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Erectile
Dysfunction
Discreet, evidence-based assessment and treatment for erectile dysfunction. ED is often a marker of underlying cardiovascular or hormonal disease — we assess and treat the whole picture.
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Overview
ED is a medical issue, not a lifestyle choice
Erectile dysfunction affects approximately 40% of men over 40 and is significantly under-treated. Critically, ED is a recognised independent risk factor for cardiovascular disease — new-onset ED in a man under 60 should prompt cardiovascular risk assessment, not just a prescription for sildenafil.
At Metovia we assess the underlying causes thoroughly before and alongside any treatment.
📋 Causes we assess
- Cardiovascular risk (hypertension, dyslipidaemia)
- Testosterone deficiency
- Diabetes and insulin resistance
- Thyroid dysfunction
- Medication side effects
- Psychological factors and stress
💉 Treatment options
- PDE5 inhibitors: sildenafil, tadalafil, vardenafil
- Daily low-dose tadalafil (on-demand or continuous)
- Testosterone replacement where deficient
- Cardiovascular risk factor management
- Lifestyle optimisation (exercise, diet, sleep)
- Referral to urology or psychosexual therapy
📚 Clinical guidelines
Assessment follows EAU (European Association of Urology) guidelines on male sexual dysfunction, BSSM recommendations for ED assessment, and NICE CG136. All new patients receive cardiovascular risk stratification — ED without vascular assessment is incomplete medicine.
All consultations are completely confidential. We offer video and telephone consultations as well as face-to-face appointments.
Initial consultation
£150 / consultation
Full assessment including cardiovascular risk review, blood tests and treatment plan
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