"No!" – says a group of experts on sexuality recently gathered in Shanghai. For as long as a couple shares the view that sex is important in a relationship, not even erectile dysfunction signals the beginning of sexual retirement.

That is the clear message of a group of doctors from various specialties who are engaged in studies on sex. The doctors were gathered in Shanghai recently to conduct "A Couple’s Solution" press seminar which launched Bayer HealthCare’s "Strike up a conversation" campaign. This is a global health education initiative designed to improve communication between men with erectile dysfunction, their partners and their doctors.

In fact, the oldest couple that Dr. John Dean, one of the sexual physicians in the group, had counseled was aged 92. Another sexual physician, Dr. Hui Meng Tan, disclosed he performed a penile implant procedure on a patient aged 86, with a wife aged 83.

"The importance of sex does not diminish with age. Sex is an important factor in any relationship," said Dr. Dean, the secretary-general of the European Society for Sexual Medicine. He practices in London and South Devon.

"Sex is important to them," Dr. Tan said of the old couple’s reason for seeking a solution. Dr. Tan is the consultant urologist at the Subang Jaya Medical Centre. He is the secretarygeneral of the Asia Pacific Society for Impotence Research, and a member of many learned societies related to sexual health.

Asian men view sex as important. One of the studies presented was "The sex and the modern man" survey in Asia, involving 5,000 men. The study identified a group of men known as Vitalsexuals. (An earlier study was made on 8,500 men in the west.)

Vitalsexuals are men over 40 who believe that sex is important; they want to satisfy their partners; they look for spontaneity; and they would seek treatment if they had ED.

Significantly, 94 percent of the Asian Vitalsexuals wished for a better sex life in the past five years. An overwhelming 71 percent of them reported that they were often or sometimes unable to satisfy their partners.

The survey also found that 49 percent of the Asian Vitalsexuals revealed that a major factor that affects their sex life is the "fear of not meeting their partner’s sexual expectations."

The study found that if they could "change something about their sex life, they would: give more pleasure to their partners (40 percent); communicate more with them (24 percent); and be more spontaneous (24 percent)."

Incidentally, the study conducted among western men showed that "sex is important to modern man, irrespective of age or location."

"Globally, men have a healthy sexual interest which is maintained until late in their life; 66 percent of men aged 75 plus still said sex was important," the study said.

Lack of sex because of erectile dysfunction, the recurrent inability of a man to attain or maintain an erection for sex, has threatened many relationships. It has also affected the productivity and personalities of both men and women.

According to another study presented during the forum, there is a "link between depression and ED."

"For the individual patient, ED may result in loss of self-esteem, poor self-image and disruption of interpersonal relationships."

A significant data in the research is: "25 percent of men with ED reported depression and anxiety; and 26 percent of men with depression and anxiety reported ED."

On the side of the women with partners who have ED, studies showed that one out of four women is depressed.

William Fisher, professor of Psychology and Obstetrics and Gynecology, said: "ED decreases sexual contact, depresses sexual desire, diminishes sexual arousal and declines orgasm – and we see a picture of a depressed sexual partner."

An estimated 152 million men worldwide – 16 percent of all men aged 20 to 75 – have erection difficulties. It is predicted that the worldwide prevalence of ED will increase to 322 million by 2025.

Recent data suggests that only 15 to 20 percent of ED sufferers are being treated.

The small number also suggests that many are not aware that ED can be treated – or some men prefer to ignore the problem completely.

It is not only the want to have more sex that should encourage men to seek medical advice on ED. It is also the fact that ED can often be a symptom of other significant medical conditions. In 70 percent of diagnosed cases, ED is due to vascular or neurological causes, diabetes, high blood pressure or atherosclerosis. ED may also be caused by spinal injury, neurological disorders, and psychological conditions such as anxiety, guilt and depression.

"On the average, it takes a man about four years until he will seek help for ED," said Dr. Siegfried Meryn, professor of medicine and medical director of the Centre for Advanced Medical Education and Health Communication at the Medical University of Vienna, Austria.

"The top motivation for men with ED to see a physician is when he believes that his relationship is in danger, and he wants his sex life to get back to normal (43 percent), and if he knows he has a true medical problem (40 percent)," Dr. Meryn said.

The findings of the various research studies encouraged Bayer HealthCare to design "Strike up a conversation" campaign to inform couples that there is treatment for ED.

The doctors all agreed that the wife plays an influential role in encouraging the husband to seek treatment. Again, turning to the studies, it was found that two-thirds of men surveyed don’t talk about ED to their wives because "they don’t know how to start."

Ironically, 85 percent of women surveyed don’t talk to their husbands about it because – "I don’t want him to feel worse than he already feels."

The reason why women didn’t start the conversation was also because they didn’t know there are treatments for ED. When they did and started the conversation with their husbands, the men in the study said they "felt like they were being supported" (47 percent); and "I was understood" (34 percent).

Model and actress Jerry Hall, the new global ambassador for erectile dysfunction, highlighted the importance of the female partner when couples are experiencing sexual problems.

Ms. Hall said: "Erectile dysfunction isn’t just a man’s problem, it affects his partner too. Women can play an important role in initiating a conversation about ED and I want to encourage men and women to openly discuss the condition and take positive steps to seek treatment by visiting their doctor. Though the topic can be difficult, confronting ED together will lead to a stronger, healthier and more fulfilling relationship."

In an interview, Ms. Hall said "it would be a sad world if there is no sex. Sex is fun. Men and women should have sex for as long as they can."

Asked if she knew about erectile dysfunction before she was invited to be the face behind Bayer Healthcare’s initiative, she answered: "Yes, I have come accross ED before and now I have some advice about it."

Bayer HealthCare AG, a subsidiary of Bayer AG, manufactures Levitra (vardenafil HCI), an erectile dysfunction treatment.