Book NowBook NowErectile Dysfunction (ED) and Low Libido are common issues that can arise from hormonal imbalance, stress, circulation problems, or medication side effects.
These conditions often affect confidence, relationships, and overall wellbeing.
At Harley Street MD, we help men overcome:
Our doctors also assess related health concerns such as diabetes, hypertension, and cardiovascular risks that may contribute to ED or reduced libido.
Erectile Dysfunction (ED) and Low Libido are common issues that can arise from hormonal imbalance, stress, circulation problems, or medication side effects.
These conditions often affect confidence, relationships, and overall wellbeing.
At Harley Street MD, we help men overcome:
Our doctors also assess related health concerns such as diabetes, hypertension, and cardiovascular risks that may contribute to ED or reduced libido.
We provide a full, confidential assessment to determine the underlying cause and develop a personalised treatment plan.
Our approach includes:
Our goal is to restore both physical function and psychological wellbeing through safe, evidence-based medicine in a confidential setting.
Erectile dysfunction (ED) and low sexual libido are among the most common men’s sexual health concerns, and they often occur together. While both conditions can be distressing, the good news is that they are usually treatable once the underlying cause is identified.
Here’s a clear, medically accurate overview of the main causes:
1. Physical (Organic) Causes
These are biological or medical factors that directly affect sexual function:
• Cardiovascular disease – Conditions such as high blood pressure, atherosclerosis (narrowed arteries), and high cholesterol reduce blood flow to the penis, making it difficult to achieve or maintain an erection.
• Diabetes – High blood sugar damages nerves and blood vessels involved in erection and can also lower testosterone levels, reducing sexual desire.
• Hormonal imbalances – Low testosterone (hypogonadism), thyroid disorders, or elevated prolactin levels can diminish libido and impair erectile response.
• Neurological disorders – Conditions such as multiple sclerosis, Parkinson’s disease, or spinal cord injury can interfere with nerve signals required for erection.
• Medications – Some blood pressure drugs, antidepressants (SSRIs), antipsychotics, and treatments for prostate disorders can cause or worsen ED and low libido.
• Substance use – Excessive alcohol, smoking, and recreational drug use negatively affect hormone levels, circulation, and nerve sensitivity.
• Obesity and poor fitness – These reduce testosterone production and impair blood flow, contributing to both ED and decreased libido.
2. Psychological and Emotional Causes
Emotional and mental health play a major role in sexual performance and desire:
• Stress and anxiety – Chronic stress increases cortisol, which suppresses testosterone and distracts from arousal.
• Performance anxiety – Fear of “not performing well” can trigger or worsen erectile difficulties.
• Depression – Often linked to reduced libido, energy levels, and pleasure response.
• Relationship problems – Poor communication, conflict, or emotional distance from a partner can contribute to both ED and low sexual interest.
3. Lifestyle and Environmental Factors
Everyday habits can have a significant impact:
• Sedentary lifestyle – Lack of exercise decreases blood circulation and testosterone levels.
• Unhealthy diet – High-fat, high-sugar diets contribute to vascular and metabolic problems.
• Sleep deprivation – Poor sleep lowers testosterone and impairs energy and mood.
• Excessive pornography use – Can alter arousal patterns and reduce natural sexual response.
4. Age and Health Conditions
While ED and reduced libido become more common with age, they are not inevitable. Age-related decline in testosterone, slower nerve response, and cumulative vascular damage can contribute, but these can often be managed with modern medical therapies, hormone optimisation, and lifestyle improvements.
Summary
In most men, ED and low libido are multifactorial — involving a combination of physical, psychological, and lifestyle elements.
A comprehensive evaluation at a men’s health clinic such as Harley Street MD typically includes:
• Hormonal testing
• Cardiovascular assessment
• Psychological and lifestyle review
Treatment can then be tailored, including lifestyle adjustments, counselling, PDE5 inhibitors (e.g. sildenafil), or testosterone replacement therapy if clinically indicated.
Erectile dysfunction (ED) is a common condition, and the good news is that it can often be improved or even resolved, depending on the underlying cause.
Temporary or situational ED:
If ED is caused by stress, fatigue, alcohol, or anxiety, it may only be short-term. Improving lifestyle habits, managing stress, and addressing performance anxiety often restores normal function.
Medical or physical causes:
ED linked to conditions like diabetes, high blood pressure, heart disease, hormonal imbalance, or nerve damage usually doesn’t go away on its own. However, most men see significant improvement with targeted treatments, such as:
• Lifestyle changes (exercise, diet, quitting smoking)
• Medications like PDE5 inhibitors (Viagra, Cialis)
• Hormone therapy if testosterone levels are low
• Specialist interventions in more severe cases
Psychological ED:
When anxiety, stress, or depression is the main factor, counselling, therapy, and stress management techniques are highly effective and can restore sexual confidence and performance.
Age-related changes:
Some natural decline in sexual function can occur with age, but many men maintain satisfying sexual activity with medical and lifestyle support.
Key takeaway:
ED doesn’t have to be permanent. Early assessment and treatment by a qualified men’s health specialist can help you regain erectile function, boost confidence, and improve your overall sexual wellbeing.
Erectile dysfunction (ED) and low sexual libido can impact a couple’s ability to conceive, but the effects vary depending on severity and underlying causes.
Erectile Dysfunction
ED makes it difficult to achieve or maintain an erection sufficient for vaginal penetration. This can directly reduce the chances of sperm reaching the egg, making natural conception more challenging. Occasional ED may have little effect, but persistent difficulties can delay or prevent pregnancy.
Treatments such as medications, hormone therapy, or assisted reproductive techniques can help restore sexual function and support conception.
Low Sexual Libido
Reduced sexual desire can lead to fewer sexual encounters, which decreases the likelihood of intercourse coinciding with ovulation. Addressing hormonal imbalances, stress, relationship factors, or lifestyle issues can help restore libido and improve fertility chances.
Underlying Health Factors
ED and low libido may signal health conditions such as low testosterone, diabetes, cardiovascular disease, or obesity, all of which can also affect fertility. Treating these conditions can enhance both sexual function and reproductive health.
Summary
While ED and low libido can affect the ability to conceive, effective medical, psychological, and lifestyle interventions exist to improve sexual health and support pregnancy. Early evaluation by a specialist is recommended for couples experiencing difficulties.
Erectile Dysfunction (ED) and Low Sexual Libido are two of the most common men’s health concerns, often affecting confidence, relationships, and overall well-being.
ED occurs when a man is unable to achieve or maintain an erection firm enough for satisfactory sexual activity, while low libido refers to a reduced interest in sex. Both may arise from factors such as stress, hormonal imbalance, fatigue, vascular or nerve issues, medication side effects, or lifestyle influences.
At Harley Street MD, we offer discreet, personalised care to determine the root cause and deliver an effective, evidence-based treatment plan — helping men restore confidence, performance, and intimacy.
Our approach to Erectile Dysfunction at Harley Street MD
At Harley Street MD, our approach to treating erectile dysfunction and low libido is comprehensive and medically grounded.
Each consultation begins with a confidential assessment that includes a full medical history, hormonal and vascular screening, and a review of lifestyle or emotional factors. Treatments are then tailored to your individual needs and may include:
• Lifestyle optimisation – improving exercise, nutrition, and sleep to support healthy testosterone levels and circulation.
• Medical therapies – such as PDE5 inhibitors (e.g. sildenafil or tadalafil) to enhance erectile function.
• Hormonal treatment – where indicated, testosterone replacement therapy to restore libido and energy.
• Psychosexual counselling – addressing anxiety, stress, or relationship factors contributing to sexual dysfunction. (not offered)
Our aim is to achieve sustainable results that improve both sexual health and overall vitality — using safe, proven, and non-invasive techniques.
Erectile dysfunction and low sexual libido are common, but effective treatments are available. The right approach depends on the underlying cause and may involve a combination of medical, hormonal, psychological, and lifestyle interventions.
1. Lifestyle Changes
Improving overall health can significantly enhance sexual function:
• Regular exercise and maintaining a healthy weight
• Balanced diet and reduced alcohol intake
• Quitting smoking and managing stress
• Ensuring adequate sleep
2. Medications for Erectile Dysfunction
• PDE5 inhibitors such as sildenafil (Viagra), tadalafil (Cialis), and vardenafil (Levitra) improve blood flow to the penis and support natural erections.
• Alprostadil injections or urethral suppositories may be recommended if oral medications are not effective.
3. Hormone Therapy
• Testosterone replacement therapy (TRT) may be offered for men with low testosterone to restore libido, energy, and sometimes erectile function.
4. Psychological and Relationship Support (Not offered here)
• Counseling or sex therapy can address anxiety, stress, or performance concerns.
• Couples therapy helps improve intimacy and communication, supporting sexual satisfaction.
5. Devices and Assisted Interventions
• Vacuum erection devices or penile implants for men who do not respond to medications.
• Assisted reproductive techniques if ED prevents natural conception.
Summary
With a personalised treatment plan, most men experience significant improvements in sexual desire, erectile function, and overall confidence. Early assessment by a men’s health specialist ensures the best outcomes.
Treatments for erectile dysfunction and low sexual desire are generally safe when prescribed and monitored by a specialist, but like all medical interventions, they can have side effects.
1. Oral Medications (Viagra, Cialis, Levitra, Spedra)
• Common: Headache, flushing, nasal congestion, upset stomach, dizziness
• Rare but serious: Sudden vision changes, hearing loss, or interactions with certain heart medications
2. Alprostadil (Injection or Urethral Suppository)
• Pain or burning at the site, bruising, or prolonged erections (priapism)
• Must be used under medical guidance
3. Testosterone Replacement Therapy (TRT)
• Acne, fluid retention, increased red blood cells, worsening sleep apnea
• Requires regular monitoring for hormone levels and prostate health
4. Psychological Therapy and Counselling (Not offered)
• Safe with no physical side effects
• May involve emotional discomfort while addressing personal or relationship issues
5. Devices and Surgical Options
• Vacuum devices: Mild bruising, numbness, or temporary discomfort
• Penile implants: Surgical risks include infection, bleeding, or device failure
6. Lifestyle Changes
• Generally safe and beneficial
• Extreme exercise or diets should be guided by a healthcare professional
Summary
Most treatments are safe, and serious complications are rare. Early assessment by a men’s health specialist ensures that treatment is effective, safe, and tailored to your needs.
Erectile dysfunction and low sexual libido are more common than many men realise and can occur at any age. These conditions may be influenced by lifestyle habits, medical conditions, hormonal changes, or psychological stress.
At Harley Street MD, your comfort and privacy are our top priorities. During your consultation, our experienced doctors will conduct a discreet evaluation to identify the cause of your symptoms and recommend an appropriate treatment plan.
Most men notice a significant improvement in sexual function, desire, and confidence with a combination of medical therapy, lifestyle support, and hormone optimisation — without the need for surgery.
If you are experiencing persistent erection difficulties or reduced sexual interest, professional help is available. Book a private consultation today to start your recovery with confidence.
Pre-Care (Before Starting ED Treatment)
1. Initial Consultation & Assessment
• At Harley Street MD, your first step is a confidential consultation where a specialist will explore your symptoms, medical history, lifestyle, and any psychological concerns.
• The doctor may perform a physical examination and ask about erection quality (e.g., morning erections, ability to maintain an erection) to help identify the cause.
• Blood tests are often ordered to check for underlying conditions. These may include: testosterone levels, lipid profile, glucose/HbA1c, and other hormones.
• A cardiovascular risk assessment is also very important, because ED can be a warning sign of heart disease.
2. Lifestyle Evaluation & Advice
• Lifestyle factors frequently play a role in ED. Our clinicians will talk through modifiable risks such as: smoking, alcohol intake, exercise, diet, and sleep.
• Psychological factors (anxiety, stress, depression) are also assessed. If needed, referral to a counsellor or psychosexual therapist may be recommended.
• Before starting any medication, we encourage making healthy changes. Even modest weight loss, regular exercise, and reducing alcohol can help erectile function.
3. Discussion of Treatment Options
• Once evaluations are complete and other causes are addressed, your clinician may recommend PDE-5 inhibitors (e.g., sildenafil, tadalafil) as first-line therapy.
• You’ll be counselled on how these medications work, key point: they only work with sexual stimulation, they don’t force an erection by themselves.
• The clinician will also talk through benefits, possible side-effects (headache, flushing, visual changes, back pain), and how to use the treatments safely.
• If you’re found to have low testosterone, your doctor may also consider testosterone testing or testosterone replacement therapy as part of your plan.
Setting Expectations & Follow-Up Plan
• We’ll agree a treatment and monitoring plan. Typically, you'll try the oral medication for several doses (often 4–8 attempts) at the right dose and with sexual stimulation before deeming it as non-responsive.
• You’ll be informed about when to return for review, we will check how well the treatment is working and whether any adjustment is needed.
• You should feel free to ask questions about cost, how to take the tablets, safety, and any concerns you might have.
Key Take-Home Messages
• ED is very common and treatable — you don’t have to “just live with it.”
• At Harley Street MD, you receive a holistic, specialist-led assessment that looks at physical, psychological, and lifestyle factors.
• Treatment (usually PDE-5 inhibitors) is combined with lifestyle advice for best results.
• Ongoing monitoring ensures treatment is safe and effective, tailored to your needs.
After-Care (Once Treatment Has Begun)
1. Follow-Up Appointments
• After you start treatment, you'll be invited back for a review (often after about 6–8 weeks) to assess how well the therapy is working.
• During this review, we will check: whether the erections are improving, how often you're using the medication, and whether you are experiencing any side-effects.
2. Monitoring & Safety
• We monitor your cardiovascular health and risk factors, because ED treatment should be safe in the context of your overall heart health.
• Side-effects are possible, such as headaches, flushing, nasal congestion, back pain or muscle aches. If these occur or persist, tell your clinician, doses may be adjusted or a different PDE-5 inhibitor may be tried.
• If the first treatment doesn’t work well, you may be offered alternative medications or approaches after proper evaluation.
3. Lifestyle & Ongoing Health
• Even with medication, maintaining a healthy lifestyle remains important. Regular exercise, reducing alcohol, quitting smoking, and controlling weight can all support long-term sexual wellbeing.
• Psychological support may continue to be helpful. Performance anxiety, stress or relationship issues can persist, and therapy or counselling can be very effective.
• If you have low testosterone, and it is being treated, we will monitor hormone levels and adjust your treatment plan accordingly.
4. Long-Term Considerations
• The British Society for Sexual Medicine (BSSM) guidelines stress that men with significant cardiovascular risk or other complexities should have ongoing specialist input.
• It’s important to have realistic expectations: not all men respond immediately, and different treatments may be needed to find what works best.
• If treatment is effective and safe, you may continue using ED medication long-term as part of your overall health plan.
When to Seek Help
• Contact us straight away if you experience any concerning symptoms, such as chest pain during sexual activity, or bothersome side-effects.
• Also inform your clinician if your ED worsens, or if the treatment stops working as well as it used to, we may need to re-evaluate causes or adjust your plan.
