Sexual Health

Erectile dysfunction is when a man cannot get or maintain an erection for long enough to have satisfactory sex. This may occasionally be accompanied by a low sex drive or loss of libido.

There are a number of possible causes including stress, tiredness and unhealthy habits (such as drinking too much alcohol). Certain medicines can also cause it as a side effect (including antidepressants and antihistamines). If it happens frequently, it could be linked to conditions that affect your blood vessels, nerves or hormones, such as high blood pressure, high cholesterol, diabetes, depression and anxiety. If you think a medication or medical condition could be the cause, please contact your doctor to discuss this further.

Oral medications (tablets) such as tadalafil and sildenafil may be suitable options. Complete our short online consultation to see if you are eligible for treatment.

If you feel stress may be a cause, you may wish to consider counselling. Eating a healthy diet, exercising regularly, stopping smoking, reducing your alcohol intake and losing weight (if you are overweight) may also help minimise symptoms. Please talk to your doctor if you think a medication or medical condition could be the cause.

Tadalafil (also known as Cialis) and sildenafil (also known as Viagra) are MHRA-approved medications to help treat erectile dysfunction. They are both part of the same class of medications that increase blood flow to the penis during sexual stimulation.

They are part of a group of medicines known as phosphodiesterase type 5 inhibitors (PDE-5 inhibitors). They work by increasing blood flow to the penis by relaxing the blood vessels, helping you achieve and maintain an erection. Please note you won't get an erection just from taking the medication. You need to be sexually aroused for it to work.

Take sildenafil approximately 1 hour before sexual intercourse, and tadalafil 30 minutes before. All strengths of sildenafil and most strengths of tadalafil (apart from the 5mg) are taken when required. Tadalafil 5mg is a daily medication taken at the same time each day.

Tadalafil comes in 10mg and 20mg 'as needed' doses, and there is also a 5mg dose for those that want to take the medication daily. Sildenafil comes in 25mg, 50mg and 100mg tablets. Once you have completed your online consultation, our clinicians will prescribe the most appropriate dose for you.

The main difference between the two is how long the effects last. Sildenafil can last for 4 to 6 hours, while tadalafil can last up to 36 hours. Tadalafil 5mg, taken daily, builds up in your system and allows for spontaneous erections whenever you are sexually aroused.

Store at room temperature, below 25°C, in a dry place away from direct sunlight. Keep in the original packaging and out of reach of children. Do not use after the expiry date on the packaging. Unused or expired medication can be taken to your local pharmacy for safe disposal.

Tadalafil is usually well tolerated. The most common side effects are facial flushing, headaches, indigestion, nasal congestion, dizziness, and changes in vision and hearing. These usually appear within a few hours and are mild and temporary. Rare but serious side effects include priapism (an erection lasting longer than 4 hours), chest pains, and changes in vision/hearing: seek urgent medical attention if these occur.

Sildenafil is usually well tolerated. The most common side effects are headaches, feeling sick, indigestion and dizziness. Many people have no side effects or only mild ones. Rare but serious side effects include priapism (an erection lasting longer than 4 hours), chest pains and changes in vision: seek urgent medical attention if these occur.

Moderate alcohol consumption (maximum 2 units) is generally considered safe. However, both these medications and alcohol lower blood pressure, so taking them together can lead to dizziness, feeling lightheaded or fainting. Alcohol can also affect sexual performance, so reducing your intake is recommended for best outcomes.

Yes, they can interact with other medications, especially certain heart medications (including nitrates), which can cause a significant drop in blood pressure. Please complete the online consultation with as much detail as possible so we can prescribe safely, and always inform your GP of all medications you are taking.

Seek urgent medical help straight away if you have chest pain or pressure before, during or after sex. Do not use nitrates (such as GTN spray or tablets) within 24 hours of taking sildenafil, as the combination can cause a dangerous drop in blood pressure; call 999. Go to A&E for an erection lasting longer than 4 hours (priapism), and stop the medicine and seek help for sudden changes in vision or hearing. Call 999 for signs of a serious allergic reaction such as wheezing, breathing difficulty or swelling of the lips, face or throat.

Yes. If you're experiencing side effects, please let us know via our contact form so our clinical team can support you. You can also report side effects directly to the MHRA through the Yellow Card scheme at www.yellowcard.mhra.gov.uk.

Complete the relevant online consultation, which is swiftly reviewed by the clinical team. Your order will either be approved and dispensed, or the clinicians will be in touch if they need further information or if the medication is unsuitable. We endeavour to review all orders within 48 working hours.

We offer flexibility: one-off purchases or 3, 6, 9 and 12 month subscriptions. Subscriptions offer significant savings, fewer monthly questions, and ensure you don't run out or have treatment gaps.

We deliver across the UK including Northern Ireland (excluding the Channel Islands and Isle of Man). Your order arrives in plain, discreet packaging with no branding or labels indicating the contents.

For regulatory reasons we cannot re-use any medication once dispensed and delivered, so we are unable to refund medication that has been dispatched. If your prescription request is declined by our prescribers for clinical reasons, you will receive a full refund automatically. If you experience side effects or feel the treatment isn't right, please contact our team and we'll work with your prescriber to explore alternatives.

Every order is reviewed by one of our specialist clinicians. Where the medication isn't considered safe or suitable based on the information provided, we will let you know we are unable to supply it. This decision is always made with your health, safety and wellbeing in mind. If you'd like to understand more, get in touch via our contact form.

It's very common and nothing to be embarrassed about. In the UK, an estimated 4.3 million men experience ED, and it can affect men of all ages. Whether it's stress, tiredness or simply the passage of time, many men experience erection difficulties at some stage.

ED can be caused by conditions that affect your blood vessels, nerves or hormones, such as high blood pressure, high cholesterol, diabetes, neurological conditions or low testosterone. Psychological factors like depression, anxiety, stress and relationship issues can also contribute, as can some medications (including certain blood pressure tablets, antidepressants and antihistamines). Lifestyle factors such as lack of exercise, obesity, smoking and heavy drinking increase the risk too.

When you're aroused, nerves in the penis release nitric oxide, which produces a messenger called cGMP. cGMP relaxes the smooth muscle so blood flows in and creates an erection; afterwards, an enzyme called PDE5 breaks down cGMP to end it. In many men with ED, the cGMP signal is too weak or broken down too quickly, so there isn't enough blood flow. Medications like sildenafil and tadalafil are PDE5 inhibitors: they block PDE5 to keep cGMP levels up, but they only work when you're already sexually aroused.

In small amounts alcohol can help you relax, but too much reduces blood flow to the penis, interferes with the nerve signals that trigger arousal, and over time can lower testosterone. There's no harmful chemical interaction between alcohol and sildenafil, but both lower blood pressure, so heavy drinking can cause dizziness, fainting or headaches and make the medicine less effective. Try to stay within 14 units a week and avoid drinking heavily on the day you take your medication.

Lifestyle changes can significantly improve erectile function. Helpful steps include staying active, eating a balanced diet, limiting alcohol to below 14 units a week, stopping smoking, maintaining a healthy weight, managing stress and getting enough sleep. These improve both heart health and blood flow, two key factors in sexual performance.

Most oral ED medications take effect within 30–60 minutes, though this can vary depending on the medication, dose and your overall health. Remember they only work when you're sexually aroused.

In some cases, yes, especially when it's caused by lifestyle factors or underlying conditions that can be addressed. Even when it isn't fully reversible, ED is highly treatable.