Erectile dysfunction: what it may reveal about your health
Medical guide on causes, assessment, treatments and warning signs of erectile dysfunction.
The essentials in less than a minute
- Erectile dysfunction is common and can have vascular, metabolic, hormonal, neurological, pharmacological or psychological causes.
- It is not advisable to choose sildenafil or tadalafil only for duration: you must first review medication, cardiovascular health and possible contraindications.
- PDE5 inhibitors are first-line treatment in many people, but should not be combined with nitrates.
- A persistent problem deserves evaluation; There is no need to wait for it to seriously affect your relationship or self-esteem.
What is it and when does it stop being something specific?
Having isolated difficulty getting or maintaining an erection does not necessarily equate to a disease. Tiredness, stress, alcohol, a new situation or concern about “performing” can play a role. We speak of erectile dysfunction when the difficulty is repeated and affects satisfactory sexual activity.
Erection depends on blood vessels, nerves, hormones, sexual stimulation and emotional context. That is why the consultation should not be limited to asking for a pill: a good assessment tries to understand what part of the system may be failing.
What the doctor checks
The clinical history usually includes onset and progression, spontaneous erections, sexual desire, pain or curvature, usual treatments, alcohol or tobacco consumption, and relationship with stress or mood. Hypertension, diabetes, cholesterol, obesity, sleep apnea and cardiovascular history also matter.
| Area | Why it matters |
|---|---|
| Gradual or sudden onset | Helps distinguish organic, situational or mixed patterns. |
| Medication | Some antihypertensive drugs, psychotropic drugs and other treatments can influence. |
| Physical exertion and cardiac symptoms | It allows us to assess whether sexual activity and treatment are safe. |
| Craving and hormonal symptoms | A decrease in desire is not always explained by the erection mechanism. |
Treatments: there is no universal option
European guidelines recommend addressing habits and risk factors along with treatment. PDE5 inhibitors—including sildenafil and tadalafil—are a first-line option for many people. They need sexual stimulation and their response depends on the pattern, the moment, the food in some cases and the cause of the problem.
Dangerous combination
Erection medications should not be combined with nitrates used for angina. If there is chest pain, fainting or shortness of breath, seek urgent care and explain what medication has been taken.
When to ask for help
It is advisable to consult if the problem persists, appears with less effort than before, is associated with loss of desire, curvature, pain or urinary symptoms, or if diabetes or cardiovascular disease exists. A painful erection that lasts several hours requires urgent attention.
The online consultation can be useful for a first assessment and to decide if the treatment is appropriate or if an examination, blood tests or an in-person review is necessary. A prescription should never be automatic.
Medically reviewed by Dr Paola Blanco
Medical reviewer for Costa Medical Services. Clinical coherence, safety and source quality reviewed.
✓ Spanish medical registration 292891820 · Review August 30, 2026
Official and clinical sources
- EAU Guidelines: Management of Erectile Dysfunction
- AEMPS · CIMA, official information on medications
Regulatory information may change. Before publishing in WordPress, you should double-check the current version of the SmPC and leaflet.
Do you need a medical evaluation?
The consultation is used to review symptoms, history, medication and decide if online management is appropriate or if you need in-person care.