Healthy Male seeks to increase awareness and understanding of erectile dysfunction, to improve accurate diagnosis and to encourage appropriate treatment and follow-up. Erectile dysfunction (the inability to achieve and/or maintain an erection sufficient for satisfactory sexual activity) is an important condition that affects the quality of life of many Australian men.
At least one in five men over the age of 40 years experience significant erectile problems and about one in ten men are completely unable to have erections 1 . Men with erectile problems can often be embarrassed, or have the view that if they are not sexually active it is not a major concern; many men do not speak with their family doctor about their condition. However, erectile dysfunction is often associated with important medical problems.
Conditions and risk factors commonly associated with erectile dysfunction 2,3,4
Cardiovascular/metabolic disease: Erectile dysfunction may be an early warning sign for cardiovascular disease and diabetes. Men with erectile dysfunction should see their family doctor for treatment and also be checked for cardiovascular risk factors such as high blood pressure, diabetes, high cholesterol, obesity, physical inactivity and smoking. Men presenting primarily for cardio-metabolic conditions should likewise be screened for sexual function.
Depression: Depression and anxiety may be a consequence of, or a risk factor for, erectile dysfunction. A man’s mental health should be considered in tandem with physical risk factors.
LUTS/BPH: Lower urinary tract symptoms and/or benign prostate hyperplasia may also be associated with erectile dysfunction. Men presenting with these symptoms should be reviewed for erectile dysfunction, sleep apnoea, cardiovascular risk factors and depressive symptoms.
Recommendations for approaching erectile dysfunction treatment
- Men should see their family doctor to discuss ALL issues in relation to erectile dysfunction, whether they are sexually active or not.
- Underlying medical problems that cause erectile dysfunction require a full medical check-up by the family doctor.
a. Men with erectile dysfunction who want to have a return to sexual activity should be offered therapies that have been TGA approved and are available through consultation with their family doctor.
b. Healthy Male strongly discourages men from obtaining non-TGA approved drugs or natural supplements that claim to treat erectile dysfunction, including from:
- unregulated online sources (high risk of counterfeit, ineffective and potentially dangerous drugs being purchased)
- ‘Erection Clinics’ that don’t properly assess the man for health conditions and risk factors
- non-TGA approved medications purchased from compounding pharmacists
- Ongoing monitoring and assessment of health conditions and erectile dysfunction can be individually tailored to the patient’s needs.
Health Male is a collaborative initiative involving leading health professionals and research organisations and is funded by the Australian Government Department of Health.
- Holden CA, McLachlan RI, Pitts M, Cumming R, Wittert G, Agius P, Handelsman DJ and de Kretser DM. Men in Australia, Telephone Survey (MATeS) I: A National Survey of the Reproductive Health And Concerns Of Middle Aged and Older Australian Men. Lancet 2005; 366: 218-24
- Martin S, Atlantis E, Wilson D, et al. (2012) Clinical and Biopsychosocial Determinants of Sexual Dysfunction in Middle-Aged and Older Australian Men. J Sex Med. 9(8):2093-2103.
- Weber MF, Smith DP, O'Connell DL, et al. (2013) Risk factors for erectile dysfunction in a cohort of 108 477 Australian men. Med J Aust. 199(2):107-111.
- Schlichthorst M, Sanci LA and Hocking JS (2016) Health and lifestyle factors associated with sexual difficulties in men - results from a study of Australian men aged 18 to 55 years. BMC Public Health. 16(Suppl 3):1043.
Resources for Health Professionals
Hatzimouratidis K, Giuliano F, Moncada I, et al. (2018) EAU guidelines on male sexual dysfunction. Available from:
McMahon C. Erectile dysfunction. Intern Med J 2014; 44: 18-26.
Available from: onlinelibrary.wiley.com/doi/full/10.1111/imj.12325
Burnett AL, Nehra A, Breau RH, et al. Erectile dysfunction: AUA Guideline. J Urol 2018; doi: 10.1016/j.juro.2018.05.004. Full AUA (American Urological Association) guideline, 2018