The quality of many of our patients’ lives would improve if they had the choice and ability to be sexually intimate. It is relatively common for men who suffer from cardiovascular disease or diabetes to suffer from erectile dysfunction (ED). They often feel too ashamed to initiate sex with their partner, or start a new relationship, because they are unable to gain or maintain an erection. They can become socially isolated and aviod physical contact. As healthcare professionals, we owe this group of patients an opportunity to talk about their sexual problems and to offer them support and treatments. But how do we open up a discussion about sex?