Which Doctor Should I See for Erectile Dysfunction?
This patient-friendly guide explains who to see (GP, urologist/andrologist, psychologist/sex therapist, hormone specialist, or heart specialist), what to expect at each step, and how to choose confidently—based on major guidelines and high-quality research.¹²⁴
Step 1: For most men, start with a GP
For most men in Brisbane, the best first appointment is with a GP who is comfortable with men’s sexual health.¹²
A GP is often the best place to start because ED is frequently linked to overall health—blood pressure, cholesterol, diabetes risk, sleep, stress, alcohol, weight, medications, and sometimes hormones.¹²
What a good GP visit for ED usually includes
Based on guideline recommendations, your GP will typically:¹²
Ask about your erections (when it started, whether it’s situational, morning erections, libido)
Review medications and health conditions that can affect erections
Check blood pressure and general health
Order targeted tests when needed (often glucose/lipids; testosterone if symptoms suggest it)
Discuss lifestyle changes that improve erections
Start first-line treatment if appropriate (often an oral PDE5 inhibitor)
Why starting with a GP matters
ED can be a marker of future cardiovascular risk in some men, especially if it’s new or getting worse.³ The point isn’t to scare you—it’s to make sure your ED care also protects your long-term health.
Step 2: See a Urologist when ED is persistent or more complex
A urologist is the main specialist for erectile dysfunction—especially when first-line treatments aren’t working, you’ve got complicating factors, or you want more advanced options.¹²
Andrology is a subspecialty focus within urology that covers male sexual and reproductive health. Practically, this often means deeper experience in ED workups and options beyond tablets.²
When to book a urologist for ED
Guidelines support specialist referral if you have any of the following:¹²
ED that doesn’t respond to tablets despite correct use
Significant diabetes, nerve injury, spinal injury, pelvic surgery, or pelvic radiation history
Penile curvature/pain (possible Peyronie’s disease)
You’re considering treatments like injections, devices, or implants
You want a more tailored plan (for example: choosing between tadalafil daily vs on-demand strategies)
What treatments can a urologist offer?
Urology guidelines describe a stepwise approach, and urologists can provide (or coordinate) the full range:¹²
Optimising oral medicines
Vacuum erection device counselling
Penile injection therapy
Penile prosthesis (implant) for severe, treatment-resistant ED when you want the most reliable option
A clear discussion of what is and isn’t supported by good evidence, so you’re not sold false hope²
Step 3: Consider a psychologist/sex therapist
A lot of ED is mixed—part physical, part psychological. Even when there’s a physical contributor, performance anxiety can “pile on” and keep the cycle going.¹²
You might benefit from a psychologist/sex therapist if you notice:
Erections are better alone than with a partner
The problem is situational
There’s strong anxiety, avoidance, or loss of confidence
Relationship stress or communication issues are prominent
Guidelines support addressing mental and relationship factors alongside medical treatment because combination approaches often work best.¹²
Step 4: See a hormone specialist
Hormones can matter—especially testosterone—but they’re not the cause of ED for most men. Guidelines recommend hormone testing when symptoms suggest it (like low libido, fatigue, fewer morning erections), and treatment should be targeted and monitored appropriately.²
In many cases your GP can manage this; sometimes you’ll be referred to an endocrinologist or a urologist with expertise in male reproductive hormones.²
Step 5: Don’t ignore heart risk
ED is not just about sex. Major consensus guidance emphasises that ED can be a useful opportunity to check cardiovascular risk—particularly in younger men with unexplained ED or men with multiple risk factors.⁴
A key safety point about ED tablets
Common ED tablets (PDE5 inhibitors) are generally safe for many men, but there are important exceptions—especially if you take nitrate medications (often for angina). Mixing nitrates with PDE5 inhibitors can cause dangerous drops in blood pressure.¹²⁴ If you have heart disease, your clinician should check medication safety and activity risk.⁴
Practical steps:
Start with a GP if…
This is new or mild/moderate ED
You haven’t tried guideline-based first steps
You want a full health check as part of treatment¹²
Book a urologist/andrologist if…
Tablets haven’t worked after correct use
You want injections/devices/implant options
You have penile curvature/pain or complex history¹²
Add a psychologist/sex therapist if…
Anxiety, stress, trauma, or relationship issues are a major driver
It’s situational or confidence-related¹²
Consider cardiovascular review if…
You have chest pain, major shortness of breath, fainting, or high heart risk
Your clinician recommends formal risk assessment⁴
Red flags:
Seek urgent medical care if you have:
Chest pain or severe shortness of breath during sex or exercise⁴
A prolonged painful erection lasting hours (priapism—urgent care needed)
Sudden severe penile pain/swelling after injury
References
Burnett AL, Nehra A, Breau RH, et al. Erectile Dysfunction: AUA Guideline. J Urol. 2018;200(3):633-641. doi:10.1016/j.juro.2018.05.004.
European Association of Urology. EAU Guidelines on Sexual and Reproductive Health: Management of Erectile Dysfunction (online guideline chapter; updated regularly). European Association of Urology; 2025.
Banks E, Joshy G, Abhayaratna WP, et al. Erectile dysfunction severity as a risk marker for cardiovascular disease hospitalisation and all-cause mortality: a prospective cohort study. PLoS Med. 2013;10(1):e1001372. doi:10.1371/journal.pmed.1001372.
Köhler TS, et al. The Princeton IV Consensus Recommendations for the Management of Erectile Dysfunction and Cardiovascular Disease. Mayo Clin Proc. 2024;99(9):1500-1517. doi:10.1016/j.mayocp.2024.06.002.
