Common Questions · Erectile dysfunction · No. 34
They didn't think it was a real problem
One dismissive consultation can end help-seeking for years. One good one is remembered just as long.
By Mr Musaab Yassin, Consultant Urological Surgeon & Andrologist. Oxford and central London.
A man can finally raise ED after months or years of hesitation and be met with “that happens at your age”, “it’s probably stress” or an automatic prescription without much discussion. Qualitative evidence shows that healthcare communication can either facilitate or shut down further help-seeking.1
ED deserves neither catastrophising nor dismissal. It is a symptom with consequences for quality of life and, sometimes, wider health.
Why can a brief dismissive response matter so much?
Because the barrier to disclosure is often already high. When a man expects embarrassment or judgement, one rushed interaction can confirm his decision not to mention the problem again. The 2026 qualitative synthesis identified clinician communication as one of four central themes in ED treatment decisions.1
What should a proper assessment include?
At minimum: onset and pattern; rigidity and maintenance; spontaneous/morning erections; libido; ejaculation; medications; diabetes and cardiovascular risk; pelvic surgery or radiotherapy; neurological symptoms; psychological/relationship context; and whether testosterone testing is clinically indicated.
Should every man need lots of tests?
No. Good assessment is not the same as over-investigation. Many men need a focused history, examination and a few targeted blood tests. Specialist testing such as penile Doppler ultrasound is reserved for selected situations.
What if treatment was prescribed but not explained?
Ask how to take it, how many attempts constitute a fair trial, what side effects to expect, what interactions matter and what the next option is if it fails. Treatment adherence is far better when the plan makes sense.
When is a second opinion reasonable?
If ED is persistent and bothersome but no meaningful history was taken, a potentially important cause has not been considered, or you have repeatedly been told simply to accept it despite wanting treatment, a more detailed assessment is reasonable.
Bottom line
ED is a legitimate medical and quality-of-life concern. A good consultation should leave you understanding what the likely causes are, whether wider health needs checking, what the treatment choices are and what happens if the first option fails.
If you have already raised this once and been told it is your age, I am sorry — that is a common experience and it is a poor one. Bring it again. A proper assessment takes one appointment and should leave you knowing what is likely causing it, whether your wider health needs checking, and what happens if the first treatment does not work.
If this sounds like you
A first consultation is £295, and follow-up £190. It usually runs at least twenty minutes; allow up to an hour if you are likely to need a scan, a flow test, or blood or urine tests on the day. You do not need a referral to book privately, and you are under no obligation to proceed with anything.
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The 1 studies behind this page▾
- Men’s Experiences and Decision-Making in Erectile Dysfunction Treatment: A Qualitative Evidence Synthesis — Ullah A, Hussain A, Chaudhry T. Cureus. 2026. doi:10.7759/cureus.111413
Mr Musaab Yassin is a Consultant Urological Surgeon and Andrologist practising in Oxford and central London. FRCS (Urol). GMC 6118378. Reviewed August 2026.
This page gives general information and does not replace an individual assessment. Figures quoted come from published research and describe groups of patients rather than any one person — your own history, anatomy and priorities change what they mean for you.