You should arrange to speak with your GP if: ED persists for more than a few weeks or is worsening over time You experience sudden onset of erectile difficulties, particularly if previously unaffected ED is accompanied by other symptoms such as reduced libido, fatigue, mood changes, or urinary problems You have cardiovascular risk factors (diabetes, hypertension, high cholesterol, smoking) as ED may be an early marker of cardiovascular disease Erectile difficulties are causing significant distress or affecting your relationship and quality of life Seek urgent medical attention if you experience: Chest pain or shortness of breath during sexual activity An erection lasting more than 4 hours (priapism) Significant penile pain, sudden curvature, or trauma Neurological symptoms such as sudden weakness or speech difficulties NICE guidance recommends that healthcare professionals take a thorough history when assessing ED, including: Medical history (diabetes, cardiovascular disease, neurological conditions, previous pelvic surgery) Medication review (prescription and over-the-counter preparations) Psychological and relationship factors Lifestyle factors (smoking, alcohol, exercise, sleep) Initial investigations typically include blood tests to assess: Fasting glucose and HbA1c (glycaemic control) Lipid profile (cardiovascular risk) Morning testosterone levels (may need repeating if low) Thyroid function , prolactin , renal and liver function tests if clinically indicated Your GP can provide appropriate management, which may include lifestyle modification advice, medication review, treatment of underlying conditions, or referral to specialist services (urology, endocrinology, or psychosexual counselling) if needed
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