Roger-Luc Chayer (Image: AI-generated / Gay Globe)
Erectile Dysfunction, a Taboo Topic in Men’s Health
One of the most taboo subjects in men’s health within Western societies remains erectile dysfunction, regardless of the person’s age or overall health status.
In my personal experience, I frequently meet men, both young and older, who suffer from erectile dysfunction and either believe it is natural, part of their nature, or are terrified to talk about their sexual performance with their doctor—even though doctors have frankly seen much worse.
I am not a doctor, but as a journalist, I would like to share today three examples involving men aged 21 to 64. Contrary to their beliefs, problems related to erectile dysfunction are neither rare nor insurmountable—far from it.
Jason, 44, Diagnosed with Hemochromatosis
Jason is a professional in the cultural sector and has worked as a freelancer for almost his entire career. Noticing that for several months he could no longer achieve satisfactory or lasting erections, he began avoiding sexual relations for fear of disappointing his partners. Since he was not in a stable relationship, this situation heightened his anxiety—the idea of constantly disappointing different partners became increasingly burdensome.
During a routine check-up with his family doctor, he finally decided to discuss the issue, unsure how to cope with the problem. The doctor prescribed a standard blood test, including testosterone measurement—the hormone primarily responsible for libido in men—to check if a drop in production might explain Jason’s difficulties.
The results were clear. The doctor called him back to inform him that instead of showing a testosterone level around 25, the tests showed a level barely above 7, insufficient to maintain a normal libido. The tests also revealed a significant iron overload in his blood, around 800 units, while the normal value is about 140. Wanting to further investigate these results, the doctor ordered an additional blood test to check for a relatively common genetic disease in Quebec, hemochromatosis, which could explain Jason’s condition. A few days later, the diagnosis was confirmed: the test was positive.
According to medical compendiums, hemochromatosis is a genetic disorder characterized by excessive absorption of dietary iron. Instead of eliminating the excess, the body progressively accumulates it in various organs, notably the liver, heart, pancreas, and endocrine glands. This iron overload can eventually cause serious damage such as cirrhosis, heart problems, diabetes, or hormonal imbalances, including a drop in testosterone levels in men. Often silent, hemochromatosis develops without obvious symptoms for years, delaying diagnosis. When signs appear, they may include persistent fatigue, joint pain, decreased libido, or erectile dysfunction.
The doctor prescribed a series of phlebotomies—removal of significant amounts of blood every two weeks—until his iron levels returned to normal, along with medication to increase his blood testosterone. About six months later, Jason showed no signs of erectile dysfunction, and the treatment has remained effective since.
Stéphane, 21, in Perfect Health
Stéphane is a very fit university student with an athletic build, running several kilometers daily. He is handsome, tall, slim, with long hair, yet he cannot achieve a satisfactory erection. As he humorously puts it, he “can’t get it up.”
This situation has never caused him major distress. He has been with a regular partner for a few months, and sexuality is not the central focus of their relationship. However, after talking with friends, he realized that being so young without a normal erection could hide a medical problem worth evaluating.
He went to the university clinic, feeling more comfortable discussing the issue in a setting with younger patients. The doctor welcomed him with great understanding and quickly asked about his diet, sports activities, and any excessive drug or alcohol use—which he did not consume—to determine if any lifestyle factors could explain the situation.
After routine blood tests, the doctor found everything perfectly normal. Nothing in his daily habits or blood tests explained the lack of satisfactory erections. The doctor then explained that it was probably due to his constitution and that this type of issue often responds very well to simple medical assistance.
He prescribed a daily dose of Cialis 5 mg, a treatment that improves blood circulation to the penis, facilitating the achievement and maintenance of an erection during sexual stimulation, while providing a continuous and discreet effect.
By the second day, Stéphane noticed a significant increase in his libido and discovered a side of himself he had never suspected. He now takes his medication daily and admits, with a big smile, that he finally enjoys a fulfilling sex life, both for himself and his partner—a change he believes has strengthened their relationship.
Robert, 64, Living with the Aftermath of a Serious Work Accident
About five years ago, Robert suffered an accident that tore muscles in his lower back, resulting in consequences that prevent him from walking or functioning normally, even at home. These aftereffects cause him intense pain. It is not so much the pain or physical incapacity that affect his sexual health, but rather the side effects of the powerful medications he must take.
“It’s been at least three years since I’ve had sex, even solo. Some medications numb my erogenous zones, and what used to excite me a lot no longer has any effect. I guess that’s aging, and I’m coming to terms with the idea that this part of my life has to be forgotten,” Robert explained to me, still well-presented and physically capable of attracting someone.
Robert shared this one day with his social worker and psychologist, both present at his residence to assess his needs and support him psychologically. Fortunately, he benefits from services covered by the CNESST, the Quebec government agency that compensates work accident victims. His psychologist explained that in 2025, many solutions exist to counter the side effects of medications on erections and libido, and that he could discuss this with his treating physician.
A doctor accustomed to treating accident victims understands these issues well. He prescribed Cialis 20 mg to be taken about two hours before any sexual activity, explaining that the medication could be effective for up to 36 hours, which eliminated pressure around foreplay.
As mentioned earlier, Cialis 20 mg works by relaxing the smooth muscles of the penile blood vessels, improving the blood flow necessary for erection. By inhibiting the enzyme phosphodiesterase type 5 (PDE5), responsible for breaking down cyclic GMP—a chemical messenger causing dilation of penile arteries—it allows this messenger to accumulate, promoting dilation and increased blood flow to the corpora cavernosa. This enhanced flow facilitates achieving and maintaining an erection in response to sexual stimulation.
Robert was amazed, in his own words, to find that he not only regained strong erections when desired but also experienced increased sensitivity in erogenous zones he had missed so much.
Erectile Dysfunction Is Not Inevitable
These three very different examples demonstrate that erectile dysfunction is not insurmountable, contrary to what many affected men believe. In many cases, medication combined with some blood tests can fairly easily resolve this type of problem. The most important step, and the starting point when experiencing erectile dysfunction or loss of libido, is to talk to a doctor.
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