Erectile problems? Answers to the 15 most frequently asked questions (2026)

Short answer: Erectile problems are common, become more frequent with age and are often caused by a combination of physical, psychological and lifestyle factors. In most cases, they can be readily explained and treated.

Erectile problems are one of the most common sexual complaints among men, but there is still a taboo surrounding them. That’s a shame, because most of the questions men have about this can be answered with facts. This article goes through the most frequently asked questions: from how common it is to when you should consult a doctor.

How common are erection problems?

Erectile problems are more common than most men realise and become more frequent with age. Research shows that around 40 per cent of men aged 40 experience them to some extent, rising to around 70 per cent among men aged 70. This clear age-related increase is strongly linked to cardiovascular risk factors, which are often the common underlying cause. The fact that it is so common does not mean it is ‘normal’ to ignore it: it is a condition that deserves to be taken seriously, regardless of age.

What are the most common causes of erectile problems?

Erectile problems arise from a disruption in the blood flow to the erectile tissues of the penis, which normally increases during sexual arousal. Physical causes include vascular conditions such as atherosclerosis, diabetes and hormonal factors such as low testosterone levels. Research into risk factors for erectile dysfunction shows that vascular and metabolic conditions are among the most significant physical causes.

In addition, psychological factors such as stress, pressure to perform and anxiety play a major role, often in combination with lifestyle factors such as smoking, alcohol consumption, being overweight and too little exercise. In practice, it is rarely down to a single cause: it is usually the result of several factors acting together.

Can erectile problems also be psychological?

Yes, erectile problems can be entirely or partly psychological in nature. Stress and anxiety activate the sympathetic nervous system, which reduces blood flow to the penis and makes it difficult to achieve an erection, even if there is nothing physically wrong. This mechanism explains why many men suffer from erectile problems caused by stress or performance anxiety, particularly in new relationships or during periods of tension.

Furthermore, physical and psychological causes are not mutually exclusive: they often occur together and reinforce one another. Open communication with a partner about what is going on can go a long way towards easing tension.

From what age do erectile problems become more common?

Erectile problems clearly increase with age, but are not a problem exclusive to older men. The prevalence rises from around 40 per cent at the age of forty to around 70 per cent at the age of seventy, which is mainly due to the accumulation of cardiovascular risk factors over time. Nevertheless, men in their twenties and thirties also regularly present with this complaint, often with a stronger psychological component such as performance anxiety or stress. Age is therefore a risk factor, not a prerequisite: any age group can be affected.

Could my lifestyle cause or worsen erectile problems?

Lifestyle has a direct and measurable impact on erectile function. Smoking damages the blood vessels and thus restricts blood flow, whilst excessive alcohol consumption has a negative impact on both blood flow and the nervous system: the link between alcohol and erectile problems is well documented. Being overweight also plays a major role, as it is often associated with metabolic syndrome and vascular damage, as research into erectile problems caused by being overweight shows.

Too little exercise and insufficient sleep further exacerbate these effects. A review article on lifestyle in urology confirms that making changes in these areas has a measurable positive effect on erectile function.

Do erectile problems go away on their own?

That depends very much on the cause. Temporary erectile problems caused by stress, tiredness or a one-off stressful situation often resolve themselves once that situation has been resolved. However, if the symptoms point to an underlying physical cause, such as vascular damage, a hormonal imbalance or low testosterone levels, they will not usually resolve without a targeted approach. Persistent or recurring symptoms are therefore a sign that you should not wait and see, but should have the cause investigated.

When should I see a doctor about erectile problems?

It is advisable to consult a doctor as soon as symptoms persist for more than a few weeks or months, or if they recur. This is certainly true for men over the age of 40, as erectile problems at this age can be an early warning sign of underlying cardiovascular disease. An appointment with your GP is also advisable if you experience pain, a sudden change in erectile function, or if there is a clear impact on your relationship or well-being. According to the Farmacotherapeutisch Kompas, a thorough medical history is essential to distinguish between physical, hormonal and psychological causes, which directly determines the most appropriate course of treatment.

What treatments are available for erectile problems?

The approach to treating erectile dysfunction usually consists of three strands, often used in combination. Lifestyle changes such as giving up smoking, cutting down on alcohol and taking more exercise tackle underlying vascular damage and metabolic risk factors. Where there is a clear psychological component, counselling or support from a sex therapist can help to break patterns relating to stress, anxiety or a reduced libido.

In addition, there is medical treatment under the supervision of a doctor, which, following a proper diagnosis, can be used to complement lifestyle changes and counselling. This combination of approaches is generally more effective than relying solely on a single approach.

Is there anything I can do myself before I seek help?

Yes, making a few lifestyle changes can already make a difference before you seek professional help. Exercising more, cutting down on alcohol, giving up smoking and getting enough sleep improve blood flow and reduce stress hormones that impair erectile function. Dealing with stress in a mindful way, for example through relaxation exercises or by talking to your partner, can also alleviate psychological symptoms. However, these steps do not resolve every cause: if symptoms persist, a doctor remains the best person to determine the exact cause.

Need help with erectile problems?

Persistent erectile problems are no cause for panic, but they are a reason to have the cause investigated. A doctor can determine whether the cause is physical, psychological or a combination of both, and which approach is appropriate. Medical treatment under a doctor’s supervision, combined with lifestyle changes and, where appropriate, counselling, can effectively contribute to an improved sex life, although sexual arousal remains a prerequisite for the treatment to be effective. Anyone wishing to look into this can take the first step via Fellos’ online intake form.

Frequently Asked Questions

Are erection problems normal at my age?

Erectile problems can occur at any age, but the likelihood increases with age. At the age of 40, around 40 per cent of men experience them at some point, and at the age of 70, around 70 per cent. It is not uncommon at a younger age either, often with a psychological cause such as stress.

Can stress really affect an erection?

Yes, stress activates the sympathetic nervous system, which reduces blood flow to the penis. This can make it difficult to achieve an erection, even if there is nothing physically wrong. Simply relaxing and discussing the stress with a partner often helps.

How long should I wait before seeing a doctor?

If the symptoms persist for longer than a few weeks or months, or if they keep recurring, it is advisable to make an appointment with your GP. This is particularly important for men over 40, as erectile problems at this age may indicate an underlying cardiovascular risk.

Is it safe to treat erectile problems yourself by making lifestyle changes?

Lifestyle changes such as giving up smoking, cutting down on alcohol and taking more exercise are safe and can make a difference. However, they do not address every cause, so if symptoms persist, you will still need to see a doctor to determine the exact cause.

How much does an initial consultation at Fellos for erectile dysfunction cost?

The cost of an initial consultation is stated on the Fellos website at the time of booking. During the online consultation, a doctor will assess your symptoms and possible causes, after which appropriate advice will be provided.