Erectile difficulties: medical and psychological support
Erectile difficulties: medical and psychological support
Getting or keeping an erection can be affected by your body, your mind or both. Doctor-led therapy looks at the whole picture. Online across the UK, or in person in Swindon.
- GMC Registered Doctor (MBBS, MRCGP)
- COSRT Registered Psychosexual Therapist (No. 4539)
- Online across the UK, or in person in Swindon
Erectile difficulties are common
Most men have trouble getting or keeping an erection at some point. It becomes a problem when it happens often, causes worry, or starts to affect your confidence or relationship.
Erectile dysfunction (ED) is not a judgement on you or your desire for your partner. It’s a signal that something, physical, emotional or both, is getting in the way of a normal response.
Physical or psychological?
Often it’s both. An erection depends on healthy blood flow, nerves and hormones, and on feeling relaxed enough to respond.
- Physical factors can include heart and circulation problems, high blood pressure, diabetes, raised cholesterol, hormonal changes, some medications, smoking and alcohol.
- Psychological factors can include performance anxiety, stress, low mood, relationship tension, pornography habits, or worry left over from a previous difficult experience.
Clues can help. Waking with erections, or being able to get an erection on your own but not with a partner, can suggest anxiety is playing a large part. Because ED can be an early sign of heart or circulation problems, it’s sensible to have your physical health checked as well.
Why a doctor-led approach helps
As a GP and psychosexual therapist, I can consider medical and psychological causes together. Where useful, I’ll suggest health checks or treatment options to discuss with your own GP, alongside therapy that tackles the anxiety and patterns keeping the problem going.
Medication can help many men, but it doesn’t address worry, avoidance or the impact on a relationship. Many people find it helps to combine approaches.
What therapy involves
- Understanding how arousal and erections work, and what disrupts them
- Breaking the cycle of performance anxiety, where fear of failing makes failing more likely
- Sensate focus: structured touch exercises that take the pressure off performance
- Communication work, so you and a partner can talk openly without blame
- Looking at stress, mood and lifestyle factors that may be contributing
You can come on your own or with a partner. Sessions are confidential and talking only. Related concerns such as premature or delayed ejaculation are also part of my work.
Session fees
Start with a short, confidential conversation
The introductory consultation lets us talk about what brings you here before you commit to ongoing sessions.
Appointments cancelled or rescheduled with less than 48 hours’ notice may be charged in full. A limited number of reduced-fee spaces may be available; please email to discuss this confidentially.
Frequently asked questions
Should I see my GP first?
It can help, especially to check blood pressure, blood sugar and cholesterol. You do not need a referral to book with me, and I can advise on which checks may be worth discussing with your GP.
Can therapy help if I already take medication for ED?
Yes. Medication helps the physical response, while therapy can address anxiety, confidence and relationship patterns. Many people benefit from both.
Can my partner come to sessions?
Yes, if you both would like that. You can also attend on your own; it is your choice.
Is erectile dysfunction always a sign of a health problem?
Not always, but it can be an early sign of heart or circulation problems, so it is worth having your physical health checked.
Are sessions confidential?
Yes. Everything you share is treated with strict confidentiality, within the professional and legal limits explained at your first appointment.
More answers on the FAQ page.
Take the pressure off. Start with a conversation.
A confidential 30-minute online conversation for £60, with no commitment to ongoing sessions.
Book Your Introductory ConsultationRelated support
Written by Dr Kahverry Rajeswaran MBBS, MRCGP, GMC-registered GP and COSRT-registered psychosexual therapist. Last reviewed: 22 October 2026