Erectile Dysfunction in Australia: an evidence-based guide for men

What is erectile dysfunction (ED)?

ED means persistent difficulty achieving or maintaining an erection sufficient for sexual activity. Occasional difficulties can happen to anyone, but recurring symptoms are worth assessing because ED can affect confidence, relationships, and broader health.

Some men notice a gradual decline over months, while others experience sudden symptoms during periods of stress, relationship strain, poor sleep, medication changes, or health changes.

Common causes and contributing factors

Physical and vascular factors

• Blood pressure, cholesterol, diabetes, obesity, and reduced cardiovascular fitness
• Smoking, high alcohol intake, and poor sleep quality
• Hormonal factors in selected cases

Psychological and relationship factors

• Performance anxiety, stress, low mood, and relationship tension
• Past negative sexual experiences and fear of recurrence

Medication and other contributors

• Some prescription medications can affect erections
• Illicit drug use and untreated chronic illness may also contribute

When to see a GP: practical red flags

Seek medical assessment if ED is persistent, getting worse, or accompanied by symptoms like chest pain, reduced exercise tolerance, major mood changes, or significant relationship distress.

Early review helps identify reversible factors and can uncover broader cardiometabolic risks worth addressing.

How ED is assessed

A structured assessment usually includes symptom history, psychosocial context, medication review, and cardiovascular risk screening.

• Sexual function history and symptom pattern
• General health review (blood pressure, weight, lifestyle factors)
• Relevant blood tests as clinically indicated
• Discussion of goals, preferences, and treatment safety

Treatment options overview

• Lifestyle and risk-factor optimisation: sleep, exercise, smoking cessation, alcohol moderation, weight and metabolic health support.
• Psychological support: performance-anxiety strategies, counselling, and relationship-focused support.
• Oral medicines: options such as sildenafil and tadalafil when appropriate.
• Device-based options: vacuum erection devices for selected patients.
• Second-line therapies: injectable therapies and specialist referral where needed.
• Surgical referral: considered in selected refractory cases.

Treatment is individualised; there is rarely a one-size-fits-all approach.

Safety and medication cautions

PDE5 inhibitor medicines are not suitable for everyone. Some drug combinations, including nitrates, can be dangerous. Always seek medical advice before starting any ED medication.

This page is general education only and does not replace personal medical assessment.

Telehealth pathway

Many men can begin ED assessment and management through telehealth, with follow-up investigations or in-person review arranged if clinically required.

Take part in current research

Anonymous survey for men with experience of ED care — face-to-face or telehealth. Takes 10–20 minutes. No login required.