Touch it and tell me what you think," Dr Mohd Ismail Mohd Tambi asks me, placing a chart with four blue "bubbles" in front of me.

He grins impishly while I squirm in my seat.

"Go ahead. You're not shy, are you? Don't be shy. It won't bite!" he encourages, sensing my embarrassment.

I blame my bashfulness on my conservative Asian upbringing.

Samuel the photographer, stifling a giggle, looks away.

"What do you think?" he asks.

Unsure how to respond, I tell him that I think nothing except that grade four is the hardest. He lets out a laugh.

"All the men who come in here will say they are a grade four but their partners will say they are a grade one or two," he says. "That's men! You can call it ego, but for men, having the capacity to make love is a manly thing. If they suffer, everyone around them suffers because they're shy about getting help."

As Malaysia's only clinical andrologist (someone who specialises in male reproductive problems), Dr Mohd Ismail, 60, is a doctor, friend and confidant to the thousands of patients with erectile dysfunction (ED) problems. But no, not all his patients are men - about 30 per cent are female who come to ask for help for their husbands.

The main grouse among men is that they cannot maintain their erection, and that is an early sign of ED, he notes. In the past, most of his patients were above 45 but of late, the age is getting younger.

"I get guys in their 80s who really take care of their health but have ED problems. But I also get the younger men who are in their 20s and might be a little obese or have lifestyle issues.

Nowadays, with peer pressure, the youngsters are clubbing, smoking, drinking and taking drugs, which affects their sexual health," explains Dr Mohd Ismail.

"This is something disturbing but the mentality is changing in line with development. I'm even getting those who are not married coming to me. ED cuts across all ages, marital status and culture."