Erectile dysfunction is the persistent difficulty getting or maintaining an erection firm enough for satisfactory sexual activity. It is very common, affecting an estimated 1 in 5 men in the UK at some point in their lives, and becomes more prevalent with age.

ED can be a sign of an underlying health condition such as cardiovascular disease, diabetes, high blood pressure, or hormonal imbalance. It is always advisable to speak with a healthcare professional if you experience persistent ED, as it may warrant further investigation.

ED has both physical and psychological causes. Common physical causes include poor circulation, high blood pressure, high cholesterol, diabetes, obesity, and hormonal changes. Psychological causes include stress, anxiety, depression, and relationship difficulties. Often, a combination of both is involved.

What treatments are available for ED in the UK? Several prescription-only medicines (POMs) are available in the UK for ED, including:

• Sildenafil (generic Viagra) – taken 30–60 minutes before sexual activity
• Tadalafil (generic Cialis) – available as a daily or as-needed dose
• Vardenafil (generic Levitra) – taken approximately 25–60 minutes before activity
• Avanafil (Spedra) – a faster-acting option, working in as little as 15 minutes

Yes. All PDE5 inhibitors are prescription-only medicines in the UK. At Heba Online Pharmacy, our independent prescribers can assess your suitability through a secure online consultation, and issue a prescription where clinically appropriate.

Sildenafil is typically taken as needed, around 30–60 minutes before sexual activity, and its effects last approximately 4–6 hours. Tadalafil has a longer duration of action — up to 36 hours — and is also available as a low daily dose (5mg) for men who prefer not to time their medication around sexual activity.

Many men with diabetes or well-controlled cardiovascular conditions can safely use PDE5 inhibitors, but this requires individual clinical assessment. Our prescribers will review your medical history, current medications, and any relevant test results before issuing a prescription.

Common side effects of PDE5 inhibitors include headache, facial flushing, indigestion, and nasal congestion. These are usually mild and short-lived. Less commonly, some men experience visual disturbances or back pain (more associated with tadalafil). Seek urgent medical attention if you experience sudden vision or hearing loss, or chest pain during or after taking ED medication.

Yes. Regular exercise, maintaining a healthy weight, reducing alcohol intake, stopping smoking, and managing stress can all have a meaningful positive impact on erectile function. ED medication works best alongside healthy lifestyle habits.