A variety of issues can lead to erectile dysfunction:

• Reduced blood flow to the penis

This is the most common cause of erectile dysfunction in men over 40 years. The arteries which take blood to the penis can become narrowed and the blood flow may be insufficient to cause an erection. Smoking, raised cholesterol and obesity can be contributing factors to this.

• Damage to nerves supplying the penis

This may be due to a neurological condition, such as multiple sclerosis or stroke, or spinal injury/surgery

• Diabetes

Diabetes is another common cause of ED and can affect the blood flow and the nerves to the penis. If you are concerned about diabetes you should see your doctor for a blood test.

• Alcohol

In the short term alcohol can reduce blood flow to the penis, and in the long term it can reduce testosterone levels and reduce sex drive. Excessive drinking (more than 10 units per week) can have a number of other negative effects on your health.

• Psychological causes

Stress, anxiety and depression are very common, and can cause or contribute to erectile dysfunction.  If you feel you may be suffering from any of these problems, you should speak to your GP.