Men’s problems in the bedroom may be a warning sign for later, more serious health issues. This is the message the Australian Physiotherapy Association (APA) is sending to all Australian men in the lead up to Men’s Health Week, June 10 – 16.

With evidence linking erectile dysfunction with subsequent cardiovascular disease, the APA is urging Australian men to put aside their embarrassment and have honest – and potentially lifesaving - discussions with their health care practitioner about their sexual health.

Erectile dysfunction (ED) is a common but often neglected condition due to its intimate nature. Prevalence increases with age, with 61 per cent of men aged 45 or older reporting some form of dysfunction.1  Worldwide, the prevalence of ED is estimated to be 300 million by 2025.

APA men’s pelvic health physiotherapist Jo Milios says that most men will experience episodes of 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.

“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. However, 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.”

“The research shows that erectile dysfunction usually precedes coronary symptoms by around three years, and can therefore be considered an early marker of CVD. But this shouldn’t be seen as all doom and gloom,” says Jo. “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.”

The evidence linking the two conditions has been compelling enough for the British Society of Sexual Medicine to encourage all newly presenting patients to be thoroughly evaluated for cardiovascular risk factors.2

“A men’s pelvic health physiotherapist is perfectly placed to treat and educate men presenting with erectile dysfunction. Pelvic floor muscle training is an effective and well established non-invasive technique to improve erectile dysfunction, and physio prescribed exercises can help with reducing the general risk of CVD in conjunction with treatment from their GP.”

Jo’s final piece of advice for men who are experiencing erectile dysfunction is simple and to the point. “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.”


Jo Milios is available for further comment or interview.


2 Hackett G, Kirby M, Wylie K et al. British Society for Sexual Medicine Guidelines on the management of erectile dysfunction in men-2017. 2018. J Sex Med 15 430-57


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