Awareness: The link between erectile dysfunction and depression or low self-esteem has been highlighted, in an effort to build awareness of the condition.
Wexford-based GP Dr Brian O'Doherty said problems achieving an erection could be caused by a depressive disorder. "However, this is not to suggest that all men who have depression suffer from erectile dysfunction," he added.
"There is a huge range of symptoms of depression and this is only one of them. Not everyone has all the symptoms of any disorder," he said. "But doctors must be aware that matters of sexual health affect self-esteem, and it may be a factor that we need to consider more when treating depression."
Dr O'Doherty said it was difficult to determine the extent of erectile dysfunction in Ireland, but it impinged hugely on sufferers' everyday lives and self-esteem. "I think that the more that comes out about erectile dysfunction, the better because it will reduce the stigma which currently exists," he says.
The effects can be devastating.
Patrick, from south Co Dublin, is in his early 60s and began having problems before he had been diagnosed with diabetes. Although erectile dysfunction is sometimes a side effect of this condition, Patrick had not been informed of this within the first year of diagnosis.
"I felt half a man," he says. "The emotional state is general frustration at your inability to react with your loved one. It's like sticking a knife in a guy's brain.
"Occasional problems were becoming more and more frequent and I bit the bullet when I was having failures eight times out of 10," he says.
A drug that has been available for over a year, Vardenafil, provided a solution to the problem. Although Patrick had tried other treatments, he had suffered adverse side effects including an unmerciful headache.
"I'm happy enough taking this drug. One does what one needs to to be able to continue with your normal lifestyle for as long as possible. I am back on an even keel now. It was just one more thing climbing up my back and one I could have done without," he says.
Dr O'Doherty agrees that for the majority of patients, the benefits of taking the drug appear to outweigh the side effects. However, he stresses that it is not only the person with the problem who needs to be considered, as it is an issue which can adversely affect not only a couple's relationship but can spill over into family life as well. "You're not just treating one person," he says. "You are treating a couple."
Patrick says women suffer as much as men and stresses that everyone who has a problem should seek help.