Due to the intimate nature of the problem, erectile dysfunction is often swept under the carpet, with many men too embarrassed to visit a health practitioner.

But more than just an awkward problem in the bedroom, erectile dysfunction may be a warning sign for later, more serious health issues.

One such issue is cardiovascular disease, with evidence linking the condition to earlier erectile dysfunction.

It’s a link the Australian Physiotherapy Association are trying to raise awareness of, encouraging men to speak up, and have an open and honest conversation about their sexual health.

Not only could it improve life in the bedroom, it could potentially save their life.

APA men’s pelvic health physiotherapist Jo Milios says that most men will experience episodes of erectile dysfunction (ED) in their lifetime, which may include premature ejaculation, problems with climaxing or changes to the shape or appearance of the penis including curvature (known as Peyronie’s disease).

“It can have a very significant negative impact on men and their partners but can be treated successfully,” says Milios.

Milios says most types of ED are related to issues such as:

• infection
• pelvic floor muscle dysfunction
• prostate abnormalities
• anxiety or depression
• medications
• illicit drugs or alcohol consumption

Despite the numerous risk factors, a growing body of literature has identified erectile dysfunction as being associated with cardiovascular disease (CVD).

“This may often be overlooked when men present to their doctor, but erectile dysfunction has a similar or greater predictive risk for cardiovascular events than traditional risk factors, such as family history or smoking.”

According to Milios, research suggests that erectile dysfunction usually precedes coronary symptoms by around three years, which is why it can now be considered an early marker of CVD.

“But this shouldn’t be seen as all doom and gloom,” says Milios.

“In fact, if men are experiencing any concerns with their sexual function, they have plenty of time to address the potential heart health concerns that may follow.”

Milios says for men wanting to discuss issues relating to sexual function, a men’s pelvic health physiotherapist is the perfect place to start.

“A men’s pelvic health physiotherapist is perfectly placed to treat and educate men presenting with erectile dysfunction.

“Physio prescribed exercises can help with reducing the general risk of CVD in conjunction with treatment from their GP.”

Not only can having the conversation be potentially life-saving, physiotherapists can also play a key role in helping with the symptoms of ED.

“Pelvic floor muscle training is an effective and well-established non-invasive technique to improve erectile dysfunction,” says Milios.

The pelvic floor comprises muscles and connective tissue that support abdominal organs, control the bowels and bladder and are involved in sexual function.

Once a patient has made contact with their physiotherapist, they should conduct a thorough assessment to establish goals, pelvic floor requirements and a treatment plan.

Physiotherapists should design a personalised pelvic floor muscle exercise program based on their client’s abilities and needs.

They should also provide advice relating to health bowel and bladder habits, lifestyle factors and general exercise.

Although prevalence of ED increases with age, 61 per cent of men aged 45 or older have reported some form of dysfunction.

It’s a growing issue, with cases of ED estimated to be around 300 million by 2025.

Along with cardiovascular disease, other risk factors include:

• Atherosclerosis-related risk factors, such as hypertension, dyslipidaemia and diabetes
• Neurological conditions, such as Alzheimer’s disease, multiple sclerosis, Parkinson’s disease, stroke, spinal cord disorders and peripheral nerve disorder
• Pelvic surgery, radiation and trauma
• Endocrinological conditions, such as thyroid disorder
• Obesity and metabolic syndrome
• Penile abnormalities
• Psychological and psychiatric conditions
• Medications
• Substance abuse

Milios’ final piece of advice for men who are experiencing erectile dysfunction? It’s simple really.

“Don’t hold back from getting checked out, the earlier the better. Not only will it improve your bedroom form, it may just save your life down the track.”