Breaking the Silence: Erectile Dysfunction & Male Infertility

One in 10 men across the globe suffers from erectile dysfunction, with cases expected to rise to 322 million by 2025 [1]. Despite the prevalence of this condition and the variety of accessible treatments, erectile dysfunction is still met with stigma, shame and a lack of understanding

We wanted to explore present-day attitudes towards erectile dysfunction and how it is impacting people in their daily lives and romantic relationships. To delve further into awareness around male sexual health, we also analysed how much Brits really know about male fertility, answering the most frequently asked questions online. We also spoke to sexual health specialists, relationship experts and those who have lived with erectile dysfunction to shed light on the impact of this condition and how men can work to improve their sex life and fertility.

We conducted a survey of 2,000 sexually active adults across the UK and discovered that 69% of men and women have, either themselves or through their partner, experienced erectile dysfunction.

Despite men between the ages of 45-54 years old being most likely to suffer from erectile difficulties (37%), a third of those aged 18-24 have experienced these symptoms demonstrating that, contrary to common perceptions, erectile dysfunction can impact people across all age groups.

The prevalence of erectile dysfunction also seemingly varies based on relationship status. Divorced men are facing the highest rates, with approximately one in two (44%) experiencing symptoms, whilst those living with their partners have the lowest rate of erectile dysfunction (28%). This highlights the potential impact relationships have on sexual health and raises intriguing questions about the factors that may contribute to these differences.

But where in the UK are men impacted the most? Below is a regional breakdown showing which cities have the highest prevalence of cases, according to our research.

To unravel the hidden challenges that people face when dealing with erectile difficulties, we explored how this condition is impacting the daily lives of both men and women. According to the study, more than half of men with erectile dysfunction are grappling with its negative effects on their mental health (52%), and younger generations are feeling particularly vulnerable. Alongside this, one in three men feel erectile dysfunction would negatively impact their social life and one in five feel symptoms would negatively impact their career, demonstrating the broad ramifications that this common condition can have on the day-to-day lives of individuals. Notably, 39% of women also stated that their partner’s erectile dysfunction would be detrimental to their mental health which highlights how influential sexual issues can be in relationships. This is reinforced by 44% of respondents citing romantic relationships as one of the key areas that would be negatively impacted by erectile dysfunction.

In the chart below, you can see the extent to which erectile dysfunction is affecting couples in the UK.

With nearly half of Brits feeling erectile dysfunction would negatively impact their romantic relationships, we spoke to Kendra Capalbo, a licensed couples therapist, who has provided valuable insight into how couples can work to improve their sex life if one is struggling to achieve or maintain an erection.

When asked about their reactions to an erectile dysfunction diagnosis, the prevailing emotions expressed by Brits were diminished confidence (32%), embarrassment (27%), and a sense of disappointment (25%). These findings, coupled with one in 10 men not being willing to talk to anyone about their condition, sheds light on the effects stigma surrounding sexual health issues are having. In fact, only a quarter of men would feel comfortable talking to their partners about their symptoms.

Eager to uncover why there is such an overwhelming negative sentiment towards erectile dysfunction, we asked respondents what they believe to be the leading cause of such stigma. The three leading causes of stigma identified were a lack of education (49%), gender stereotypes (36%) and media representation (27%).

How is Erectile Dysfunction represented online?

To gain comprehensive insights into how erectile dysfunction is portrayed in the media and online, we conducted a Google Image search on the topic. Our analysis covered almost 700 images that appeared in the search results. Among the first 100 images, we found that 71% carried a negative representation. These images typically depicted disappointed or angry women, an upset man in bed, or men appearing anxious while looking at medication.

This was also true for AI image generation, as you can see below. When asked to visualise a discussion between couples about erectile dysfunction we are met with images reflecting anger, worry and disappointment.

We spoke to Bayu Prihandito, an esteemed Psychologist and Life Coach, to map out how couples can best approach and navigate positive conversations around erectile dysfunction to improve intimacy and establish a mutual understanding. “Approaching conversations around erectile dysfunction can be a delicate process and handling it positively can make a significant difference to both parties in a relationship.

Here are some of my top tips on how to broach these conversations with your partner:

Choose the Right Time and Place: The significance of initiating these discussions in a serene and private setting cannot be overstated. Opt for a moment free from distractions, ensuring a comfortable atmosphere that facilitates open communication.

Exercise prudence in timing; for instance, refrain from addressing the matter immediately before or after sex – this is a time when emotions are high, and sexual issues are brought to the forefront.

Open with Affirmations: Start the conversation by emphasising your love, empathy, and care for your partner. Make it clear that you're discussing the matter because you truly value your shared intimacy and relationship. This approach instantly sets the conversation in a positive light.

Create a Non-Judgmental Environment: If your partner struggles with erectile difficulties it is on you to establish an understanding and non-judgmental dialogue. Keep in mind that they may feel embarrassed or anxious talking about it, so be patient and understanding. Equally, for the affected party, be appreciative of your partner’s feelings – conversations can be the first step to understanding, allowing them to come to terms with what is going on.

Promote Medical Help: You can suggest visiting a healthcare professional together. This can not only help find possible treatments but also shows your commitment to being supportive and face the issue together, as a couple.

Continuous Communication: Keep the conversation going, but do it without being pushy, using love, empathy, and openness. It will make it easier to discuss progress, setbacks, or changes in treatment.”

We then asked the AI image generation tool to visualise supportive dialogues between couples addressing erectile dysfunction.

Much like Prihandito's tips, these visualisations are centred around fostering intimacy, providing comfort and exuding positivity in the interactions.

Our data reveals that 62% of men with erectile dysfunction have turned to medications such as Viagra, Cialis and Sildenafil which all work by improving blood flow to the penis. In a surprising revelation, it has come to light that a considerable number of men are secretly taking these medications without informing their partners. The results of our survey show that one in 10 men across the UK are discreetly taking medication to treat their erectile dysfunction.

The age group of 25 to 34 appears to be the most secretive, with over 17% of individuals in this demographic opting to use erectile dysfunction medication covertly, keeping their partners unaware of their intake. This trend underscores the importance of fostering open dialogues and trust within relationships, especially when it comes to sensitive health matters.

Keen to explore further how Brits are dealing with erectile dysfunction beyond medication, we interviewed four men from varying age groups, delving into their personal experiences and the proactive measures they have undertaken to improve their condition.

One in seven couples have difficulty conceiving in the UK [2]. In 50% of couples that cannot conceive, the male is wholly or partly the reason [3]. Fertility issues in men are typically caused by a low sperm count, decreased sperm mobility and abnormally shaped sperm cells. To find out how much Brits know about male fertility, we quizzed 2,000 people on the signs and causes of male infertility and intentionally included false answers to emphasise the key knowledge gaps.

The results showed that all respondents bought into at least one myth surrounding erectile dysfunction and male fertility, such as over one in three Brits (38%) believe wearing tight boxers is a leading cause of infertility. Key knowledge gaps also included a staggering 91% of respondents being unaware that decreased facial hair could be a sign of a low sperm count and over a quarter (27%) of respondents dismissed the idea that there are any discernible signs. In reality, low sex drive and pain and swelling of the testicles alongside decreased facial hair are all key signs of a potentially diminished sperm count.

With regards to ways in which people can look after their fertility, 70% of Brits miss the impact of eating processed food and lack of sleep. This is particularly true for people above the age of 45, with only around one in four attributing these key lifestyle choices as having an impact on male fertility.

In an attempt to bridge these knowledge gaps, we spoke to Dr Hana Patel, a general practitioner specialising in male fertility checks, to answer the five most frequently asked questions about male fertility on Reddit:

1. Should I make any life changes to improve my fertility?

The main way that you can look after your fertility is by leading a generally healthy lifestyle. Exercising regularly, eating a balanced diet as well as trying to reduce alcohol consumption and smoking are the best ways to promote sperm health. One other top tip is to have sex regularly. Regular ejaculation has been found to improve sperm count and quality by preventing sperm from becoming stagnant.

2. Does the thickness of semen determine fertility?

When sperm is expelled in ejaculation it should have a thick consistency, thin semen can be a sign of a low sperm count. However, a very dense ejaculate can affect other seminal quality parameters such as sperm motility. Therefore, abnormally thick semen could also be a sign of fertility issues.

3. Do higher numbers mean better sperm quality?

A high sperm count does not necessarily mean that you are more fertile than others, but it is often a sign of good sperm quality. Normal sperm densities range from 15 million to greater than 200 million sperm per milliliter of semen.

4. When should I seek professional help?

If you have struggled to conceive after a year of trying, I would recommend both partners see a GP. Aside from this, pain or swelling of the testicles and changes in the consistency of your ejaculation may be signs that you should seek professional help.

5. How does diet affect sperm quality?

Diet is an important factor in fertility. Some vitamins and minerals (especially vitamin C, zinc, and selenium) are known to be important factors in the production of sperm. Generally, a diet low in fat with plenty of fruit and vegetables is recommended.

What to know more about your sperm health? Take this quiz to find out how your lifestyle choices are impacting your fertility.

It is clear that the stigma surrounding erectile dysfunction and male infertility is still impacting the daily lives of people affected. Whether you or your partner have experienced symptoms, supportive, open conversations and education are at the heart of overcoming negative sentiments and taking the first step to dealing with these sexual health issues. If you need help getting or keeping an erection, you can order from a range of medications that can help. These medications all have a low risk of side effects and are effective for most people who try them.