Men are ignoring the early signs of erectile dysfunction - putting symptoms down to stress, fatigue or just 'getting older' - leaving them at risk of developing life-threatening heart conditions, a top GP has warned.
Experts say that there are five key signs that all men need to be aware of, including fewer morning erections and reduced sensitivity.
As many as half of all men aged 40 to 70 will at some point experience erectile dysfunction, according to the British Association of Urological Surgeons.
The prevalence rises significantly with age - by 70, over two-thirds may be affected.
Dr Donald Grant, GP and Senior Clinical Advisor at The Independent Pharmacy, said: 'Erectile dysfunction doesn't happen overnight.
'In many cases, there are plenty of early warning signs that can indicate a potential issue with achieving or maintaining an erection.
'Despite this, many early signs are often ignored or brushed off as stress, tiredness, or simply getting older.
'Recognising the warning signs early and seeking advice can make a significant difference, not just for sexual health, but for overall wellbeing.'
As many as half of all men aged 40 to 70 will at some point experience erectile dysfunction, according to the British Association of Urological Surgeons.
Research has shown that men with erectile dysfunction are at higher risk of suffering from heart disease.
One study by US scientists, published in The Journal of Sexual Medicine, found men with erectile dysfunction had a 70 per cent increased risk of an early death from any cause.
Another Dutch study found men with erectile dysfunction were up to 250 per cent more likely to develop cardiovascular disease, the leading cause of death globally. Experts say that this is because erections are an early warning sign for disease.
'Erections rely on strong and consistent blood flow, so a reduction in morning erections could be an early indication of the body's vascular changes,' says Dr Grant.
Now experts say that these are the warning signs that men need to watch out for.
Loss of morning erections
Waking up with an erection is a sign that a man is healthy according to experts. Medically termed nocturnal penile tumescence, or night time erections, these are a normal part of male sexual function.
During certain stages of sleep, parts of the nervous system that normally control the muscles governing blood flow to the penis switch off.
This, along with naturally fluctuating hormone levels, leads to erections at night and in the morning on waking. Studies show that, for most men, it is normal to get between three and five erections a night, each of about ten to 30 minutes.
FirmTech - a company that manufactures penis monitors - analysed data from 150,000 men and found the number of night-time and morning erections remains relatively stable throughout life.
A morning erection is essentially the final nocturnal penile tumescence and the only insight a man can have into whether they are still getting them without an expensive penis monitor.
'Many men don't understand that regular morning erections are a sign of healthy blood flow and nerve function,' says Dr Grant.
'This means when they become weaker or less frequent, it can often be a sign that circulation isn't working as efficiently as it should. Erections rely on strong and consistent blood flow, so a reduction in morning erections could be an early indication of the body's vascular changes.
'Occasional changes are completely normal and can be influenced by stress, poor sleep, or alcohol. However, if someone notices a persistent decline over weeks or months, it's important to seek medical advice from your GP.'
Lower sex drive or loss of sexual desire
Last month research dispelled the commonly-held belief that libido declines with age. Researchers from the University of Tartu in Estonia analysed data from more than 67,000 adults ranging in age from 20 to 84.
They discovered that male sexual appetite increased through their 20s, peaked in the early 40s and then began a gradual decline.
Now experts say that reduced libido can be a key warning sign for erectile dysfunction. ‘Reduced libido is one of the most common early indications that something may be affecting a man’s sexual health,’ says Dr Grant.
‘With so many potential contributing factors, men often ignore or dismiss them as stress, ageing, low testosterone, or temporary lifestyle changes such as increased alcohol consumption.
‘ED can cause reduced libido because sexual desire and sexual performance are closely linked. When a man begins to experience difficulty with erections, it can lead to anxiety around intimacy, lowered confidence, and a fear of repeated problems, reducing sexual interest over time.’
Longer time needed to get an erection after sex
Even if a man can get an erection, a delay between being able to get another can be an early warning sign of erectile dysfunction.
'It's completely natural for recovery time after orgasm to increase gradually with age. However, a sudden or significant change in the amount of time it takes to achieve an erection after having sex can sometimes indicate hormonal shifts, reduced blood flow, or underlying health concerns,' says Dr Grant.
'Many men put this sign down to age, but this sign should never be ignored. If recovery time has increased alongside other symptoms such as reduced firmness or lower libido, it may be an early sign of erectile dysfunction and is worth discussing with a GP.'
Reduced penile sensitivity or weaker erections
Experts say one of the earliest signs of the problem is an erection that lacks rigidity. This means it might feel soft to the touch or be difficult to maintain during intercourse.
FirmTech says its research has shown that, between the ages of 20 and 60, rigidity reduces, on average, by about 15 per cent. And for those with underlying health issues, this change can be far more pronounced.
'Finally, it can be normal for men experiencing ED to notice reduced sensitivity. This may mean that stimulation feels less intense than it once did, making it more difficult to achieve or maintain a firm erection,' says Dr Grant.
'Changes in sensitivity can be attributed to many different potential factors, including reduced blood flow, heightened stress, or lifestyle habits such as smoking or excessive alcohol consumption. Like all of these signs, it's important to monitor this symptom closely.'
Inconsistent erections or difficulty maintaining firmness
Experts say that the final early warning sign that men need to look out for is inconsistent erectile dysfunction.
'Occasional erectile difficulty is completely normal and can happen to any man. However, if issues begin occurring more frequently, even if not every time, this inconsistency can signal the early stages of ED,' says Dr Grant.
'Due to stigma or fear of embarrassment, men often wait until the problem becomes constant before seeking help, but recurring issues are usually the body's way of highlighting an underlying issue that shouldn't be ignored.'