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Referral pathways should be considered in the following circumstances: Urology : for men who do not respond to PDE5 inhibitors, or those with structural penile abnormalities (e.g., Peyronie's disease) Endocrinology : for confirmed hypogonadism, hyperprolactinaemia, or suspected pituitary disease Cardiology : for men with high or uncertain cardiovascular risk before initiating treatment or resuming sexual activity Men experiencing ED should contact their GP rather than self-treating with unproven devices, as proper diagnosis may identify important underlying health conditions requiring specific management