How to talk to your partner about erectile dysfunction (ED)

If your erections have changed recently, there's a fair chance you've been carrying the worry on your own.

A lot of men put off saying anything for weeks or months. They hope it sorts itself out, or they feel the subject is somehow tied to how "manly" or desirable they are.

That reaction is understandable.

In a UK survey of 12,490 men published in 2022, 41.5% of men reported some degree of ED, including 29.3% of men aged 18 to 39.

So if this is happening to you, you're not alone. And the person most likely to help you through it is the one sharing your bed.

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Here's the part many men don't expect. When nothing is said, partners rarely stay neutral. They fill the silence with their own explanations.

Common worries partners describe include:

• Wondering whether they've done something wrong
• Worrying that they're no longer found attractive
• Questioning whether their partner is interested in someone else
• Feeling shut out when affection quietly stops

These worries are natural, and they're almost always wrong.

ED is very rarely about how someone feels about their partner.

The usual causes are physical (blood flow, nerve signals, hormones, some medicines) or linked to stress and anxiety.

Research shows partners feel the effects too.

In the international FEMALES study, 293 female partners of men with ED reported that desire, arousal, and orgasm became less frequent for them after their partner's erection problems began.

Blame makes it harder still.

In a 2021 study published in Sexual Medicine, 79% of women surveyed had been with a partner who lost his erection, and around 1 in 7 had been blamed for it.

Women who were blamed reported lower self-confidence and were more likely to end the relationship.

The takeaway is simple. Silence and blame cost both people something. A calm, honest conversation costs much less.

There's a reassuring side to the research.

Partners can also shape whether treatment happens at all.

Follow-up analysis of the FEMALES data found that women's attitudes towards ED and its treatment were linked to whether their partner raised it with a doctor and went on to use treatment.

Sticking with treatment matters too.

When researchers have asked men why they stopped taking ED tablets, partner-related reasons come up regularly, alongside side effects and cost.

Couples-focused studies suggest that when partners are involved from the start, treatment is more likely to fit into the relationship rather than feel like a secret.

There's also a direct link with anxiety.

One difficult night can lead to worry about the next time, and that worry can make an erection harder to get.

Clinicians call this performance anxiety.

Saying it out loud, and hearing that your partner isn't keeping score, takes a lot of that pressure away. We explain the psychological side in more detail in our guide to anxiety-related ED.

When you talk about ED with your partner can matter almost as much as what you say. Couples who've been through this often find these steps help:

• Pick neutral ground. A walk, a drive, or a quiet evening on the sofa usually feels easier than the bedroom.
• Avoid the moment straight after sex. Emotions run high, and it's easy to say something defensive or hurtful.
• Give it time. Five minutes before work, or with children likely to walk in, isn't the moment.
• Keep it sober and private. A clear head helps both of you hear what's actually being said.
• Know your opening line. You don't need a script, but a first sentence in your head makes it much easier to start.

You don't need a perfect speech. Honesty and warmth do most of the work.

It helps to use "I" statements. They describe how you feel rather than sounding like an accusation or a verdict on the relationship.

If you're the one with ED, openers that often work:

• "There's something I've been worried about, and I want you to know it's not about you."
• "I've been having trouble with erections lately. I think it's made me a bit distant, and I'm sorry about that."
• "I've felt embarrassed, so I've avoided it. I'd rather we talk about it together."
• "I'm going to get it checked. Would you help me look into the options?"

Things that tend to make the conversation harder:

• Joking it away so the subject never gets taken seriously
• Blaming stress, work, or your partner without talking it through
• Avoiding all physical affection so the topic can't come up
• Promising it will go away on its own without getting it checked

If the first conversation is short or awkward, that's fine.

Most couples revisit it several times. The first chat is about opening the door, not solving everything at once.

If your partner has just opened up, or you're the one hoping to talk about it, the first response sets the tone for everything after.

If you're the partner, openers that often help:

• "I've noticed things have felt different lately. I'm not upset, I just want to know how you are."
• "This doesn't change how I feel about you. We'll work it out together."
• "I've read that this is really common. Shall we look into it together?"
• "Would it help if I came with you to an appointment, or sat with you while you do a consultation?"

Ways partners can show support:

• Listen first, without rushing to fix things
• Say clearly that you still find them attractive
• Try not to take it personally, because it's very rarely about you
• Offer to be involved in appointments or treatment decisions, if they'd like that

It's also fine to be honest about your own feelings. Saying "I'll be honest, I'd started to worry it was about me" often brings couples closer, because it shows you've both been carrying something.

ED doesn't have to mean intimacy stops. Many couples find that taking the focus off penetrative sex for a while actually helps, because it removes the "will it or won't it" pressure.

Approaches couples find useful:

• Non-penetrative intimacy. Kissing, touching, massage, and other ways of being close keep the connection going without attaching it to performance.
• Sensate focus. A structured touching exercise developed by sex researchers Masters and Johnson. Partners take turns touching each other, starting away from the genitals, with an agreement to pause intercourse for a set period. The aim is to reduce anxiety and rediscover pleasure.
• Psychosexual therapy. A talking therapy with a specialist in sexual problems. It looks at the emotional and physical side together, and partners can usually attend. Your GP can refer you, or you can see a private therapist.
• Relationship counselling. Useful if ED has led to tension, resentment, or long silences.

Looking at treatment as a team can make it feel less daunting. The main options licensed in the UK are:

Whatever the underlying cause for ED, the first-line treatment for most men is the same class of medication, PDE5 inhibitors, which work by improving blood flow to the penis.

In the UK, four treatment options are licensed for ED: Viagra (sildenafil), Cialis (tadalafil), vardenafil, and Spedra (avanafil).

Apart from the above-mentioned treatments, UK also has a Generic Impotence Trial Pack, which includes 4 tablets of tadalafil 10mg, 4 tablets of vardenafil 10mg, and 4 tablets of sildenafil 10mg. The prices for the same starts from £49.99.

Two are available without a prescription, after a short pharmacist consultation: Viagra Connect (sildenafil) and Cialis Together (tadalafil).

Which one suits you often comes down to how long you want it to last and how you'd like to plan around it, rather than the underlying cause.

PDE5 inhibitors should not be taken alongside nitrate medications (commonly prescribed for angina) or recreational nitrates ('poppers'), as the combination can cause a dangerous drop in blood pressure.

Tell your prescriber about all medications you're taking, including any for blood pressure or chest pain, before starting treatment.

Our guides on Viagra vs Sildenafil and Cialis daily vs on-demand walk through the practical differences.

Addressing an underlying cause, whether that's blood pressure, weight, alcohol, stress or a medication switch, often improves things further, alongside or instead of tablets.

We cover the lifestyle part of it in Lifestyle and ED: weight, alcohol, sleep and exercise, and the anxiety part of it in Anxiety-related ED: the psychological side.

ED is sometimes an early sign of another health condition, which is a good reason to treat the conversation with your partner as the first step rather than the last.

The arteries that supply the penis are narrower than those supplying the heart. If they start to fur up (atherosclerosis), erection problems can show up years before heart symptoms do.

A large systematic review in European Urology found ED is linked to a higher risk of heart disease, stroke, and death from any cause.

Other common causes include:

• High blood pressure or high cholesterol
• Type 2 diabetes
• Low testosterone or other hormone problems
• Depression or anxiety
• Side effects of some medicines, including some blood pressure tablets and antidepressants

It's worth booking a GP appointment if:

• Erection problems keep happening or have lasted more than a few weeks
• You also notice chest pain, breathlessness, tiredness or needing to pee more often
• ED started suddenly, or after an injury, surgery or a new medicine
• You already have diabetes, heart disease or high blood pressure

Important safety point: Don't take sildenafil, tadalafil, or similar tablets if you use nitrates, often prescribed for chest pain (for example, GTN spray or isosorbide tablets).

The combination can cause a dangerous drop in blood pressure. If you get chest pain during or after sex, call 999.

Many couples find it reassuring to go to appointments together.

A doctor will usually ask about lifestyle and relationships, check blood pressure, and may arrange blood tests for blood sugar, cholesterol, and testosterone. More detail is in our guide on when to see a doctor about ED.

Our process is straightforward. From start to finish, this is what happens when you order with us:

1. Fill in the medical questionnaire. It takes 5 to 10 minutes. The questions are thorough on purpose
2. A GMC-registered prescriber reviews your answers. If they need more details, they will message you through your account
3. If treatment is approved, it is dispensed and dispatched. Next-day delivery, with the full patient information leaflet included
4. If it is not approved, the prescriber explains why. You are not charged for treatment that is not issued

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