Men's Experiences and Decision-Making in Erectile Dysfunction Treatment: A Qualitative Evidence Synthesis

This paper presents a qualitative evidence synthesis investigating men's clinical experiences, psychosocial challenges, and decision-making related to help-seeking and treatment for erectile dysfunction (ED). The findings suggest that ED affects relationship experiences, self-esteem, psychosocial well-being, and help-seeking behaviors. Studies identified through Scopus, PubMed, and PsycINFO were synthesized qualitatively, focusing on adult men's experiences of ED, disclosure, treatment engagement, and decision-making. The review protocol was not prospectively registered. Searches were conducted in March 2026, and the included studies represented diverse clinical contexts, including general ED care, diabetes care, cancer survivorship, and cardiovascular rehabilitation. Eight qualitative studies involving 209 participants were included, and four major themes emerged: masculinity, stigma, and self-silencing; relational consequences influencing help-seeking and disclosure; healthcare communication as a barrier or facilitator to care; and treatment trade-offs, adherence, and acceptability. Men frequently reported negative effects on emotional well-being and help-seeking behaviors due to ED. Delay and hesitation in disclosure and help-seeking were attributed to fear of judgment, lack of support, and negative effects on confidence and self-esteem. Participants valued respectful communication from healthcare professionals and preferred supportive, individualized approaches that included relationship support. Decisions to seek treatment were influenced not only by perceived effectiveness but also by side effects, emotional burden, relationship concerns, and communication experiences. The findings should be interpreted with consideration of the limited number of included studies and the restriction to English-language publications. These findings suggest that ED care should incorporate respectful, stigma-sensitive communication and individualized counseling to facilitate treatment-seeking and improve treatment engagement.