Many family doctors are reluctant to discuss sex with their male patients, says a Dublin GP.
Embarrassment for both parties, lack of time or knowledge and the doctor's reluctance to invade the patient's privacy contribute to the problem, said Dr Stephen Murphy.
"While these are all understandable sentiments, we may be missing an opportunity to make a real, valid and important intervention that could make a significant difference to a patient," he stressed.
Family doctors need to understand their "own biases and comfort levels when discussing potentially controversial issues" such as extramarital sex, sex abuse, termination of pregnancy, same-sex relationships, bisexuality, transgender issues and unusual sexual practices.
He also advises doctors to bring the patient's partner into the consultation early on.
"The GP should consider methods to allow the tactful integration of the partner into the therapeutic relationship."
He said it is surprising "how often the male is under the delusion his partner may not have noticed his problem".
Sexual dysfunction, the Dublin GP said, is a common problem for men in their early 40s and increases with age.
Erectile dysfunction (ED) affects about 16pc of men ranging from about 8pc in the 20-30 year age group to 37pc of men in the 70-75 year age group.
Dr Murphy made his comments in Forum, the Journal of the Irish College of General Practitioners.