Erectile dysfunction in Ireland

Erectile dysfunction (ED) means repeated difficulty getting or keeping an erection firm enough for satisfactory sexual activity. An occasional difficulty after stress, poor sleep or alcohol does not necessarily mean you have ED. If it keeps happening, a GP assessment can help identify the cause and a suitable treatment.

The Irish Study of Sexual Health and Relationships collected data in 2003. A published analysis reported erectile dysfunction in 15.4% of participating men aged 18–64, using a question about problems lasting at least one month in the previous five years. This historical survey result is not a current national rate, does not cover every age group and does not measure new cases per year.

Prevalence describes how many people report a condition; incidence measures new cases over time. We have not identified a reliable current Ireland-wide annual incidence estimate. International figures should not be relabelled as Irish statistics. TILDA's report on sexual activity in adults over 50 is not an ED prevalence study.

International prevalence: the Massachusetts Male Aging Study

A US community survey conducted in Massachusetts in 1987–1989, published by Feldman and colleagues in 1994, found a combined prevalence of minimal, moderate and complete erectile difficulty of 52% among men aged 40–70. This includes mild difficulties: it does not mean 52% had complete ED. The estimated prevalence of complete ED rose from 5% at age 40 to 15% at age 70.

International incidence: how often new cases developed

A follow-up analysis from the same Massachusetts study, published by Johannes and colleagues in 2000, found 25.9 new ED cases per 1,000 man-years (95% confidence interval 22.5–29.9). It included 847 men without ED at baseline, aged 40–69 at entry, followed for an average of 8.8 years. One thousand man-years means, for example, 1,000 men observed for one year; it is a measure of time at risk, not the percentage of all men who have ED.

ED often has more than one cause. It is not a personal failure and does not automatically mean a lack of attraction. Blood flow, nerves, hormones, medicines and psychological factors can all play a part.

• Blood-vessel and metabolic health: diabetes, high blood pressure, high cholesterol, obesity and smoking can contribute.
• Stress and mental wellbeing: performance anxiety, depression, relationship strain and poor sleep may affect erections.
• Medicines: some antidepressants and other treatments may contribute. Do not stop a prescribed medicine yourself; ask for a review.
• Hormonal or physical causes: low testosterone, pelvic surgery, nerve conditions or penile curvature may need examination or tests.

Persistent ED can sometimes be an early marker of cardiovascular disease. Depending on your history, a GP may recommend blood pressure measurement, glucose or HbA1c, cholesterol and an early-morning testosterone test. Not everyone needs the same tests, and online care cannot replace an examination when one is necessary.

Both medicines are PDE5 inhibitors: they support blood flow during sexual stimulation. They do not create desire and do not cause a continuous erection. The time window is not a guarantee that treatment will work for you. Your GP chooses the medicine and dose after reviewing your health, other medicines and preferences.

Other treatment options

• Lifestyle and underlying health: stopping smoking, regular activity, reducing heavy drinking and treating diabetes or blood pressure can help.
• Psychosexual or talking therapy: useful when anxiety, stress or relationship factors are contributing; it can be combined with medical treatment.
• Other oral medicines: vardenafil or avanafil may be considered by a clinician when appropriate; suitability and availability vary.
• Vacuum erection devices: a non-tablet option, including when tablets are unsuitable; seek advice on choosing and using a medical device.
• Specialist care: alprostadil, injections or surgical options may be considered after assessment. These are not promised through a NOVAGP Smart Prescription request.
• Testosterone: only for appropriately assessed, confirmed deficiency — not a routine ED treatment or an online performance booster.

This is a safety overview, not a complete list of contraindications. The product leaflet and your clinician's advice take priority. Tell the GP about every prescription medicine, supplement, recreational drug and pharmacy product you use.

Our existing ED questionnaire and GP review cover the checks below. These are the current assessment steps, not a promise of a prescription or a fixed treatment regimen for everyone.

When we move away from a questionnaire

The current NOVAGP questionnaire flags nitrate/nicorandil use, cardiac symptoms or a heart attack/stroke in the last six months, specified eye problems and a history or risk of prolonged erections. A GP decides the appropriate next step. A consultation does not make a contraindicated medicine safe, and emergency symptoms need urgent care rather than booking.

A €25 Smart Prescription request includes GP review; medicine costs are separate at your pharmacy. If the GP cannot safely prescribe online, the request fee is refunded in full. A €39 video or phone consultation allows a fuller discussion of new or persistent symptoms, unsuccessful treatment and possible tests or referral. Neither pathway guarantees a prescription.

If treatment does not help

Tell your GP how and when you took it, whether there was sexual stimulation, any heavy meal or alcohol, and any side effects. Do not keep escalating the dose or combine tablets. The GP can review correct use, underlying causes and whether a different treatment, examination or specialist referral is needed.

• HSE: erectile dysfunction — causes, treatment and pharmacy supply
• Irish survey analysis (2012): male sexual dysfunction; survey data collected in 2003
• Feldman et al. (1994): Massachusetts Male Aging Study — prevalence; 1987–1989 survey
• Johannes et al. (2000): Massachusetts Male Aging Study — incidence over 8.8 years
• European Association of Urology: management of erectile dysfunction
• EMA: Viagra — authorised product information and patient leaflet
• EMA: Cialis — authorised product information and patient leaflet

Sources checked on 27 October 2026. Irish survey figures describe historical research, not today's national incidence. This guide provides general information; an individual assessment and the medicine's current patient leaflet are essential.

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