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[4] You should contact your GP if: You experience persistent or worsening erectile dysfunction that affects your quality of life or relationships ED develops suddenly or is accompanied by other symptoms such as chest pain, breathlessness, or new neurological symptoms You have concerns about how your diabetes or its treatment may be affecting your sexual function You are experiencing psychological distress , anxiety, or depression related to sexual health You wish to discuss treatment options for ED, including whether PDE5 inhibitors are appropriate for you Seek urgent medical attention if you experience: Chest pain or cardiovascular symptoms during sexual activity A painful erection lasting more than four hours (priapism) Sudden loss of vision or hearing whilst taking ED medications Your GP can conduct a comprehensive assessment including: Review of your diabetes control (HbA1c, blood glucose patterns) Cardiovascular risk assessment (QRISK) and blood pressure measurement Hormonal evaluation, including morning testosterone levels (before 11am) on two separate occasions if clinically indicated [4] Medication review to identify any drugs that may contribute to ED Discussion of psychological factors and relationship issues Remember that sexual health is an integral component of overall wellbeing , and healthcare professionals are accustomed to discussing these concerns in a confidential, non-judgemental manner

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