Don't mention erectile dysfunction. It's a topic many men find embarrassing. But wait. Poor erection has an upside - it's a good thing as it serves as a portal to men's health.
Owing to their socialisation, men tend to ignore health symptoms and avoid seeking medical care but this has dire consequences later on in life.
But few are heeding the warning signs. For instance, says Urology Channel, about 13m men in the US experience testosterone deficiency (also known as hypogonadism), yet less than 10% of them receive medical treatment.
Poor health among men is often detected when they present erectile dysfunction. A huge 40% of men aged 40, according to Dr Irwin Goldstein, director of Sexual Medicines at Alvarado Hospital in the US, have sex problems. "After reaching 40, they lose 1,5% of the testosterone per year. So, by the time you're 60, you would have lost 30% of your testosterone," he says during his visit to SA. Insufficient levels of testosterone can lead to memory loss and decline in muscle strength.
WHAT IT MEANS
 A dysfunction can signal cardiovascular diseases, diabetes and/or prostate cancer
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Testosterone is the principal male sex hormone. Its levels affect such sex characteristics as bone mass, vocal cords as well as hair, in addition to maintaining energy levels.
Hypogonadism leads to low libido, which in turn sees men visiting physicians. That should be viewed in a positive light not least because it provides what Prof Mohamed Haffejee describes as "an ideal opportunity" for the assessment of men's overall health as well as avoiding preventable diseases.
Contrary to popular belief, the effect of erectile dysfunction and testosterone deficiency or "male menopause" goes beyond sex. Dysfunction tends to signal bigger things like cardiovascular diseases, diabetes, prostate cancer and hypertension says Haffejee, head of the urology department at Wits. Negative factors like joblessness can lead to bad sex, he says, adding that "sexual dysfunction has a negative effect on quality of life".
To prevent heart diseases, Haffejee offers an interesting prescription: "Sexual intercourse three times a week diminishes the risk of cardiovascular events by 50%."
Says Goldstein: "Don't ignore a bad erection because it could mean something else is wrong. View a quality erection as a health barometer, and if for any reason it's missing, seek help.
"Most men who experience sexual dysfunction generally assume it's a psychological problem or age but that's not always the case. Since the arrival of Viagra 10 years ago, men have been going to the doctors and doctors are investigating and detecting a lot of things such as prostate," Goldstein says. "If these conditions are found early, this exercise can save lives. That's why it's important for men to always be on the lookout for erections."
Haffejee says health care access for men in the 15-64 age group can go a long way in counteracting the effects of erectile dysfunction.
Irregular checkups can lead to high prevalence in coronary heart diseases and the acceleration of obesity. This, coupled with men's reluctance to seek medical help, also explains the discrepancy in life expectancy among different genders.
In Ireland for instance, the life expectancy for females is 81 - seven years higher than men, in line with many other developed countries. However, in SA things look quite different. Here, the prevalence of HIV/Aids has altered population growth patterns. Now men are expected to live two years longer than women, with the life expectancy average plunging to younger than 50.
But as scientists say, it's not too late for men to change their ways. "Knowing is not enough, we must apply [the knowledge]. Willing is not enough, we must do," Haffejee says, citing renowned German writer J W Goethe.
