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Emergency medical attention is required if erectile dysfunction is accompanied by: Chest pain or severe breathlessness during sexual activity, which may indicate cardiac disease call 999 or attend A&E immediately Priapism (a painful erection lasting more than 4 hours) seek urgent medical care immediately as this is a urological emergency Acute penile trauma or suspected penile fracture (sudden pain, swelling, bruising, and loss of erection during intercourse) seek urgent medical care Non-urgent concerns that should be discussed with your GP at a routine appointment include: Sudden onset of ED, particularly if associated with new medication Penile deformity (e.g., Peyronie's disease) or pain during erection Loss of morning erections combined with other symptoms of low testosterone (fatigue, reduced libido, mood changes, loss of muscle mass) Your GP can provide appropriate referral pathways if specialist input is needed, such as to urology, endocrinology, or psychosexual medicine services, in line with NICE Clinical Knowledge Summaries (CKS) guidance on erectile dysfunction

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