Sexual Health · 6 min read · Published 2026-02-20
Sexual health remains one of the most undertreated areas of men's medicine in the UK. Despite affecting an estimated 4.3 million men in Britain, erectile dysfunction (ED) and related concerns are still shrouded in embarrassment — which means millions of men suffer in silence rather than seeking the straightforward medical help available.
At The 35+ Club in Chelsea, we approach sexual health as we would any other aspect of men's wellbeing: with clinical rigour, discretion, and without judgement.
Erectile dysfunction isn't simply a problem of ageing — it's often an early warning sign of underlying cardiovascular disease. The blood vessels supplying the penis are smaller than those supplying the heart, meaning vascular damage typically manifests as erectile difficulties three to five years before it presents as cardiac symptoms.
This is why any responsible doctor treats ED as a medical investigation, not just a prescription opportunity.
Low testosterone is a frequent contributor. When total testosterone falls below 12 nmol/L, libido and erectile function are often among the first casualties. However, testosterone is rarely the sole factor — oestradiol levels, thyroid function, and prolactin all play supporting roles.
Endothelial dysfunction — damage to the lining of blood vessels — reduces blood flow throughout the body, including to the penis. Risk factors include high blood pressure, elevated cholesterol, insulin resistance, and smoking.
Performance anxiety, stress, relationship difficulties, and depression can all contribute. Often, there's a combination of physical and psychological factors, creating a cycle that's difficult to break without professional support.
Many commonly prescribed medications — including antidepressants (SSRIs), beta-blockers, and certain hair loss treatments — can impair sexual function. A medication review with your doctor can identify whether this is a contributing factor.
At our Chelsea clinic, a sexual health assessment includes:
If low testosterone is confirmed, treatment can significantly improve both libido and erectile function. This may involve testosterone replacement therapy, with regular monitoring to ensure safety and efficacy.
Medications such as sildenafil (Viagra) and tadalafil (Cialis) remain effective first-line treatments for erectile dysfunction. However, they should be prescribed as part of a broader treatment plan — not as a standalone solution that ignores the underlying cause.
Evidence consistently shows that regular cardiovascular exercise, weight management, alcohol reduction, and improved sleep quality can meaningfully improve sexual function — sometimes to the point where medication becomes unnecessary.
Low-intensity extracorporeal shockwave therapy (LiESWT) is an emerging treatment that stimulates new blood vessel formation in penile tissue. Early evidence is promising, particularly for men with mild to moderate vascular ED.
We understand that discussing sexual health requires trust and privacy. Our Chelsea clinic on Ives Street is designed for exactly this — private consultation rooms, no shared waiting areas with other specialties, and a team that treats these conversations as routine clinical practice.
Sexual health difficulties after 35 are common, treatable, and often a valuable window into your broader cardiovascular and hormonal health. Ignoring them doesn't make them go away — but investigating them properly can improve not just your sex life, but your overall health and longevity.
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