When should someone see a doctor for persistent erectile problems?

1. How “persistent” is defined in clinician guidance and why it matters

Clinical and patient-facing sources acknowledge there are no hard-and-fast, universally endorsed rules, yet many practices operationalize persistence by frequency or duration — for example, difficulty more than about one-quarter of attempts or about half the time, or problems lasting several weeks to months — as a threshold to see a clinician ^{[3] [4] [5] [6]}. That pragmatic framing exists because occasional performance problems are common with stress, fatigue or alcohol, while recurrent dysfunction is more likely to reflect treatable medical causes ^{[6] [7]}.

2. Red flags that should trigger urgent or sooner evaluation

Certain presentations require more immediate medical attention: a sudden inability to maintain erections after trauma or surgery, erections that are painful, or ED accompanied by chest pain, shortness of breath, dizziness or other cardiovascular symptoms — all of which can signal acute injury or cardiac risk ^{[5] [8]}. Sources emphasize that ED may be an early warning sign of coronary disease, diabetes, high blood pressure or high cholesterol, so systemic symptoms or rapid change in function merit prompt assessment ^{[2] [8]}.

3. The clinical payoff of early assessment: diagnosing hidden disease and improving outcomes

Approximately three‑quarters of ED cases have a physical basis on evaluation, so seeing a doctor is not just about restoring sexual function but about identifying conditions such as diabetes, vascular disease or hormonal abnormalities that carry broader health consequences ^{[1] [2] [9]}. Major centers recommend primary care or urology evaluation because simple blood tests, medication reviews and targeted vascular or neurologic studies can reveal treatable causes and permit interventions that improve both sexual health and overall prognosis ^{[10] [9] [8]}.

4. Who to see and what to expect during evaluation

Most men can start with a primary care physician who will take a medical history, review medications and risk factors, do a focused exam and order blood or urine tests; referral to a urologist or specialized clinic is common when initial treatments fail or specialized testing is needed ^{[11] [12] [9]}. Diagnostic steps commonly include labs for glucose, lipids and hormones and, when indicated, vascular studies such as penile Doppler ultrasound — all aimed at matching treatment (lifestyle change, PDE5 inhibitors, injections, devices or surgery) to cause ^{[8] [12] [9]}.

5. Barriers, stigma and pragmatic guidance on timing

Embarrassment and misconceptions delay care for many men despite ED’s prevalence, with estimates ranging from tens of millions affected and higher rates with age, so pragmatic advice from health systems is simple: if erections are inadequate for intercourse on a repeated basis or treatments that once worked stop working, schedule an evaluation rather than waiting ^{[13] [14] [6] [4]}. Clinics differ in numeric thresholds — some flag >25% of episodes, others use sustained impairment over weeks to months — but all sources converge on acting when dysfunction is recurrent, worsening, or affecting relationships or mental health ^{[3] [5] [11]}.

6. Final takeaways

When erectile problems are repeated (often framed as occurring a substantial portion of the time), persistent for weeks to months, sudden and unexplained, painful, or accompanied by other health symptoms, medical evaluation is indicated because ED commonly reflects treatable vascular, metabolic, neurologic or psychological causes and can be a harbinger of cardiovascular disease ^{[3] [1] [2] [5]}. There are no universal cutoffs, so the practical rule used by many clinics is: if sexual function is not reliably satisfactory, or treatments stop working, see a primary care doctor or urologist to rule out underlying disease and discuss evidence-based therapies ^{[6] [11] [12]}.