Love, masculinity, and the modern man’s silent crisis

“My heart burns with grief,” King Pandu lamented, at war with his lust. Cursed, he was condemned to death if he so much as laid a finger on his wives. “What life remains for a man who cannot embrace the woman he loves?”

Desire, as depicted in the 2000-year-old story from the Adi Parva, influences our sense of self-worth. The ability to desire and feel loved shapes how men understand their place in the world. Men grow up believing they are only as good as their performance. When it falters – at work or in bed – many feel broken.

New research concludes that anxiety and depression lead to erectile dysfunction, a persistent inability to achieve satisfactory sexual performance. ED is not a transient failure of desire, like the harangued husband during in vitro fertilisation. In thirty years, ED has spread from affecting 152 million in 1995 to over 320 million. Surveys suggest one in six Indian men face ED, while data indicate higher prevalence in Japan (one in three) and the United States (about one in four), with even higher rates in males over 70.

Other risk factors include: pollution, metabolic illnesses (obesity, prostate issues, hypertension, type 2 diabetes, high levels of blood cholesterol, and substance abuse), and cardiovascular disease. Among diabetic men in India and the US, nearly two-thirds struggle with it.

What presents today as ED reflects a deeper, older fear: the wasting of life’s essence – shukra, taqat, and veerya. Long before ED entered clinical vocabulary, the Dhat syndrome – predating Western sexual medicine – articulated the sexual anxieties of Indian men. The fear was not dysfunction but depletion: semen loss as a drain on strength, memory, and manhood. Men speak of “leaking fluid,” of vitality slipping away, of the body being quietly drained. India’s contemporary ED burden is not merely a biomedical phenomenon but a modern expression of long-standing cultural vulnerabilities. To understand ED as more than a standalone medical condition ought to recognise the enduring interplay between emotional life, cultural belief, and the meanings societies attach to masculinity.

The global ED market is expected to reach $9.3 billion, fuelled by sales of anti-impotence drugs. Anti-impotence drugs’ largest consumers by volume are Indians, spurred by cheap generics. Saudi Arabian and Egyptian men rank among its highest per-capita consumers. In the US, ED is medicalised and monetised, offering consumers renewed confidence. In all three regions, pills circulate freely, treating symptoms without addressing psychological burdens. Male sexual dysfunctions also generally go unnoticed and untreated due to sidestepping of cultural beliefs, relational conflict, cardiovascular risk, and socioeconomic/systemic factors.

Four counterarguments misrepresent ED: First, ED is merely an ageing issue. This is wrong as ED is increasingly common among younger men, for whom desire ought to feel effortless. Among American youth, a 31-fold increase in ED, compared to the last decade, has been observed. Indian doctors note its increase in men aged between 20 and 35. Second, blames pornography: although excessive porn amplifies performance anxiety and poor communication, it doesn’t explain ED in depressed or stressed men who don’t consume porn. But blaming ED on porn addiction allows societies to evade confronting its structural and emotional causes. Third, medications and new treatments like shockwaves solve the issue: drugs often mask symptoms, ignoring underlying issues. Finally, seeking help is a sign of weakness: this deters open discussions and exacerbates shame.

ED isn’t merely a blood flow issue. It reflects a failure of language, permission, and love. In voicing their fears, Indian men use somatic and existential language: “Har boond se kamzori hoti hai” (every drop causes weakness) and “Mardangi khatam ho rahi hai” (my manhood is ending) rather than biomedical concerns. Complaints merge sexual with broader issues: back pain, fatigue, anxiety, and confidence loss.

Desire is one of the first casualties of modern intimacy – and one of the least talked about. Men instead may struggle with their desire brought on by ED through: extramarital affairs or one-night stands to prove their virility (novelty boosts dopamine, temporarily masking ED; escalating use of porn; avoidance of sex [for fears of “failing” partners]; avoidance of getting married and dating; overinvestment in work or fitness, or they may blame their partners for being unattractive. Recognising the anxiety-depression connection can empower partners to engage in conversations about intimacy, health, and ultimately, strengthen their bond.

Responding meaningfully to ED demands more than medication; it requires cultural permission for men to voice their struggles with desire, fear, and love. Without that permission, anxiety hardens into illness, intimacy collapses into silence, and love becomes fraught with shame. Before dysfunction takes hold of the body, it takes hold of meaning – and before men lose their capacity for erection, they often lose their confidence of being loved. Silence, not erectile dysfunction, is the real affliction.

(The writer is an international psychologist, former professor, and writer on culture, cosmopolitanism, and global affairs)

Disclaimer: The views expressed above are the author's own. They do not necessarily reflect the views of DH.