The willingness of men to discuss their sexual problems depends on their age, culture, religion, upbringing, marital status, the impact the problem has on their life and also their understanding of the problem and its causes. It is important that general practitioners offer patients and their partners the opportunity to discuss erectile dysfunction in the same way as one might ask routinely about angina or breathlessness. Erectile dysfunction is more common in individuals who smoke, or who have hypertension, diabetes or hyperlipidaemia. Sexual dysfunction and cardiovascular disease are commonly associated with each other. Erectile dysfunction is understandably common in men during and after any illness or hospitalisation. Sexual activity is generally safe and is encouraged as part of a normal healthy lifestyle in male and female patients with heart disease. Sexual matters for patients, particularly for those with cardiac conditions, are as important as other lifestyle issues and should be given equal consideration and care.