According to research presented at the 28th annual European Association of Urology Congress, study authors took a look at 6,228,509 men diagnosed with ED. Those that filled a prescription or heeded their doctor’s advice were considered “treated,” while those that were diagnosed and did not follow advice were deemed “untreated.” The findings: Nearly 75% of the men went untreated. In other words, men aren’t taking the initiative for the remedies that are available to them. Why? One reason could be the fact that ED is a complicated issue, one that can’t be solved with a simple pill or one-time conversation, says Charles Cutler, MD, an internal medicine specialist on the board of regents of the American College of Physicians. “There are a number of psychological considerations that need to be worked through with the partners.” And that commitment can be a real deterrent for patients. More from Prevention: When He Doesn’t Want Sex Of course, seeking treatment comes only after admitting there’s a problem—something that can be extremely difficult for men to do. So how can you bring up the topic of ED if you suspect your man may be struggling with it? We talked to relationship expert Stephan Labossiere, author of How to Get a Woman to Have Sex With You If You’re Her Husband about how to broach the subject: Timing is everything. The last thing you want to do is force a conversation right after sex or bring it up when you’re arguing, says Labossiere. “If you want it to be received properly, it’s best to have that conversation when everything is fine in the relationship.” Empathy is paramount. Because of all the jokes about men who “can’t get it up,” so to speak, ED can be an incredibly painful experience, says Labossiere. So the most important thing is to reassure him that you’re there to support him and have empathy for what he’s going through. Choose your words wisely. “Don’t use anything that has a negative connotation to it or anything that’s critical,” Labossiere says. Just focus on the issue at hand in a calm, neutral way. It’s a health matter, not a shortcoming. “Let him know you understand there’s more to it than an inability to maintain an erection,” says Labossiere. In reality, ED can be caused by a number of health issues, including diabetes, multiple sclerosis, and stress, which means it has nothing to do with “manliness,” no matter how many stupid jokes exist. The fact that ED is a health issue also makes talking about it—and following through with a doctor and treatment—essential. More from Prevention: 10 Essential Sex Tips For Diabetics