One in five Australian men over the age of 40 suffer from impotence but worryingly, many men are putting off that all-important doctor's visit.
Erectile dysfunction, also known as impotence, is the inability to get and/or maintain an erection for sexual intercourse. It's not a disease in itself, but rather a symptom of another problem, either physical or psychological.
According to a 2005 study published in the Lancet journal, at least one in five Australian men over the age of 40 often experience erectile problems, and about one in 10 are unable to have erections at all.
However, according to Brett McCann, relationships and sexual health counsellor and CEO of Impotence Australia, it's not just older men who are affected.
"About 30 percent of men over the age of 18 would be having some sort of difficulty getting or maintaining an erection," he says.
Occasionally being unable to get an erection is normal and could simply be due to a big night on the booze, anxiety, stress or a lack of sleep. But reoccurring impotence may be a symptom of an underlying, potentially life-threatening disease, which is why seeing your doctor is important.
And it's not just your health to consider. According to McCann, erection problems also take their toll on relationships.
"If a relationship was shaky beforehand, this is certainly not going to help it and if the relationship is strong, it still will challenge that relationship," McCann says.
And here's the good news: impotence is treatable in 95 percent of cases.
What are the causes of impotence?
Experts believe that approximately 75 percent of cases of erectile dysfunction are caused by a physical condition, which McCann says can include diseases such as "diabetes, high-blood pressure, cardiovascular disease, any sort of neurological diseases like multiple sclerosis. And for about 5 percent of men, there may be low testosterone."
Lifestyle factors can also play a big role in male performance issues. "If a man smokes and is overweight then he's highly likely to have erectile dysfunction," he adds.
A smaller number of cases are caused by psychological factors, such as stress, depression and relationship problems.
The entire list of possible causes for impotence is extensive: you can view it on the Impotence Australia website.
Visit your GP
So you've noticed a problem. What next? "I think the first step is to see a GP," McCann says.
Your doctor will complete a medical assessment which includes testing blood-sugar levels, cholesterol and blood pressure. Depending on the findings, they may refer you for specialist care or recommend the appropriate treatment for you.
Treatments for erectile function vary with the individual. "Oral tablets are common and effective as what they call a first-line treatment," McCann says. "Your doctor would prescribe the suitable one."
Viagra and Cialis are perhaps two of the drugs you would have heard of. They are drugs known as PDE5 inhibitors, which inhibit a particular enzyme in the penis, enhancing its response to sexual stimulation.
Other treatments for erectile dysfunction include counselling, injections, hormone therapy, or for severe cases, penile implants.
'I'll wait and see …'
According to McCann, Australian men tend to take the "I'll wait and see" approach to their health, hoping that the problem will go away.
"The research shows that the majority of men will wait up to two years before seeking help, which is a long time," he says.
However, often symptoms don't improve as the underlying issue hasn't been addressed and by the time they actually see their doctor, the problem has reached crisis point.
"So by the time they see a doctor, they are also dealing with a relationship problem, as well as a medical crisis," McCann says.
For more information, visit Impotence Australia.