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• Vasculogenic conditions alter the flow of blood to the penis. Erectile dysfunction is closely linked to cardiovascular disease, so your doctor might start by looking at this. High blood pressure (hypertension) and diabetes can both cause ED. Diabetes is a condition caused by a surfeit of glucose in the blood that affects both the flow of blood to the penis and the nerve endings in your penis. It is therefore both a vasculogenic and a neurogenic condition.

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• men at risk of priapism, e.g. if you have sickle cell anaemia
• men using other erectile dysfunction medications
• men with a penile implant
• men who have been told to avoid sexual activity

Men with the following conditions should not use Alprostadil:

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