer an inclusive service that includes an online consultation, prescription (subject to our GP’s approval) and your medication with free next day delivery. Simply complete a short online medical questionnaire, and our GP will immediately review your health profile. As soon as your order is approved your medication will be shipped via UPS courier. Our service is fast, convenient, and discreet.


What is erectile dysfunction?

Erectile dysfunction - Also known as impotence or ED 

If you are unable to achieve or maintain a satisfactory erection in most cases over a six month period, a doctor may diagnose erectile dysfunction. Erectile dysfunction is a medical condition where a man is unable to achieve a firm erection, or is unable to maintain an erection for long enough to have sex. This could be caused by stress, alcohol, tiredness, tension in a relationship, or simply by being with the wrong sexual partner.

Approximately 20% of UK men currently suffer from erectile dysfunction. It is estimated that most men will experience at least one incidence of ED during their lifetime. Fortunately, erectile dysfunction is easily treatable for the majority of men. 

Erectile dysfunction symptoms

There is some variation in erectile dysfunction symptoms, and these may affect your preferred treatment. They may also indicate wider physical or psychological health problems. 

Common ED symptoms

  • Complete inability to achieve any erection, either alone or with a partner. No spontaneous erections, early morning erections, or erections in your sleep. 

This is usually indicative of underlying physical problems, and you should immediately seek a full medical checkup.

  • Soft erections where penetration of the vagina is difficult and (if achieved) may be unsatisfying for both partners. 

This usually suggests a problem with blood flow, particularly if a soft erection occurs when you are sexually aroused and attempt to masturbate while alone.

  • The ability to achieve an erection when alone and aroused, but not with a sexual partner. 

This situation suggests underlying psychological issues. Treatment may include counselling, cognitive behavioural therapy, and a trial prescription for a light dosage of erectile dysfunction tablets.

  • The loss of an erection during sex

There may be either physical or psychological causes. Your GP will suggest a course of treatment. ED medication may help. 

  • Occasional impotence

If you are sometimes able to function normally, and are sometimes impotent, there could be a variety of causes, including stress and fatigue, or issues with your partner - as well as physical problems. Having a fast acting ED tablet available as needed may be beneficial. 

What causes erectile dysfunction?

Erectile dysfunction or impotence has two underlying causes; psychological problems and physical problems. Sometimes the two can overlap. Men who experience ED as a side effect of a physical problem, often develop depression, anxiety, or feelings of inadequacy as a consequence of being unable to achieve an erection and have sex. If communication with your partner is difficult, or your partner feels rejected by your inability to have sex, the problems may be compounded.

Psychological causes of erectile dysfunction

There can be many psychological causes of erectile dysfunction. These can range from temporary problems, to deep underlying issues like childhood sexual abuse, that need long-term treatment. Men who are willing to explore and deal with the psychological causes of impotence will usually be able to overcome their ED. 

If you experience any of the following problems, your erectile dysfunction could be psychological in origin. You may benefit from counselling and cognitive behaviour therapy, as well as a prescription medication for the treatment of erectile dysfunction. Men who undertake this treatment may also experience a wider improvement in self confidence and quality of life. 

  • Significant stress at work
  • Financial worries
  • Problems in your current relationship
  • Anxiety about your own body or sexual performance
  • Difficulties relating to women (or your preferred sexual partners)

Physical causes of erectile dysfunction

Men who’ve enjoyed a healthy sex life for years, and who have no obvious psychological issues, may suddenly find that they suffer from erectile dysfunction. This is particularly true for men over the age of 40. 

In these cases, the causes are usually physical in origin. Nonetheless, a sudden inability to achieve an erection can be deeply worrying and can also place a lot of strain on a relationship. 

The four major causes

Physical causes of erectile dysfunction can be divided into four main categories. 

  • Vasculogenic
  • Neurogenic
  • Hormonal
  • Anatomical


When a healthy man becomes sexually aroused, his penis fills with blood, becoming erect. To achieve an erection, the blood supply to your penis may have to increase by up to 40%. If you’re highly aroused, this can be almost instantaneous, and can result in a firm and long lasting erection. 

If you are suffering from a vasculogenic condition, the blood supply to your penis may be reduced or interrupted. Cardiovascular disease, high blood pressure and diabetes can all cause impotence or erectile dysfunction. 

Erectile dysfunction as a health warning

Illnesses like diabetes, high blood pressure, MS, Parkinson’s disease and cardiovascular disease that can cause erectile dysfunction are potentially fatal conditions. If you experience erectile dysfunction, it is highly recommended to get a full checkup with your GP as soon as possible. You shouldn’t be put off by embarrassment or shame, because most doctors are used to treating ED in men on a regular basis and will deal with you sympathetically. 


Neurogenic conditions are related to the central nervous system (brain, spinal cord, and nerves). Serious illnesses like multiple sclerosis and Parkinson’s disease can produce a range of unpleasant side effects, including erectile dysfunction. ED can often be managed by using erectile dysfunction tablets such as Viagra, Viagra Connect, or Sildenafil.

A stroke, spinal condition, or diabetes can also result in neurogenic erectile dysfunction. Men who suffer spinal injuries in traffic accidents, falls, or sports may also face erectile dysfunction. For a young, physically active man, this can be particularly difficult to deal with. 


Most people probably associate hormonal issues with women, but men may also be affected by changes in their hormonal balance. A change in hormone levels can sometimes result in impotence. If you are experiencing erectile dysfunction, your GP may check how your thyroid gland is functioning and may also check for Cushing’s syndrome or hypogonadism. You may be referred to an endocrinologist for specialist treatment. 


An injury or nerve damage to the penis or pelvic area, as well as conditions like Peyronie’s disease, or certain cancer treatments, can cause impotence. If you are suffering from any of these conditions it is very important to be open about them with your GP. 

Erectile dysfunction at a glance 

If you have any of the following medical conditions, they may be contributing to your erectile dysfunction.

Lifestyle related issues

  • Alcoholism or drug abuse
  • Smoking and tobacco use
  • Obesity
  • High cholesterol
  • Type 2 Diabetes
  • Lifestyle related fatigue

Some of these conditions may be side effects of other medical problems rather than poor lifestyle choices, but they can all be improved or ameliorated by leading a healthier lifestyle. 

Leading a healthier lifestyle may be the first step towards overcoming erectile dysfunction. Once you’ve overcome your ED, you may find that you begin to enjoy a better sex life as a result of being fitter and healthier. Your GP can give you specific advice about how to improve your general health. 

  • Give up smoking entirely
  • Reduce your alcohol intake to less than 14 units a week and don’t binge drink.
  • Lose weight if your doctor says that you are overweight
  • Avoid junk food and aim for healthy eating
  • Take regular physical exercise
  • Reduce stress and anxiety

These are long-term health solutions, but they may begin to deliver beneficial results in a surprisingly short time. 

Medical conditions and illnesses

  • Heart disease
  • Atherosclerosis
  • High blood pressure
  • Diabetes
  • Metabolic syndrome 
  • Parkinson's disease
  • Multiple sclerosis
  • Peyronie's disease 
  • Sleep disorders
  • Prostate cancer or enlarged prostate
  • Injuries to the pelvic area or spinal cord

Prescription medicines that can cause erectile dysfunction

There are certain prescription medicines whose side effects can cause erectile dysfunction. This may complicate how you manage your ED, but the problems can often be overcome. Your GP may change or reduce your prescription medication, or give you a prescription for a compatible erectile dysfunction pill. When you complete your online medical questionnaire it is extremely important that you mention any prescription medications that you are currently taking. 


Do not stop taking any prescription medication unless instructed to do so by a doctor. There are many possible solutions for the treatment of erectile dysfunction that your GP will be able to explore with you. You should not compromise your health in an attempt to find a short-term solution to ED.. 

Prescription medications for the following conditions may interfere with your ability to achieve a functioning erection. 

  • Diuretics – cause your body to increase the amount of urine it produces. Commonly used to treat high blood pressure, heart failure, and kidney problems
  • Antihypertensives – used to treat high blood pressure, e.g. beta-blockers
  • Fibrates – prescribed to decrease cholesterol levels
  • Antipsychotics – used for some mental health conditions, like schizophrenia
  • Antidepressants – prescribed to tackle depression or sometimes pain
  • Corticosteroids – contain steroids (these are a type of hormone)
  • Antagonists – for stomach ulcers
  • Anticonvulsants – prescribed to people with epilepsy
  • Antihistamines – used to manage allergies, like hay fever
  • Anti-androgens – suppress androgens (male sex hormones)
  • Cytotoxics – used in chemotherapy

A consultation with your GP will usually be enough to determine whether the cause of your erectile dysfunction is an underlying physical problem or illness. Your doctor will then be able to explain your options and discuss a treatment plan, usually involving a trial prescription for an erectile dysfunction medicine. 

Alcohol and erectile dysfunction medication

A lot of patients ask, “Can I take Viagra with alcohol?”. Taking Viagra (or any other ED medication) with excessive alcohol is generally not recommended. 

Erectile dysfunction treatments that use PDE - 5 inhibitors as active ingredients can act as hypertensives, meaning that they lower your blood pressure. Alcohol has a similar effect, and the combination of the two may result in side effects. 

Avoiding brewer’s droop

Alcohol also reduces the flow of blood to the penis. Most people have heard of ‘brewer’s droop’ a slang term for alcohol induced erectile dysfunction. Brewer’s droop is the traditional British euphemism for the difficulties encountered by men who have drunk too much beer prior to sex. It is a major cause of temporary erectile dysfunction in younger men. Drinking excessively may reduce your ability to gain an erection, even when you have taken an erectile dysfunction tablet. 

Alcohol and sex often go together, whether it involves a romantic glass of wine or a good night out. Many couples find that a few drinks reduce inhibitions and increase self confidence and spontaneity, as well as enhancing pleasure and excitement. If you want to combine alcohol and sex, it is generally recommended to do so in moderation. As a guideline, the government advises against drinking more than 14 units of alcohol in a single week and recommends spreading these units out over the course of the week. 

Erectile dysfunction treatments

Previous generations of men with erectile dysfunction or impotence generally suffered in silence. The condition was seen as embarrassing and shameful, and there were few effective treatments available. Erectile dysfunction sufferers were seen as inadequate men and were the subject of jokes and mockery. Many sufferers were drawn to quack cures and fake medications like ‘spanish fly’ usually bought via mail order. 

Erectile dysfunction was a tragic condition that could crush male self esteem, damage intimate relationships, and destroy patients’ quality of life. Fortunately, understanding of erectile dysfunction or impotence has been entirely transformed over the last few decades. 

Viagra - The accidental erectile dysfunction treatment

In 1989 US pharmaceutical company Pfizer was working to develop a treatment for heart-related chest pains. During clinical trials they quickly discovered that the active ingredient Sildenafil had some interesting - and unexpected - side effects. The most striking of these was patients’ ability to achieve firm and long lasting erections. The new medication was given the brand name Viagra and marketed as erectile dysfunction tablets. By 2016, Viagra was being prescribed to almost 3,000,000 UK men, according to The Guardian. 

The success of Viagra, and now its generics, has revolutionised how we view erectile dysfunction in men and brought the issue out into the open. Men may still feel embarrassment, but are willing to seek treatment and improve their lives. The internet offers a wealth of information and resources, as well as the chance to order prescriptions for erectile dysfunction treatments online.

The erectile dysfunction treatment revolution

The commercial success of Viagra sparked a revolution in research and development that led to the marketing of several new brands based on different PDE-5 inhibitors. The various brands all work to overcome ED by increasing the flow of blood to the penis, but have a range of durations, onset times and side effects. 

The Active Ingredient: PDE - 5 inhibitors 

(Phosphodiesterase type 5 inhibitors)

There are currently four main PDE - 5 inhibitors in use as the active ingredients of erectile dysfunction medication:

  • Sildenafil 
  • Tadalafil 
  • Vardenafil 
  • Avanafil

How do PDE - 5 inhibitors work?

In order to achieve an erection, the volume of the blood in the penis has to increase by up to 40%. When you become sexually aroused, the extra blood flows into the penis through its blood vessels. Once there, the blood needs to remain in place until you ejaculate. As soon as the blood flows back out you will lose your erection. 

When your body is functioning correctly, your body releases cGMP when you are sexually aroused. This enzyme helps dilate blood vessels and smoothen the muscles in the penis causing the corpora cavernosa (sponge like tissues of the penis) to fill with blood. It also prevents blood from flowing back out of the penis. 

The phosphodiesterase-5 enzyme (PDE-5) works to break down the cGMP when it is time for the erection to subside. If this enzyme is over-produced or released too realy, it interferes with sex. That’s where the PDE-5 inhibitors come in to do their job. 

What is the difference between generic and branded erectile dysfunction tablets?

Branded erectile dysfunction medications are simply the first medicine to have used a particular substance as an active ingredient. The parent company or manufacturer invested in research and development and testing and succeeded to obtain licensing and approval for the new medication.

Branded erectile dysfunction medications available at Doktor ABC include:

Each branded medication uses a specific PDE -5 inhibitor as an active ingredient.

Branded Medication Active Ingredient
Viagra Sildenafil
Viagra Connect Sildenafil
Cialis Tadalafil
Cialis Daily Tadalafil
Levitra  Vardenafil
Spedra Avanafil

Pharmaceutical companies usually file for a patent on their new medication. Nevertheless, they do not retain exclusive rights indefinitely. After 15 years, when the patent runs out, other companies are allowed to manufacture medications that use the same active ingredients as the branded medications. 

The new generic medications are basically a copy of the branded medication, but they use the name of the active ingredient as a brand name.

e.g. you could buy the branded medication Viagra (manufactured by Pfizer) or a generic version marketed under the name Sildenafil by rival companies, such as Teva and many others. 

  • Generic medications sold in the UK are subject to exactly the same licensing and regulation as branded medications.
  • Generic medications may be cheaper because the manufacturer did not have to invest in the R&D process, testing or initial marketing. 

Can I get ED medication on the NHS?

Various erectile dysfunction treatments are currently available on the NHS, but their availability is strictly limited to certain categories of patients, and the rules governing their prescription may be subject to change. Branded ED medications are only available in a limited number of circumstances. 

Patients with certain serious medical conditions may be entitled to NHS prescriptions for erectile dysfunction tablets. If you do not meet these criteria, you will have to pay a prescription charge and an additional charge for your GP to give you a private prescription. 

The following paragraph offers a comparison between the NHS and DoktorABC in terms of convenience and pricing. It is intended as a rough guide only:

Doktor ABC offers a full prescription renewal service that is obtained by completing a short online medical questionnaire (subject to immediate review by an online GP). There are no embarrassing face to face encounters, and your privacy and patient confidentiality are assured. 

To renew a Sildenafil prescription on the NHS you must make an appointment with your GP and visit the surgery for a consultation. You must then take your prescription to a chemist and collect your medication. 

According to the NHS website, a private prescription for 4 Sildenafil tablets will cost “around £20”*. DoktorABC offers an all inclusive prescription renewal service that includes your online consultation and prescription, the medication and next day delivery by UPS Express courier. You pay one price for all. Check prices here.

DoktorABC Timescale National Health Service Timescale
Short online medical questionnaire 2 minutes GP’s appointment Up to 2 weeks **
Review by online GP Immediate Surgery waiting room and GP consultation  Typically, up to 1 hour
Processing of approved prescriptions. Next day delivery by UPS courier. Trip to a local pharmacy Varies according to individual circumstances.

* The NHS website does not mention the dosage of the tablets. 

**According to a survey published in The Guardian

Unless you fall into certain specific patient categories 

The branded ED medicines Viagra, Cialis, Levitra and Spedra are only available on the NHS for people with ED who have or have had:

  • Diabetes
  • Multiple sclerosis (MS)
  • Parkinson's disease
  • Polio
  • Prostate cancer
  • Spina bifida
  • A spinal cord injury
  • Certain genetic conditions, such as Huntington's disease
  • Major pelvic surgery, such as surgery to remove tumours
  • Removal of the prostate (prostatectomy)
  • Dialysis or a kidney transplant for kidney failure 

They're also sometimes available on the NHS for men experiencing severe distress as a result of ED, but only after an assessment at a specialist centre.

How do I choose the right erectile dysfunction treatments?

There are several proven erectile dysfunction treatments on the market. Most men have heard of Viagra, but may be less familiar with other medications that use PDE-5 inhibitors. It’s important to choose the right medication. Our GP will evaluate your medical questionnaire carefully to make sure that you receive a safe and effective treatment that meets your individual health requirements. It may help if you also have some insight into the diagnostic process. 

Questions to ask yourself before requesting a specific erectile dysfunction treatment:

  • How often do I intend to have sex?
  • How long do I want each tablet to last for?
  • How many ED tablets do I need to order?
  • Do I prefer a branded erectile dysfunction medication or a generic medication?
  • Do I have underlying medical conditions that may affect my suitability? 
  • Are there indicators that I may suffer from side effects with a specific treatment?

If you are unable to answer the last two questions, our online questionnaire will help you focus on the information needed by the GP to evaluate your suitability. Our online GP will consider your preferences carefully when he or she evaluates your medical questionnaire and checks whether there are any health issues that may affect your treatment. 

What to consider when choosing a prescription service: 

  • Do I need my prescription urgently?
  • Will I need repeat prescriptions over a long period?
  • Is it convenient for me to see a GP and go to the chemists?
  • Am I putting off seeking treatment through shyness or embarrassment?
  • How important is discretion and privacy to me?

If you answered yes to any of the above questions, Doktor ABC can offer a fast, discreet and convenient prescription renewal service. All you have to do is complete a short online medical questionnaire in complete confidence. This will be immediately reviewed by one of our online GPs. Once your prescription is approved, your order will be sent for discreet next day delivery by UPS courier. Checkout prices include your prescription, medication, and delivery. 

Prices from £20.99
(incl. prescription + next day delivery)

Doktor ABC can also supply over the counter (non prescription) erectile dysfunction tablets like Viagra Connect with free next day delivery. 

Erectile dysfunction and age

Erectile dysfunction has traditionally been seen as an old man’s complaint, and it’s true that most patients are from the over 40 age group. As we age, we inevitably become more vulnerable to illness and our systems become less robust. However, there has been a significant increase in male life expectancy in the UK, as well as a revolution in health care over the previous decades. Men aren’t just living longer; they have much higher expectations about their quality of life. This often includes having an active sex life well into old age. 

While men over 40 may be naturally at risk of impotence and erectile dysfunction, their willingness to seek treatment has improved. Erectile dysfunction is now regarded as an easily treatable minor health problem rather than a secret curse. Even men in their 70s and 80s can often have full sex with the help of a low dosage of prescription erectile dysfunction tablets. 

Erectile dysfunction in your 20s

Men in their 20s are increasingly asking GPs for prescriptions for erectile dysfunction treatment. It’s hard to say whether the problem of erectile dysfunction in younger men has increased because previous generations may have been reluctant to seek help. If you suffer from erectile dysfunction in your 20s, the problems are more likely to be psychological in origin. 

Young men complain of being under greater pressure and of experiencing uncertainty and anxiety about their roles and identity. There may also be increasing issues with body image in young men, as well as unrealistic self-expectations about sexual performance. Erectile dysfunction in 20-somethings is usually treated by counselling, cognitive behavioural therapy - CBT - and a trial prescription of low dosage erectile dysfunction tablets. This should still be preceded by a full medical checkup to rule out any hidden physical problems.  

Possible erectile dysfunction cures

There are a number of other cures for erectile dysfunction or impotence. These range from medically recommended treatments to alternative therapies that have not yet been scientifically validated. 

If you suffer from certain medical conditions that make the use of a PDE-5 inhibitor based medication problematical, or you experienced unpleasant side effects from your erectile dysfunction tablets, you may benefit from trying a different ED cure. 

Vacuum pump 

Vacuum pumps for treating erectile dysfunction should not be confused with sex toys, or with similar devices that are fraudulently marketed as tools for increasing penis size. 

A vacuum pump is usually a simple mechanical pump consisting of a clear plastic tube and a hand or battery operated pumping device. Once you have inserted your penis into the tube, you pump out the air, creating a vacuum. The suction effect draws blood into your penis, causing a firm erection. If you immediately place a rubber ring around the base of your penis, you should be able to retain your erection for around half an hour and enjoy full sex. 

It takes a certain amount of practice to use a vacuum pump and rubber ring adeptly. Many couples find that the whole process of achieving an erection creates awkwardness and becomes a passion killer. Spontaneous sex can also be problematical. Vacuum pumps are unsuitable for people with bleeding disorders who are taking anticoagulant drugs. Vacuum pumps are reported to cause pain or even bruising in many users. 

Erectile dysfunction cream

A possible treatment for impotence is an erectile dysfunction cream like Vitaros which is currently available on prescription in the UK. Vitaros contains the active ingredient alprostadil, which is absorbed through the sensitive skin of the urethra and glans of the penis. Erectile dysfunction creams are applied into the opening of the urethra (the small hole that you urinate and ejaculate out of) using a special applicator device. 

The cream stimulates the flow of blood to the penis, allowing you to have normal sex. The effects of the cream may last for up to two hours. For certain types of sex, it may be necessary to use a condom, and both you and your partner may experience uncomfortable side effects from the cream. 

Foods for erectile dysfunction

There are no miracle diets or special foods for erectile dysfunction, although many websites use the subject as clickbait. There are certain foods that affect blood circulation, testosterone levels and sperm health, but there is no scientific evidence that eating them will cure erectile dysfunction. 

An improved diet may help you lose weight and be generally healthier, which in turn may improve your daily sense of well being, energy levels and mood. This can be important when you’re trying to overcome erectile dysfunction.

Erectile dysfunction exercises

There is some evidence that strengthening the muscle groups around the pelvic floor may help some patients with erectile dysfunction. Erectile dysfunction exercises are generally quite easy to perform at home and don’t need any special equipment. They may be useful as part of a wider holistic approach to ED treatment - and can help with certain other genito-urinary conditions - but are not a cure for erectile dysfunction. 

Fraudulent cures for erectile dysfunction

Fraudulent cures and quack medicines for erectile dysfunction have been offered to the gullible and the desperate for thousands of years. Modern versions of fake cures include so called ‘herbal supplements’, and fake copies of branded or generic ED medications. These are mostly sold online and often make false claims about their efficacy or are sold at ‘discount prices’. 

Some fake cures may contain small amounts of PDE -5 inhibitors taken from genuine prescription medications or may even contain harmful ingredients. 

How to avoid fake cures for erectile dysfunction

Always ensure that you buy your ED medications from a trusted supplier. Doktor ABC’s online prescription renewal service regulated by the General Pharmaceutical Council (GPhC), and is approved and monitored by the US company LegitScript. All medications are originals and are manufactured in the UK.

Our Service in 3 Simple Steps

1. Start your order

Complete a simple online health questionnaire

2. Select preferred treatment

Our GP will issue your prescription, if the medication is safe for you

3. Next day delivery

You will receive your medication the next day

Start your order

Complete a simple online health questionnaire

Select preferred treatment

Our GP will issue your prescription, if the medication is safe for you

Next day delivery

You will receive your medication the next day