Erectile dysfunction (ED) means finding it hard to get or keep an erection firm enough for sex. It is common, becomes more likely with age, and can usually be treated. With Global Health you can request erectile dysfunction treatment online in Spain. You complete a secure, confidential questionnaire, a doctor reviews your answers, and if treatment is clinically suitable the doctor issues an electronic prescription that you receive in your Global Health account and can take to a pharmacy in Spain. If it is not suitable, the doctor explains why and suggests what to do next.
What is included
- A review of your medical questionnaire by a doctor
- A prescription for licensed erectile dysfunction medication, if clinically suitable
- An electronic prescription in your Global Health account, ready to take to a pharmacy in Spain
- Written advice on how to take the treatment and what to expect
- Secure messaging with the doctor about your request
The medication is not included and is paid for separately at the pharmacy.
Who this service is not suitable for
Our doctors cannot safely prescribe erectile dysfunction treatment online if you:
- are under 18
- take any nitrate medicine for chest pain or angina (tablets, sprays or patches), or use recreational poppers
- have had a heart attack or stroke in the last six months
- get chest pain, severe breathlessness or dizziness during sex or light exercise
- have very low blood pressure, or high blood pressure that is not controlled
- have severe heart disease, or have been told by a doctor that sex is not safe for you
- have severe liver or kidney disease, or an inherited eye condition affecting the retina
- have pain, a new curve or a lump in the penis, or ED that started suddenly after an injury
If any of these apply, please book a video consultation with a GP so a doctor can assess you properly.
How it works
- Complete the questionnaire. Answer questions about your erections, general health, blood pressure and any medication you take. It takes about five minutes.
- Doctor review. A doctor reviews your answers against clinical guidance and may message you if more information is needed.
- Prescription issued. If treatment is suitable, the doctor issues an electronic prescription that you receive in your Global Health account and can take to a pharmacy in Spain.
What is erectile dysfunction?
Most men have trouble with erections now and then, often because of tiredness, stress or alcohol. This is normal. Erectile dysfunction is when the problem keeps happening. Common erectile dysfunction symptoms are difficulty getting an erection, losing it before or during sex, or erections that are not as firm as before. Morning or night-time erections that still happen can suggest the cause is psychological rather than physical.
What causes it?
An erection depends on healthy blood flow, nerves, hormones and mood working together. Physical causes include narrowed blood vessels, high blood pressure, high cholesterol, diabetes, being overweight, smoking, heavy drinking and low testosterone. Some medicines, including some for blood pressure and low mood, can contribute, as can nerve damage after pelvic surgery. Psychological causes include stress, anxiety about performance, depression and relationship difficulties. Often there is a mix of both.
Erectile dysfunction as an early warning sign
The blood vessels in the penis are small, so narrowing of the arteries can show up there before it causes symptoms in the heart. ED can therefore be an early sign of heart disease. Erectile dysfunction and diabetes are also closely linked, because high blood sugar damages nerves and blood vessels over time. If you have not had a recent check, we recommend asking your GP for a blood pressure reading and blood tests for cholesterol and blood sugar.
Erectile dysfunction treatment options
Prescription erectile dysfunction medication works by relaxing the blood vessels in the penis so more blood can flow in when you are sexually aroused. The tablets do not cause an erection on their own and do not increase sex drive. Your doctor will discuss which option suits you:
- shorter-acting tablets are usually taken about an hour before sex and work for several hours
- longer-acting tablets can work for up to around a day and a half, and some can be taken as a low daily dose
- a heavy, fatty meal can slow some tablets down, and alcohol makes erections harder to get
- if the first dose does not work, try it on several separate occasions before deciding it is not effective
Never take more than one dose in 24 hours. Lifestyle changes also help and can improve your overall health: stopping smoking, cutting down on alcohol, regular exercise and reaching a healthy weight. If stress, anxiety or relationship issues play a part, counselling or psychosexual therapy can be very effective. Other treatments, such as vacuum devices or injections, need an in-person specialist assessment.
Side effects and safety
Side effects are usually mild and short-lived. The most common are headache, facial flushing, indigestion, a blocked or runny nose, dizziness and back or muscle aches. Seek urgent medical help if you have an erection that lasts more than four hours, or sudden loss of vision or hearing.
Never take erectile dysfunction tablets with nitrate medicines or poppers, because together they can cause a dangerous drop in blood pressure. Some medicines for an enlarged prostate or blood pressure, and some antifungal and HIV medicines, can also interact, so tell the doctor about everything you take. If you get chest pain during or after sex, stop, rest and call 112. Tell the ambulance crew you have taken ED medication, as it affects which treatment they can give you.
When to see a doctor in person
See your GP if you have pain or a curve in the penis, a lump in a testicle, low sex drive with tiredness or low mood, or signs of diabetes such as feeling very thirsty and passing urine more often. A GP visit is also a good idea if you have never had your blood pressure, cholesterol or blood sugar checked. You can also meet our doctors or see all online prescription services.