What to say to your GP

01Why it is worth doing at all

You may be entirely certain this is psychological. You may well be right. Go anyway, and go early.

Erection difficulties are one of the small number of symptoms that can be an early signal of something else going on — often cardiovascular or metabolic, often very treatable, and considerably easier to deal with when it is caught early. That is the medical case, and it is a good one.

But there is a second reason that matters more to most men reading this. Not knowing is its own weight. Some part of you has been running a background process for months, wondering whether there is something seriously wrong. That process consumes attention, and attention is exactly what this problem is made of. Getting checked does not only rule things out. It lets you stop wondering, and put what is left where it belongs.

02The words

You do not need to explain the psychology, tell the story, or justify being there. Three sentences will do it. A GP has had this conversation many times; you are considerably more embarrassed about it than they are.

That is the whole appointment, opened. If you get no further than the first sentence, you have done the difficult part — they will take it from there.

Two additions, if either is true for you: “It still happens normally on my own and first thing in the morning” is clinically useful information and tells them a great deal. So is “It started around the time I began taking [medication].”

03If you cannot say it out loud

Plenty of men cannot, and that is not a character failure. There are several ways round it, and none of them is cheating.

• Write it down and hand it over. Print the three sentences above, or show them on your phone. Doctors are entirely used to this.
• Use the online consultation form if your practice has one. You type it, they read it, and the appointment starts with everyone already knowing why you are there.
• Ask for a telephone appointment. Saying it is markedly easier when you are not being looked at.
• Ask for a particular doctor — by name, or by sex, if that makes the difference between going and not going. Reception will not ask why.
• Lead with something else and add it at the end. “While I’m here — there’s one other thing.” It is not the elegant approach, and it works.

04What tends to happen next

This varies by practice and by person, so treat the following as a general shape rather than a prediction about your appointment.

1. Some questions

   When it started, whether it came on suddenly or gradually, whether it happens every time, whether morning erections have changed, what else is going on — stress, sleep, mood, alcohol, medications.

2. Some basic measurements

   Blood pressure is usual. Height and weight may be taken.

3. Possibly blood tests

   Commonly used to look at things like blood sugar, cholesterol and sometimes hormone levels. Usually a separate short appointment.

4. A medication review

   A number of common prescriptions can affect erections. If your timing lines up with a new one, say so — there may be alternatives.

5. A conversation about options

   Which may include medication, lifestyle changes, referral, or a discussion about the psychological side. You are allowed to ask questions and to go away and think.

05Three things worth asking

• “Is there anything in my results that would explain this?” A plain answer either way is useful. If everything is normal, that is not a dead end — it is information that points you somewhere specific.
• “Could any of my current medication be contributing?” Worth asking directly rather than waiting to be told.
• “If this turns out to be mostly anxiety, what would you suggest?” Some practices can refer for psychosexual or relationship therapy. Availability varies enormously, so it is worth knowing what exists locally.

06And then

If something physical turns up, you have caught it, and you are now dealing with a known thing rather than a feared one.

If nothing does — which, for men with the pattern described on this site, is the more common outcome — that is not a wasted trip and it is not a verdict of “it’s all in your head.” Pressure and anxiety are not imaginary; they are physiological, and they have a mechanism. You have simply ruled out one set of causes and can now work on the one that is left, without the background process running.