In short
Erectile dysfunction (ED) is the consistent or recurrent inability to get or keep an erection firm enough for sex. ED affects 18 percent of men aged 50 to 59 and 37 percent of men aged 70 to 75, about 1 in 5 and more than 1 in 3. ED shares its causes with heart disease and often appears years before a heart problem, so it is always investigated, not only treated.
Condition Overview
What is erectile dysfunction?
Erectile dysfunction is the consistent or recurrent inability to acquire or sustain an erection of sufficient rigidity and duration for sexual intercourse, according to clinical guidance. An occasional failure is not erectile dysfunction. Low desire and early ejaculation are separate problems with their own causes: low libido in men and premature ejaculation.
How common is erectile dysfunction?
Erectile dysfunction is the most common sexual problem in men and rises with age. It was reported by 18 percent of men aged 50 to 59 in one study and by 37 percent of men aged 70 to 75 in a multinational study of over 27,000 men. In the Massachusetts Male Aging Study, 40 percent of men at 40, 4 in 10, reported some impairment of sexual function (Journal of Urology, 1994).
What causes erectile dysfunction?
Erectile dysfunction has vascular, neurological, hormonal, medication and psychological causes, often more than one at a time. The main risk factors besides age are listed here:
- Blood vessels: high blood pressure, diabetes, raised cholesterol, smoking, obesity and heart disease
- Hormones: low testosterone, raised prolactin and thyroid disease
- Medicines: thiazide diuretics, antidepressants such as SSRIs, spironolactone and anti-androgens; about 25 percent of cases, 1 in 4, are linked to medication
- Nerves: diabetes, spinal injury, multiple sclerosis, and pelvic surgery or radiotherapy
- Psychological: performance anxiety, depression, stress and relationship conflict
- Sleep: obstructive sleep apnoea and restless legs syndrome
Low testosterone explains erectile dysfunction in a minority of men and is measured in every man with ED: low testosterone.
Why is erectile dysfunction linked to heart disease?
Erectile dysfunction and heart disease share the same risk factors and the same damage to the inner lining of blood vessels (endothelial dysfunction). In an umbrella review of meta-analyses, men with ED had a 45 percent higher risk of cardiovascular disease and a 55 percent higher risk of heart attack, about one and a half times the risk of men without ED. Erectile dysfunction therefore works as an early warning sign.
Men with ED and diabetes, high blood pressure or raised cholesterol receive a cardiovascular risk assessment before treatment, and men at high risk see a cardiologist first.
Does sudden or gradual onset matter?
Yes, the onset points to the cause. Erectile dysfunction that starts suddenly one night in a man without earlier problems is typically psychological, most often performance anxiety, unless it follows pelvic surgery or trauma. Erectile dysfunction from vascular, hormonal or nerve causes fails sporadically at first and then more consistently.
Morning and night erections are a second clue. Normal spontaneous erections make a vascular or nerve cause unlikely, and complete loss of night erections points to a physical cause.
How is erectile dysfunction diagnosed?
Erectile dysfunction is diagnosed from the history, an examination and blood tests. The history and examination identify the cause in about 95 percent of cases but need blood tests for accuracy, according to clinical guidance. The standard tests are:
- Blood sugar: fasting glucose or HbA1c (glycated haemoglobin, the average blood sugar over three months); men with ED had twice the risk of undiagnosed diabetes in a US survey
- Cholesterol: a lipid profile for cardiovascular risk
- Hormones: morning total testosterone, repeated with LH and prolactin if low, and thyroid function
- General: full blood count, kidney and liver function
Penile ultrasound is needed only in special situations, such as a curvature or no response to tablets. What the first appointment involves: ED consultation.
How is the severity of erectile dysfunction measured?
Severity is measured with the IIEF-5 (International Index of Erectile Function, 5-item version), a questionnaire scored from 5 to 25 (International Journal of Impotence Research, 1999). The table lists the 5 bands.
| Score | Severity |
|---|---|
| 22 to 25 | No erectile dysfunction |
| 17 to 21 | Mild |
| 12 to 16 | Mild to moderate |
| 8 to 11 | Moderate |
| 5 to 7 | Severe |
The same questionnaire is available as a 1-minute erection self-check.
Erectile dysfunction in Dubai and the UAE
Why do men in the UAE seek help late?
The UAE expert panel on erectile dysfunction recorded that many men in the region do not raise sexual problems with a doctor at all; in one regional survey 28 percent of men, more than 1 in 4, said they would not discuss the problem with their doctor (Journal of Multidisciplinary Healthcare, 2025). The panel also found that men in the UAE present younger than in most published series.
What is the risk of buying tablets without a diagnosis?
A regional survey of 1,008 men cited by the UAE expert panel on erectile dysfunction found that 84.1 percent of men using erection tablets had bought them without a prescription, more than 8 in 10, and only 38.1 percent of the users had erectile dysfunction at all (Journal of Multidisciplinary Healthcare, 2025). The UAE Ministry of Health and Prevention has warned against sexual enhancement products that contain undeclared sildenafil, tadalafil or vardenafil, because of the risk of a severe fall in blood pressure (Khaleej Times).
A consultation about a sexual problem with Dr Felix is private and documented with ordinary medical confidentiality. Nothing requires a partner to attend or to be told.
How erectile dysfunction is treated: erectile dysfunction treatment, sildenafil (Viagra) and tadalafil (Cialis). With a specific risk factor: ED treatment for diabetics, ED treatment with high blood pressure or ED treatment for young men.
When to See a Doctor
- Erections fail or fade in most attempts over several weeks.
- You have diabetes, high blood pressure, raised cholesterol or smoke and notice weaker erections.
- Erection tablets bought elsewhere have not worked or caused side effects.
- Erection problems started after a new medicine.
- Chest pain, breathlessness or palpitations during sex or exertion: urgent medical assessment.
- An erection lasting more than 4 hours: go to an emergency department immediately. Do not wait for a clinic callback.
- A new curve, lump or pain in the penis: assessment before any treatment.
How Dr. Felix Assesses This
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1
History
Onset, morning erections, desire, relationship, medicines and the 5-question IIEF-5 score.
-
2
Examination
Blood pressure, pulses, weight, body hair, breast tissue and testes.
-
3
Blood tests
HbA1c, lipids, morning testosterone, thyroid, blood count, kidney and liver function.
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4
Cardiovascular risk and plan
Risk graded low, intermediate or high, cardiology referral where needed, and the treatment plan.
Treatment Options
ED Consultation
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Sildenafil (Viagra) in Dubai
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Tadalafil (Cialis) in Dubai
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Why Early Treatment Can Matter
Early assessment of erectile dysfunction finds heart and metabolic disease while it is easier to treat. Erectile dysfunction often precedes a cardiovascular diagnosis, and men with ED carry about one and a half times the cardiovascular risk of men without it.
Early assessment also prevents a cycle of anxiety and avoidance. Erectile dysfunction is associated with a higher risk of depression, and depression with a higher risk of ED.
Why Early Treatment Can Matter
Early assessment of erectile dysfunction finds heart and metabolic disease while it is easier to treat. Erectile dysfunction often precedes a cardiovascular diagnosis, and men with ED carry about one and a half times the cardiovascular risk of men without it.
Early assessment also prevents a cycle of anxiety and avoidance. Erectile dysfunction is associated with a higher risk of depression, and depression with a higher risk of ED.
Most men respond
Erection tablets work in most men, and cause-specific treatment improves results further.
The hidden risk
Undiagnosed diabetes, high blood pressure and heart disease are found at the first assessment.
One assessment
History, examination, blood tests and heart risk in one visit, then a clear plan.
Cost & Consultation Investment
The cost of an erectile dysfunction assessment covers the consultation with Dr Felix, the examination, the blood tests and the written plan. Dr Felix explains the full cost before anything is done.
Frequently Asked Questions
Erectile dysfunction is often an early warning sign of heart disease, because both share the same risk factors and blood vessel damage. Men with ED have about one and a half times the cardiovascular risk of men without it.
Erectile dysfunction becomes more common with age, affecting 18 percent of men aged 50 to 59 and 37 percent of men aged 70 to 75, but it is never simply normal. It has a cause at every age, and most causes are treatable.
Yes, erectile dysfunction is psychological in many younger men, typically from performance anxiety. A sudden start with normal morning erections points to a psychological cause.
Low testosterone causes erectile dysfunction in a minority of men and mainly lowers desire. Testosterone is measured in every man with ED, repeated if low, and treated only when the deficiency is confirmed.
The cost covers the consultation, examination, blood tests and written plan with Dr Felix. The full figure is explained before anything is done.
Evidence
Where this information comes from
Every figure on this page is taken from the sources below. All of them are free to read, so you can check them yourself.
- Erectile Dysfunction: AUA Guideline
- Impotence and its medical and psychosocial correlates: results of the Massachusetts Male Aging Study
- Development and evaluation of an abridged, 5-item version of the International Index of Erectile Function (IIEF-5)
- Erectile Dysfunction: Expert Panel Recommendations for Evaluation and Management in the United Arab Emirates
- Don’t consume sexual enhancement pills, warns UAE health ministry
- EAU Guidelines on Sexual and Reproductive Health
This page is general medical information and does not replace a personal consultation. Trial results are averages across large groups, not a prediction for any one person.