Psychological vs. Physical Erectile Dysfunction: Understanding the Difference

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Summary: 

  • Psychological ED is sudden and inconsistent. Physical ED develops gradually and presents the same across all situations.
  • ED affects around half of Singaporean men aged 30 and above, rising to 90% of men aged 70 and above.
  • Physical ED can be an early warning sign of cardiovascular disease and should not be dismissed as a standalone concern.
  • A standard blood test does not screen for STIs. This must be requested separately.
  • Treatment ranges from oral PDE5 inhibitors and injectables to ESWT and counselling, depending on the underlying cause.

Erectile dysfunction (ED) affects around half of Singaporean men aged 30 and above, according to a population-based study published in the Singapore Medical Journal. Some cases stem from a physical condition; others from psychological factors like stress, anxiety or relationship strain. Many involve both. Knowing which is at play is the first step towards effective treatment.

What’s the Difference Between Psychological and Physical ED?

The distinction between psychological vs physical ED lies in the underlying cause. Psychological ED originates from mental or emotional factors, while physical ED results from a medical condition affecting blood flow, nerve function, or hormone levels.

The two categories are not always separate: a physical cause can lead to anxiety about performance, which then compounds the problem.

Signs of Psychological ED

Psychological ED tends to be situational. A man may experience no difficulty achieving an erection during sleep or masturbation, yet struggle in a partnered setting. This pattern suggests the physiological mechanism is intact, and the underlying cause is psychological rather than physical.

Performance anxiety can subsequently establish a self-reinforcing cycle: fear of failure impairs function, and a single episode of difficulty can increase the likelihood of recurrence through subsequent preoccupation with performance.

Signs of Physical ED

Physical ED tends to be consistent. When erectile difficulty is present in every situation, including during sleep and masturbation, it points to an underlying physiological cause rather than an emotional one. Because many of these causes are vascular and share the same mechanism as heart disease, physical ED should not be treated as a standalone concern; it can be an early signal worth investigating.

Differences at a Glance

Feature

Psychological ED

Physical ED

Onset

Sudden, often tied to a specific event

Gradual

Consistency

Inconsistent (present with masturbation or during sleep, absent with a partner)

Consistent across all situations

Common contributors

Anxiety, depression, stress, relationship difficulties

Hypertension, diabetes, cardiovascular disease, obesity, low testosterone, nerve damage, certain medications (e.g. some antidepressants and blood pressure medicines)

What it suggests

Physical mechanism intact, cause is situational

Underlying physiological cause, consistent across situations

What You Should Know About ED

Men’s Erectile Dysfunction is not a life-threatening condition, but it can be the first sign of an underlying cardiovascular issue, since ED and heart disease share the same vascular mechanism.

ED can also affect a man’s sense of well-being, his relationships, and his quality of life. Physical and psychological factors often overlap: a physical cause may trigger anxiety about performance, which then worsens the problem and creates a cycle that is harder to resolve than either factor alone. 

An accurate diagnosis usually requires assessment of both.

If any of the concerns in this article are familiar, a consultation with a doctor is an appropriate next step.

Who Is Most Likely to Develop ED?

Risk factors for physical ED:

  • Age
  • High blood pressure
  • Diabetes
  • Obesity
  • Cardiovascular disease
  • Smoking
  • Certain medications
  • Sedentary lifestyle
  • Heavy alcohol use

Risk factors for psychological ED:

  • High stress levels
  • Anxiety disorders
  • Depression
  • Unresolved relationship conflict
  • Major life changes (new job, financial pressure, bereavement)

ED is not limited to older men. Younger men, including those in their twenties and thirties, can also be affected, particularly where psychological factors are involved. In this age group, performance anxiety and stress are more commonly implicated than vascular disease.

Men who fall into multiple risk categories, for example, a man in his fifties with diabetes who is also experiencing work-related stress, are more likely to have a mixed presentation involving both physical and psychological elements.

When Should You See a Doctor About ED?

Men experiencing Erectile Dysfunction for more than a few weeks, or ED that is affecting their relationship or wellbeing, should seek an assessment. Early assessment is useful even where symptoms are mild, since ED can be an early marker of cardiovascular or metabolic conditions that benefit from prompt management.

A doctor will typically review medical history, current medications, and lifestyle factors, and may carry out a physical examination and blood tests to check for underlying conditions such as diabetes or low testosterone. A standard blood test alone does not screen for sexually transmitted infections (STIs), so separate STI testing should be requested if this is a concern.

Where symptoms suggest a psychological component, such as inconsistent erectile function across different situations, a doctor may also explore stress, anxiety, or relationship factors as part of the assessment. 

The goal is not simply to categorise the ED as one type or the other, but to identify all contributing factors so that treatment can be tailored accordingly.

ED Treatment Options at DTAP Clinic

DTAP Clinic provides consultations for Erectile Dysfunction treatment and sexual health concerns. Once the underlying cause of ED has been identified, treatment is tailored accordingly, rather than applying a single approach to every patient.

Oral medications, known as PDE5 inhibitors, are commonly used. Clinical evidence suggests many patients experience improved erectile function with these medications, though response varies between individuals.

If oral medication is not suitable or not effective, other options include injectables, which can produce an erection within minutes and typically last up to one hour, and extracorporeal shockwave therapy (ESWT).

ESWT uses low-intensity shockwaves that are thought to stimulate the growth of new blood vessels and is used mainly for vasculogenic ED, the type caused by reduced blood flow. A course typically involves 6 to 12 sessions over several weeks. Evidence on how long the benefits last varies between patients, and some studies report the effect diminishing over time. It is not suitable for every type of ED, so a doctor’s assessment is needed to determine whether it is appropriate.

Unsure which treatment is appropriate? A doctor at DTAP Clinic can assess the underlying cause and advise accordingly.

Frequently Asked Questions About Erectile Dysfunction in Singapore

Can ED be both psychological and physical? Yes. Many men have a mixed presentation, where a physical cause contributes to anxiety, which then worsens erectile function further.

Does ED always require medication? Not necessarily. Treatment depends on the underlying cause. Some men benefit from addressing lifestyle factors or psychological contributors, while others require medication or procedural treatment.

Is ED a normal part of ageing? Erectile Dysfunction becomes more common with age, rising from around 43% of men in their forties to over 77% of men in their sixties in local research. This does not mean it should go unaddressed.

Can young men get ED? Yes. ED can affect men in their twenties and thirties, often linked to psychological factors such as stress or performance anxiety.

Book an Appointment at DTAP Clinic

If you are experiencing symptoms of erectile dysfunction, book an appointment at the DTAP. No referral is required.

Do PE and ED Go Together? What You Need to Know

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Summary: 

  • PE and ED frequently appear together: men with ED are significantly more likely to also have PE, and each condition can make the other worse if only one is treated.
  • The link is largely psychological. Anxiety about losing an erection can drive rushed ejaculation, and chronic PE can feed performance anxiety that contributes to ED.
  • ED can be an early warning sign of cardiovascular disease, with studies suggesting it may precede a cardiac event by three to five years.
  • Both conditions are treatable in Singapore. DTAP Clinic assesses and manages PE and ED together, which produces better outcomes than treating them separately.

Premature ejaculation (PE) can be frustrating enough to deal with. But for many men, premature ejaculation doesn’t appear alone. 

Research suggests that men with erectile dysfunction (ED) are significantly more likely to also experience PE, and vice versa. Without knowing how the two are connected, it is easy to spend months addressing one problem while the other quietly undermines your progress.

The good news is that both premature ejaculation and erectile dysfunction are treatable. When they are assessed and managed together, outcomes are generally better than treating either in isolation. Here is what you need to know.

What Are PE and ED, and How Are They Different?


What Is Premature Ejaculation?

Premature ejaculation (PE) is when ejaculation happens sooner than you or your partner would like, either before or very shortly after penetration, and with little control over the timing. 

Some research suggests it may affect up to 30% of men at some point in their lives, though figures vary depending on the diagnostic criteria used. PE is classified as either lifelong (present from your first sexual experiences) or acquired (developing after a period of normal function).

What Is Erectile Dysfunction?

Erectile dysfunction (ED) is the persistent difficulty in achieving or maintaining an erection firm enough for satisfactory sexual activity. Studies suggest that ED affects around 52% of men between the ages of 40 and 70 to some degree. 

It is not simply a normal part of ageing, and occasional difficulty is not the same as ED. The diagnosis typically applies when the problem is persistent and causes personal distress.

Can You Have Both PE and ED at the Same Time?

PE and ED are separate conditions, but they frequently occur together. Research suggests that men with ED are significantly more likely to also experience PE. 

If you are anxious about losing your erection, you may unconsciously rush to ejaculate, reinforcing a pattern of PE over time. Chronic PE can equally lead to performance anxiety that contributes to ED. This cycle is difficult to break without addressing both conditions at the same time.

Sound familiar? Book a confidential consultation at DTAP Clinic and get a clear picture of what is going on.

What Causes PE and ED?

Premature ejaculation and erectile dysfunction can have psychological and physical causes, and in many cases, more than one factor is involved.

Cause

PE

ED

Side effects of medication

✓

✓

Anxiety and performance pressure

✓

✓

Depression

✓

✓

Relationship stress

✓

✓

Smoking, excess alcohol, inactivity

✓

✓

Cardiovascular disease

 

✓

Type 2 diabetes

 

✓

High blood pressure or cholesterol

 

✓

Obesity

 

✓

Prostate inflammation (prostatitis)

✓

 

Low testosterone or thyroid imbalance

✓

✓

Penile hypersensitivity

✓

 

If you are managing depression and noticing sexual side effects from medication, it’s important to raise this with your doctor rather than stopping treatment without guidance.

When Should You See a Doctor About PE or ED?

Consider speaking to a doctor if any of the following apply to you:

[ ] PE or ED is occurring consistently, not just occasionally

[ ] You frequently or almost always ejaculate within one minute of penetration

[ ] Either condition is causing you distress or affecting your relationship

[ ] You have noticed a recent, unexplained change in your sexual function

[ ] You have risk factors for cardiovascular disease and have not had a check-up recently

Studies suggest that ED may be a sign of long-term cardiac issues for some men, which makes it worth taking seriously beyond its impact on your sex life. 

Both conditions are well-understood and treatable. Delaying care does not make them resolve on their own.

What to Expect at Your First Consultation

A consultation for PE or ED is straightforward and confidential. Your doctor will ask about your symptoms, medical history, lifestyle, and any medications you are taking. The goal is to understand what is driving your symptoms so that the right approach can be recommended.

Ready to see what that first conversation looks like for you? Book an appointment at DTAP Clinic online in a few clicks.

How Are PE and ED Diagnosed in Singapore?

Your doctor will assess both conditions through clinical history, physical examination where relevant, and targeted blood tests. 

  • For PE, the focus is on how long the problem has been present, how often it occurs, and whether it is situational or consistent. 
  • For ED, your doctor will ask about the firmness and duration of erections, check blood pressure, and may use validated tools such as the International Index of Erectile Function (IIEF). 

Blood tests checking testosterone, blood glucose, and cholesterol are standard, and a penile Doppler ultrasound (a scan to evaluate blood flow to the penis) may be recommended in some cases.

Your PE and ED Treatment Options in Singapore

If you are looking for premature ejaculation treatment in Singapore, there are several evidence-based approaches available at DTAP Clinic. DTAP recommends combining behavioural techniques with medication for the best results.

Behavioural techniques: The pause-squeeze technique and withdrawal method help you build ejaculatory awareness and control over time, and are most effective when practised with a partner.

Topical treatments: Desensitising creams reduce penile sensitivity before intercourse. Applying the cream and wearing a condom over it helps avoid inadvertently numbing your partner.

Oral medication: Dapoxetine, a short-acting SSRI (selective serotonin reuptake inhibitor) specifically licensed for PE, is taken one to three hours before sexual activity. Studies indicate it can increase intravaginal ejaculatory latency time (IELT, the time between penetration and ejaculation) by approximately two to three times compared to placebo.

For ED treatment, options include PDE5 inhibitors (phosphodiesterase type 5 inhibitors) such as sildenafil and tadalafil, which increase blood flow to the penis and are effective for a significant proportion of men.

For those who do not respond to oral medication, penile injectables offer a locally acting alternative. Extracorporeal shockwave therapy (ESWT) takes a different approach entirely, using low-intensity shock waves to stimulate the growth of new blood vessels and restore the natural mechanism for erections. It is particularly suited to vasculogenic ED (ED caused by blood vessel problems) and is not suitable for all types of ED.

When both conditions are present, your doctor will consider a combined plan. Managing performance anxiety alongside medication is often central to achieving lasting improvement in both.

Frequently Asked Questions About PE and ED

Can premature ejaculation cause erectile dysfunction?

Yes. Chronic PE often leads to performance anxiety, which is a well-recognised driver of ED. The two conditions can reinforce each other, which is why it is worth having both assessed together.

Is premature ejaculation treatable in Singapore?

Yes. PE is a well-understood condition with several evidence-based options available, including behavioural techniques, topical treatments, and oral medication. Many men see meaningful improvement with the right approach.

How long does treatment take to work?

This varies by treatment and individual. Dapoxetine is taken on demand and may produce results quickly. Behavioural techniques typically require consistent practise over several weeks.

Is my consultation confidential?

Yes. All consultations at DTAP Clinic are completely confidential. Your records are private, and nothing is shared without your consent.

Ready to Take the Next Step? Talk to DTAP Clinic

DTAP Clinic has been caring for men’s sexual health since 2005, with doctors experienced in assessing and managing both PE and ED across five Singapore locations: Clarke Quay, Novena, Orchard, Holland Village, and Kovan.

Book an appointment online or contact us to speak to a doctor about your concerns.

Erectile Dysfunction at 30: Is It Normal and What Causes It?

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Summary: 

  • You’re not alone. It is common for men below 40 to experience erectile dysfunction.
  • An erectile dysfunction at 30 is typically due to stress, anxiety, lifestyle habits, or a hormonal issue.
  • Occasional difficulty getting erect is normal. But see a doctor if it happens consistently for four weeks or more.
  • Lifestyle changes may help, but will not resolve a hormonal or psychological cause. That’ll require medical support.

Erectile Dysfunction at 30: Is It Normal and What Causes It?

Erectile dysfunction (ED) affects men in their 30s more often than most people realise. It’s frequently mistaken for a permanent problem when it’s usually anything but.

ED sits at the intersection of physical health, mental wellbeing, and lifestyle in ways that most men are never told about. Understanding which of these factors is driving your condition is key to addressing it.

Is Erectile Dysfunction at 30 Normal?

It depends on what you mean by normal. Occasional difficulty getting or maintaining an erection — when you’re stressed, sleep-deprived, or have been drinking — is common and not a clinical concern. Most men experience this at some point.

Persistent ED, where difficulty occurs consistently across most sexual situations over several weeks or more, is a different matter. It’s not something to dismiss, but it’s also not as rare as most men assume. Research suggests that around one in four men seeking treatment for ED are under 40. It’s a recognised pattern in younger men, not an anomaly.

In men over 60, ED more commonly has cardiovascular or hormonal roots. In men in their 30s, psychological and lifestyle factors tend to dominate — though physical causes are by no means rare.

Common Causes of Erectile Dysfunction at 30

Psychological causes are particularly prevalent in this age group. Performance anxiety (worry about sexual performance that itself interferes with arousal), stress, depression, and relationship difficulties can all disrupt the neurological and hormonal signals needed for an erection. For some men, a single difficult experience creates a cycle of anxiety that perpetuates the problem.

Lifestyle factors including poor sleep, excessive alcohol consumption, smoking, and a sedentary lifestyle can impair vascular function (the health of the blood vessels that supply the penis). Nicotine, in particular, affects your endothelial function (the ability of blood vessel walls to relax and expand), which is central to erectile health.

Hormonal imbalances such as low testosterone (the primary male sex hormone) or elevated prolactin (a hormone that, when raised, can suppress sexual function) may be involved. These are detectable through a straightforward blood panel.

Obesity and metabolic issues, including insulin resistance (reduced sensitivity to the hormone insulin, which regulates blood sugar) and early-stage type 2 diabetes, are increasingly common in men in their 30s and are recognised contributors to ED.

Pornography-related factors are increasingly discussed in clinical settings. Frequent use of pornography may, in some men, make it harder to become aroused with a real partner. Researchers have suggested this could be linked to the way pornography conditions sexual response over time.

Medications including certain antidepressants, antihypertensives (blood pressure medications), and antihistamines may list ED as a side effect.

How to Know If You’re at Risk 

ED exists on a spectrum. Occasional difficulty getting or maintaining an erection, particularly when you’re tired, stressed, or have been drinking, is generally not cause for concern. What warrants attention is when you experience difficulty achieving an erection in most or all sexual situations, over a period of several weeks or more.

Here are the factors that may increase your risk of experiencing erectile dysfunction at 30: 

  • Smoking or heavy alcohol use
  • Body mass index (BMI) above 30
  • High levels of chronic stress, or a recent diagnosis of depression or anxiety
  • Poor cardiovascular fitness or a known heart condition
  • A family history of diabetes or hormonal disorders
  • Use of medications known to affect sexual function, such as antidepressants, antihypertensives (blood pressure medications), and antihistamines

If several of these apply to you, it’s worth speaking to a doctor rather than waiting to see if things improve on their own. Book an appointment at DTAP Clinic to get started. 

When Should You Get Tested?

If ED has been occurring consistently for four weeks or more, that’s a reasonable threshold to seek a professional assessment. Earlier is also fine. There’s no benefit in waiting.

You should seek assessment sooner if you also notice a reduced sex drive, unexplained fatigue, changes in mood, or difficulty urinating, as these may point to an underlying hormonal or physical cause that benefits from prompt investigation.

A Step-by-Step Guide on What Happens at Your Appointment

Knowing what to expect can make it easier to take that first step. Here’s a general outline of what a typical ED assessment at DTAP Clinic involves:

Step 1: Medical history. Your doctor will ask about the nature of your symptoms, how long they’ve been occurring, and whether they happen in all situations or only some. They will also ask about your general health, medications, lifestyle habits, and any relevant mental health history. Be as honest as you can. This information directly shapes your care.

Step 2: Physical examination. A brief physical exam may be carried out to check for signs of hormonal issues, such as changes in body hair distribution or testicular health. Blood pressure is also commonly measured, as hypertension (high blood pressure) is closely linked to ED.

Step 3: Blood tests. A blood panel is likely to include testosterone levels, blood glucose (to screen for diabetes), a lipid profile (cholesterol levels), and possibly prolactin and thyroid hormones. These results help identify or rule out physical contributors.

Step 4: Discussion of options. Once your results are available, your doctor will discuss what they found and what your options are. Treatment for erectile dysfunction at 30 may include:

Treatment

What it involves

Key detail

Lifestyle Modifications

Diet, exercise, alcohol reduction, sleep, and stress management

Often the first step; may be sufficient for mild or lifestyle-driven ED

Counselling or Sex Therapy

Talking therapy addressing psychological contributors

Most effective where anxiety, stress, or relationship factors are involved

PDE5 Inhibitors (Oral Medication)

Drugs that increase blood flow to the penis, including sildenafil

Response rates of 60% to 74%; not suitable alongside nitrate medications

Injectable Treatments

Self-administered injection directly into penile tissue

May work more consistently than oral medication for some men

Extracorporeal Shockwave Therapy (Eswt)

Low-intensity sound waves to stimulate new blood vessel growth

Typically six to 12 sessions; aims to address the vascular cause, not just symptoms

Hormonal Treatment

Medication to correct testosterone or other hormonal deficiencies

Recommended only where a deficiency is confirmed via blood tests

Step 5: Follow-up. ED management is rarely a one-appointment process. Follow-up allows your doctor to assess how you are responding to any treatment and adjust accordingly.

Speak to a Doctor at DTAP Clinic About Erectile Dysfunction

If you‘ve been experiencing ED and have been putting off getting it checked, DTAP Clinic’s men’s health team offers confidential, non-judgmental consultations for ED and a range of treatments for related concerns. Our doctors are experienced in assessing and managing ED in younger men.

Take the first step and schedule an appointment with us. 

FAQs About Erectile Dysfunction at 30

Is it normal for a 30-year-old to have ED?

It’s more common than most people expect. Studies suggest that around one in four men seeking treatment for ED are under 40. 

How can I fix my erectile dysfunction at 30 naturally?

Lifestyle changes including regular exercise, quitting smoking, cutting back on alcohol, and improving sleep have been shown to improve erectile function in some men, especially when ED is linked to vascular or metabolic factors. But doing these alone may not resolve hormonal or psychological causes on their own.

Can erectile tissue heal on its own?

Sometimes, yes. If the cause is reversible, such as stress, alcohol use, or a medication side effect, addressing it may restore normal function. Where there’s vascular damage or a hormonal imbalance, medical intervention is usually needed.

How do men cope with erectile dysfunction?

Open communication with a partner tends to reduce the performance pressure that can make ED worse. Cognitive behavioural therapy (CBT) and sex therapy have clinical backing for men where psychological factors are involved.

Shockwave Therapy for ED: Does It Really Work?

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Summary: 

  • Shockwave therapy targets one of the main root causes of erectile dysfunction: poor blood flow.
  • It’s typically recommended for men with mild to moderate vasculogenic ED, including those who take oral medication but would rather not depend on it before sex.
  • Improvements from shockwave therapy for ED can last up to 24 months, with the strongest effect typically around the 12-month mark.

Shockwave Therapy for ED: Does It Really Work?

More than half of Singaporean men aged 30 and above live with some degree of erectile dysfunction (ED). By their sixties, that figure rises to over three in four. Yet most never bring it up with a doctor. ED is a medical condition with well-evidenced treatments, and one of the more significant developments in recent years, extracorporeal shockwave therapy (ESWT), is changing how specialists approach mild to moderate cases. 

Below, we explain how shockwave therapy for ED works, who it’s likely to help, and what a proper clinical assessment involves.

What Is Shockwave Therapy for Erectile Dysfunction (ED)?

ESWT delivers brief, focused acoustic pulses (sound waves) to the penile tissue from outside the body. The goal is not to treat the symptom of ED directly, but to address one of its most common underlying causes: poor blood flow.

When acoustic waves are applied to the tissue, they stimulate the formation of new blood vessels in a process called angiogenesis, improving blood supply to the penile tissue. Over a course of treatment, this may help restore the natural erectile response, without the need for medication taken before sex.

A typical course involves six to 12 sessions, each lasting around 15 to 20 minutes. The procedure is non-invasive, requires no anaesthetic, and is performed as an outpatient treatment. Most men report minimal discomfort.

How Does It Compare to Other ED Treatments?

ESWT sits in a different category from most other ED treatments because it targets the underlying cause rather than managing the symptom.

Treatment

How It Works

Key Limitation

Recommended For

PDE5 Inhibitors

Temporarily increases blood flow by blocking the PDE5 enzyme

Must be taken before sex; does not address the underlying cause

Men with mild to moderate ED seeking on-demand relief

Vacuum Erection Device

Draws blood into the penis mechanically

Cumbersome; less spontaneous

Men who cannot use medication

Penile Injections

Injected directly into penile tissue to trigger erection

Dropout rates due to discomfort are a noted clinical limitation

Men unresponsive to oral medication

Penile Implant (Surgery)

Surgically placed device provides on-demand erection

Invasive; reserved for severe cases

Men who have not responded to other treatments

Shockwave Therapy (ESWT)

Acoustic pulses stimulate new blood vessel growth

Not suitable for all ED types

Men with mild to moderate vasculogenic ED

Why Do Men Develop Erectile Dysfunction?

ED has multiple possible causes, and in many cases more than one factor is involved.

The most common is vascular: the arteries supplying blood to the penis narrow or stiffen over time, reducing the blood flow needed for an erection. This is closely linked to the same risk factors as cardiovascular disease. In some cases, an ED may appear years before a cardiac event as an early warning sign.

Common contributing factors to ED include:

  • Vascular disease
  • High blood pressure, high cholesterol, and type 2 diabetes
  • Low testosterone or other hormonal imbalances
  • Nerve damage, including from prostate surgery or spinal injury
  • Psychological factors: performance anxiety, depression, and chronic stress
  • Lifestyle factors: smoking, excessive alcohol consumption, obesity, and physical inactivity

Who Is Most Likely to Respond to Shockwave Therapy for ED?

If your ED is rooted in reduced blood flow rather than nerve damage or psychological causes, you may want to discuss shockwave therapy with your doctor.

Men who respond well to PDE5 inhibitors but would prefer not to rely on them before sex are also good candidates. So are men who have not responded adequately to oral medication, a recognised limitation particularly in men with diabetes or significant vascular damage.

When Should You See a Doctor About ED?

The honest answer: sooner than most men do.

ED is a medical condition, not a reflection of age, masculinity, or personal failure. Yet many men wait months or years before raising it with a doctor, often because of embarrassment or the assumption that nothing can be done. Both are worth setting aside.

Consider seeing a doctor if any of these apply to you:

  • ED is happening consistently, not just occasionally.
  • It’s affecting your relationship or quality of life.
  • It appeared suddenly rather than gradually.
  • You have also noticed fatigue, low mood, reduced libido, or urinary changes.
  • You have risk factors for cardiovascular disease, such as high blood pressure, diabetes, high cholesterol, or smoking.

How DTAP Clinic Treats Erectile Dysfunction

DTAP Clinic takes a comprehensive approach to ED, beginning with a thorough assessment before any treatment is recommended. The aim is to identify the underlying cause first, then build a treatment plan around it, rather than defaulting to a single solution.

Shockwave therapy for ED is available at DTAP as part of that treatment pathway. Depending on the assessment findings, it may be recommended alongside other interventions, including oral medication, hormone optimisation, or lifestyle changes.

What Happens at Your First Consultation?

Your first consultation is confidential and doctor-led. Here’s what you can expect:

  1. Your doctor takes a full medical and sexual history. This covers how long you’ve been experiencing symptoms, how often they occur, whether you get morning erections, and any relevant health conditions you have been diagnosed with.

  2. A physical examination is carried out where relevant. This may include checking blood pressure, examining the genitals for any structural abnormalities, and assessing general cardiovascular health markers.

  3. Blood tests are ordered to identify underlying contributors. These typically cover fasting glucose (to screen for diabetes), a lipid panel (cholesterol levels), and testosterone. Abnormal results in any of these can point directly to the cause of your ED and shape our treatment approach.

  4. If a vascular cause is suspected, a penile Doppler ultrasound may be arranged. This is a non-invasive scan that measures the speed and volume of blood flow through the penile arteries. It’s a direct way to confirm whether reduced blood flow is driving your symptoms, and it informs whether shockwave therapy is likely to be effective for you specifically.

  5. A treatment plan is recommended based on your results. Rather than defaulting to a standard protocol, our doctors use the full picture from your assessment to recommend the most appropriate combination of treatments for your situation.

Take the First Step Towards Treating Your ED at DTAP Clinic

ED is treatable. For the majority of men, the right combination of assessment and treatment produces meaningful improvement, and the earlier you seek help, the more options are available to you.

DTAP Clinic offers confidential, doctor-led consultations for erectile dysfunction at clinics across Singapore, with locations in Clarke Quay, Novena, Orchard, Holland Village, and Kovan. 

Book a consultation today.

FAQs on Shockwave Therapy for ED

Does shockwave therapy really help erectile dysfunction?

It can, but shockwave therapy for ED is not a guaranteed fix. Some clinical trials have shown real improvements, particularly in men whose ED is caused by poor blood flow. Whether it’s likely to work for you depends on what’s driving your symptoms, which is why a proper assessment should come first.

How long does shockwave therapy for ED last?

Research suggests improvements may persist for up to 24 months following a completed course of treatment, with the strongest effect typically seen at around 12 months. Some men undergo maintenance sessions to sustain results, though individual outcomes vary. 

What is the strongest treatment for erectile dysfunction?

It typically depends on what’s causing it. There’s no single best treatment for ED, as what works well for one man may not be appropriate for another, which is why the starting point is always finding out what’s actually going on.

Can ED be 100% cured?

In some cases, yes. If ED is driven by a reversible cause such as low testosterone, medication side effects, or lifestyle factors, addressing those causes can restore erectile function fully. For ED with a vascular or structural basis, treatment may significantly improve function rather than resolve it completely. Either way, meaningful improvement is achievable for most men with the right diagnosis and treatment plan.

Diabetes in Men & 5 Associated Men’s Health Conditions

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By 2030, the number of Singapore residents above 40 with diabetes is projected to increase by another 200,000 from about 400,000 today. 

The prevalence of diabetes among adults increased from 8.2% in 2004 to 11.3% in 2010. A higher proportion of men were diabetic (12.3%) compared with women (10.4%). We can imagine how the number would have increased even more by today.

For men living with type 2 diabetes, they are also at higher risk for certain conditions as compared to other men. In this article I will share more about unique mens health issues faced by men with type 2 diabetes.

1. Erectile Dysfunction (ED)

According to a study published in Journal of Diabetes, Metabolic Syndrome and Obesity: Targets and Therapy, men with diabetes are much more likely to experience Erectile Dysfunction than men who don’t have diabetes. High blood glucose causes damage to small blood vessels and/or  nerves like the ones that supply the penis. Hence poorly controlled diabetes contributes to Erectile Dsyfunction.

Other than sugar control, there are also some diabetic medicines that causes side effects like ED which adds on to the problem.

Other than diabetes, these men are usually also obese and suffering from hypertension, both of which also adds on to the risk for ED.

https://youtu.be/xVUwgNqRKho

2. Urinary Tract Infection: 

Urinary Tract Infection (UTI) is usually caused by bacteria. It can affect any part of the urinary tract. Anywhere including the kidneys, bladder, ureters, urethra, and, in men, the prostate gland. Most of the time the infection is in the bladder. Women are 10 times more likely to get a UTI as compared to men. However men with diabetes are at a higher risk of getting UTIs than men without diabetes.

Why are men with diabetes more prone to UTIs? There are a few possible reasons. One, men with diabetes have poor circulation. This reduces the ability of white blood cells to travel in the body and fight off any kind of infection. Two, high glucose levels can also raise the risk of a UTI. Three, some men with diabetes have poor ability to empty their bladders. What happens is, urine stays in the bladder for too long and this becomes conducive for bacteria to grow.

3. Balanitis

Balanitis is an infection of the skin on the head (glans) of the penis. In uncircumcised men, this area is covered by the foreskin, or prepuce. Balanitis can occur in both circumcised and uncircumcised men, however, uncircumcised men are at higher risk for balanitis and also recurrent infections.  

Any man can develop balanitis, but the condition is most likely to occur in men who have phimosis (tight foreskin) or poor hygiene. Other than this group of men, men with diabetes are also at high risk of balanitis especially if they have poor sugar control. When sugar is poorly controlled, excess sugar may be exreted in the urine. This sugar rich urine when trapped underneath the foreskin, will provide a conducive environment for yeast and bacteria. On top of that, men with poorly controlled diabetes is also unable to fight of infections effectively. Read: What are the Causes of Balanitis

https://youtu.be/1F5iKRxhg8k

4. Posthitis

Posthitis is inflammation of the foreskin It is characterized by swelling or redness of the foreskin. In some cases, it may happen together with tears on the foreskin which may be quite painful. It is usually caused by an infection like fungus or bacteria. In some cases, it might be due to tears in the skin due to abrasion or friction during intercourse. The selling may lead to phimosis and tightness of the foreskin which makes it difficult for the skin to retract. 

Circumcision is usually a definite treatment for men who has recurrent balanitis posthitis or UTI. It is a very effective treatment to reduce the risk of UTIs, balanitis and also there won’t be anymore posthitis when the foreskin is removed.

5. Low Testosterone

 In the past few years, scientists have found some connection between low testosterone and diabetes. One study showed that in 2,100 men over age 45, the odds of having low testosterone were 2.1 times higher in men with diabetes. Low testosterone doesn’t cause diabetes but it might be the other way around. Men with diabetes might develop low testosterone. Read Andropause

A link between diabetes and low testosterone is well established. Men with diabetes are more likely to have low testosterone while men with low testosterone are more likely to develop diabetes as well. Testosterone improves the body’s ability to take up sugae in response to insulin. Men with low testosterone may have insulin resistance. In this condition, their body need to produce more insulin in order to reduce the same amount of sugar in the blood.

Read: Low Testosterne & Low Libido

All in All

So if you happen to be diagnosed with type 2 diabetes, do keep a look out for some of the issues mentioned above. If you happen to have any of the above conditions, do consider health screening as any of the condtions might be an indication of diabetes. Do consult your doctor if you are experiencing any of the above symptoms and conditions.

 
 
Make An Appointment |  Find A Doctor

Sildenafil & Tadalafil Singapore – Treat Erectile Dysfunction (ED)

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In this article, we are going to talk about a topic that some people may find embarrassing – Erectile Dysfunction or ED for short.

ED is a very common condition. In one study, more than 50% of men in Singapore reported some form of ED. The prevalence increased from 43% in their forties s to almost 80% for men in their sixties. 1 

Aside from affecting your quality of life and relationships2, ED is also an important marker for general health. ED could be the first sign of a chronic disease like Diabetes, High Blood Pressure and High Cholesterol.2,3

Not being able to achieve an erection at all is considered severe ED. Milder forms of ED include not being able to sustain an erection and also not being as firm or hard as you used to be. 4

When you see a Doctor for ED, he will first ask you a detailed medical history and conduct a physical examination.5 He may also need to conduct some tests to find out if there is a medical problem causing your ED. 5

Treating Erectile Dysfunction

Nowadays, there are many effective treatments for ED. Tablets called PDE5Is are safe, convenient, painless and effective for treating ED. 6,7 Other treatment options include low intensity shock wave therapy8, penile injections9 and penile implants.10

Using Sildenafil & Tadalafil Medications To Treat Erectile Dysfunction

Sildenafil and Tadalafil are two widely prescribed medications used to effectively manage ED. Understanding how these medications work and their benefits is crucial for anyone experiencing ED.

How Sildenafil and Tadalafil Work: Sildenafil and Tadalafil belong to a class of medications known as phosphodiesterase type 5 (PDE5) inhibitors. They work by enhancing blood flow to the penis during sexual stimulation, helping to achieve and maintain an erection.

Benefits of Sildenafil:

  • Rapid onset of action (typically within 30-60 minutes).
  • Effects last up to 4-5 hours.
  • Available in various doses to suit individual needs.

Benefits of Tadalafil:

  • Longer duration of action (up to 36 hours).
  • Can be taken daily at lower doses for continuous treatment.
  • Quick onset of action, usually within 30 minutes.

Choosing Between Sildenafil and Tadalafil: The choice between these medications often depends on individual preferences, lifestyle factors, and specific health considerations. Consulting with a healthcare provider is essential to determine the most suitable option.

Considerations Before Use: Before using sildenafil or tadalafil, discuss any existing health conditions, medications, or allergies with a healthcare provider. Adhering to prescribed doses and usage guidelines is crucial for safety and effectiveness.

Sildenafil and tadalafil are effective treatments for erectile dysfunction, offering distinct benefits that cater to different patient needs. Understanding how these medications work and consulting with a healthcare provider can help individuals make informed decisions regarding their ED treatment.

Also Watch: How Do You Inject Caverject

If you feel that your erections are not what they used to be, see your GP and tell him you may have ED and get yourself treated. There is no need to be embarrassed and suffer in silence. 

If you have wish to speak to a doctors about Erectile Dysfunction problem or learn more about treatment for Erectile dysfunction, please contact our men’s health clinics.

 

References:

1. Tan JK et al. (2003). Erectile dysfunction in Singapore: prevalence and its associated factors—a population-based study. Singapore Med J; 44: 20–26.

2. Paraskevas, K.I. et al. (2009) Erectile dysfunction: a warning sign of silent vascular disease Int Urol Nephrol; 41: 909

3. Cappelleri, J., Rosen, R. (2005). The Sexual Health Inventory for Men (SHIM): A 5-year review of research and clinical experience. Int J Impot Res; 17: 307–319

4. Dutta TC, Eid JF. (1999). Vacuum constriction devices for erectile dysfunction: a long-term, prospective study of patients with mild, moderate, and severe dysfunction. Urology; 54(5): 891–89

5. L.A. Levine (2000). Diagnosis and treatment of erectile dysfunction. Am. J. Med; 109: 3-12

6. Gresser U, Gleiter CH. (2002). Erectile dysfunction: comparison of efficacy and side effects of the PDE-5 inhibitors sildenafil, vardenafil and tadalafil—review of the literature. Eur J Med Res; 7: 435–46

7. Sheila A Doggrell. (2005) Comparison of clinical trials with sildenafil, vardenafil and tadalafil in erectile dysfunction. Expert Opinion on Pharmacotherapy; 6(1): 75-84

8. Kitrey, N. D., Gruenwald, I., Appel, B., Shechter, A., Massarwa, O., & Vardi, Y. (2016). Penile Low Intensity Shock Wave Treatment is Able to Shift PDE5i Nonresponders to Responders: A Double-Blind, Sham Controlled Study. Journal of Urology, 195(5), 1550–1555.

9. Heaton, J. et. al (2001). Intracavernosal alprostadil is effective for the treatment of erectile dysfunction in diabetic men. International Journal of Impotence Research, 13(6), 317–321.

10. Montorsi, F.et.al. (2004). Penile implants in the era of oral drug treatment for erectile dysfunction. BJU International, 94(5), 745–751.

 

Also See: Erectile Dysfunction Treatment In Malaysia

Avanafil For Erectile Dysfunction

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Phosphodiesterase 5 Inhibitors (PDE5i) are a class of medications used to treat Erectile Dysfunction. They are the first line of therapy in men who are present with symptoms of having poor quality of erections. As mentioned in our previous articles, a healthy erection is one of the cornerstones of male reproductive health. – Men’s Health Clinic Singapore

Not all PDE5i are made the same, understanding how each one works will allow better discussion with your attending physician when deciding which medication will work best for your situation. In general, inhibition of PDE enzymes in the body results in the dilatation of blood vessels throughout the body. Consequently, medications such as PDE5i that enhance erections can lead to unwanted side effects of headaches and back pain. Medical research therefore has been focused on creating ED medications that are more focused on inhibition PDE5 only in order to enhance erections with minimal side effects.

Avanafil is an example of a highly specific PDE5i and has the potential benefits of providing good quality erections with minimal side effects. Studies done on the molecular binding of Avanafil have shown that it is 110-fold more selective to PDE5 than other PDE5 inhibitors. The additional benefit of Avanafil is the faster absorption of the medication compared to the other PDE5i. A faster absorption translates to faster onset of the medication, therefore with an absorption of 30 to 45 min makes it the fastest acting PDE5i at the moment. One of the largest clinical studies for the medication involving 600 patients showed a significant improvement in erection quality at 100mg and 200mg doses.

Although more specific than other PDE5i, Avanafil does still result in the common side effects of the medication class albeit to a lesser extent. These side effects include headache, flushing and nasal congestion. Absorption of Avanafil is affected by fatty food with a 20% decrease in absorption which translates to a 1 hour delay in onset. 

Avanafil is a good addition to the PDE5i class of medications that help men suffering from ED. Avanafil is only available with a Doctor’s prescription. Discussing your concerns with your attending physician can help you create a treatment plan to include Avanafil or the other PDE5i medications can help you achieve better quality erections and enhance your reproductive health.

Speak to our doctor today to find out if Avanafil is suitable for you.

Avanafil is available at our clinics.

References:

  1. Mehrotra N, Gupta M, Kovar A, Meibohm B. The role of pharmacokinetics and pharmacodynamics in phosphodiesterase-5 inhibitor therapy. Int J Impot Res. 2007;19:253-264
  2. Goldstein I, McCullough AR, Jones LA et al. A randomized, double-blind, placebo-controlled evaluation of the safety and efficacy of avanafil in subjects with erectile dysfunction. J Sex Med. 2012;9:1122-1133

How Do You Inject Caverject?

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Caverject

Caverject is a medication that is used for Erectile Dysfunction (ED).

Also read: TOP 7 MYTHS AND FACTS ABOUT ERECTILE DYSFUNCTION

What’s in Caverject?

The main ingredient is Alprostadil. This medication increases blood flow into the penis and dilates the blood vessels. By so doing, it will improve erection in the penis.

Unboxing Caverject

What is included in a box of Caverject?

  • One bottle of powder – the medication
  • Two needles, one big and one small
  • A paper manual to refer to
  • A syringe that contains the diluent which will be used to dilute the medication powder
  • 2 packets of alcohol swabs
https://youtu.be/hwvV72MMHeE

Dr Taufiq, Resident Doctor, DTAP Clinic, will be sharing on how to properly administer Caverject.

How do you inject Caverject?

Step 1: Open the vial of the powder and use an alcohol swab to clean the top of the vial.

Step 2: Break open the seal for the syringe with diluent

Step 3: Open the packaging for the large needle and attach the large needle to the syringe. Make sure it’s sealed tightly together. Pull off the cap of the needle and be careful, the needle is very sharp, do not accidentally poke yourself.

Step 4: Inject the needle into the vial and fill the vial with the diluent.

Step 5: Remove the needle and slightly shake the bottle, mixing the solution with the powder.

Step 6: Once the diluent and powder in the vial is mixed, draw out the liquid and put back the cap of the large needle in order to remove it. When putting on the cap, make sure you hear a cap sound before proceeding to turn it anticlockwise to remove it.

Step 7: Remove the smaller needle from the packaging and attach the syringe turning it clockwise until it fits. You will need to remove the excess air inside the diluent.

To do so, remove the cap of the needle, make sure the liquid goes up to the top and the air goes all the way up. Put back the cap and check with your doctor for the right dose. Inject the right dose by looking at the measuring lines at the side of the syringe.

Step 8: Preparing for the injection.

The area of injection is the top and side of the penis. Do not inject directly into the top but slightly to the right into the muscle of the penis. Clean area of injection with an alcohol swab and inject at a 45 degree angle towards the cleaned area. Go in directly and inject and once it is complete, remove it.

Step 9: After the injection you are advised to press on the injection wound and massage the medication upwards to distribute the medication into the penis muscle.

[Always dispose of sharps into a sharps box or in a container or plastic bottle.]

Potential risks or side effects?

Potential risks or side effects from using Caverject includes bleeding and pain in the penis. The risk of pain can be alleviated by pressing onto wound. If you are allergic you are advised not to use it, do speak to your doctor before using this medication.

When should I use Caverject?

Caverject is to be used 15 minutes before sexual intercourse.

Watch next: CAUSES OF ERECTILE DYSFUNCTION & TREATMENT OPTIONS (VIDEO)

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5 Things a Weak Erection is Telling You

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Erectile Dysfunction (ED) is the inability to achieve or maintain an erection sufficient for satisfactory sexual performance. So if your erection is not able to satisfy you and/or your partner, you may have ED.
If your erection is weak, bedroom performance might not be the only problem that you are suffering from. It might be an indicator of another health condition.

What is Erectile Dysfunction

How Do I know If I have Erectile Dysfunction?

You can also use the below following questions to help yourself in determining whether you could possibly be suffering from Erectile Dysfunction:

1 – Almost never, (1 point)

2 –  A few times, (2 points)

3 – Sometimes, (3 points)

4 – Most times, (4 points)

5 – Almost always, (5 points)

 

Questions:

  • How confident do you feel that you can get and keep an erection?
  • When you have erections, how often are they hard enough for sex?
  • Were you able to maintain your erection after penetration?
  • Were you able to maintain your erection until orgasm?
  • Are you satisfied with your sex life?

If you scored between 1-7 points, you likely have severe Erectile Dysfunction.
8-11 points moderate Erectile Dysfunction, 12-16 points are mild to moderate Erectile Dysfunction, 17-21 mild Erectile Dysfunction and lastly 21-25 points no Erectile Dysfunction.

Below are the top 5 things that a weak erection may be telling you.

1. Diabetes

Men with type 2 diabetes tend to develop ED 10-15 years earlier than men without diabetes.
As men with diabetes age, the occurrence of ED becomes more common. 50-60% of men above 50 years of age with diabetes gets problem with erection. For those above 70, more than 95% are affected.
Diabetes may damage nerves, blood vessels that control erection. So having a weak erection may be an indicator of diabetes.

2. Hypertension

Hypertension or high blood pressure is one of the top causes of weak erections.
A study published in the Journal of the American Geriatrics Society found that 49% of men between 40-79 years of age with high blood pressure had erectile dysfunction. Another study in Journal of Urology found that 68% of men with hypertension had some degree of erectile dysfunction.
Hypertension affects the blood flow and the normal physiology of the male erection. On a side note, some drugs used to treat hypertension may also cause ED. So do speak to your physician if you are experiencing weak erection and on anti-hypertensive medication.

3. Low testosterone

If your weak erection is also accompanied by other symptoms like low libido, low energy levels, low mood, you might be suffering from low levels of testosterone. Testosterone production slows down as men age. On top of that, there are other lifestyle factors that may also affect testosterone levels like physical activity, obesity, stress levels etc.
Do seek advice from a doctor who is familiar with treatments of testosterone deficiency. Check your levels and seek advise whether testosterone replacement may help with your condition.

4. Heart Disease

There is a very strong link between erectile dysfunction and heart disease. Many studies have shown that men with heart disease have a higher chance of having ED.
In one study, 57% of men who had bypass surgery and 64% men who had a heart attack, had ED. On the other hand, having ED also puts you at high risk of developing heart disease.
Heart disease can be detected early or prevented with regular health screening and also healthy lifestyle habits. Keeping a healthy weight, regular physical activity, healthy balanced diet are some of the ways to prevent heart disease. If you do have other chronic diseases like high blood pressure, high cholesterol or diabetes, do get treated and get them under controlled.
Read: Getting Heart Attack at a Young Age

5. Depression

Depression is a condition that is indicated by persistent sadness, a feeling of hopelessness and a pessimistic outlook.
Symptoms of depression include:

  • Fatigue
  • Loss of interest in formerly pleasurable activities
  • Low self-esteem
  • Changes in appetite
  • Apathy
  • Sleep disturbances

In cases of depression in men, sometimes it may not be as easily recognised as in women. Men who are depressed may spend more time talking about physical symptoms than their emotions.
One of the physical symptoms that may happen is ED. Journal of Sexual Medicine published a review of 42 studies looking at ED and depression. It was reported that men with depression had a 39% increase risk for ED.
So a weak erection may also mask an underlying psychological condition like depression.

All in All

The above 5 things are an indication that a weak erection may be a symptom to another condition that you are suffering from. So don’t be too quick to brush it off or just solve it with a pill, speak to a doctor who is experienced with managing ED and make sure you don’t have an underlying medical condition.
If you need to speak to our doctors, please visit our men’s clinics.  Alternatively, you can email us hello@dtapclinic.com.sg or call us for an appointment.
Take Care.

Other Read:

 

Causes of Erectile Dysfunction & Treatment Options (Video)

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Erectile Dysfunction or ED in short and the treatment options

First, What is Erectile Dysfunction?

It occurs when a man is unable to get or keep an erection that allows for penetration during sexual activity.

Is Erectile Dysfunction common?

It is estimated that 1 in 4 to 1 in 5 men over the age of 40 have the issue
And it becomes more common as we grow older
So What are the Cause of Erectile Dysfunction?
ED is usually multi-factorial meaning that there are many factors that can cause the issue

  1. Age
  2. Chronic diseases like hypertension and diabetes
  3. Low testosterone levels (See: Andropause)
  4. Certain medicines or drugs like alcohol
  5. Psychological factors like stress, anxiety, new partner

For the let’s discuss what are some treatment options if you have Erectile Dysfunction.

The most common Erectile Dysfunction Treatment option is Medicine

There are tablets, such as Viagra and Cialis you can take or inject prior to your sexual contact that can help with ED
They work by increasing blood flow to the penis.
Treatment option 2 is by using a Penile vacuum device. It Works by creating a vacuum, which forces the blood into the penis; a ring is then used to prevent the blood from flowing out from the penis thus maintaining an erection
A more invasive option is by surgical penile implants can be inserted by surgeons
Another Erectile Dysfunction treatment option is by undergoing Electroshockwave therapy or ESWT in short
One of the causes of Erectile Dysfunction is the poor flow of blood into the penis caused by unhealthy blood vessels.
By shooting multiple low-intensity shockwaves into the penis, new and healthy blood vessels develop. This is known as neo-vascularization.

It works by delivering painless low-intensity shock waves into the penis. This stimulates the penis to make new blood vessels. More blood vessels mean better blood flow into the penis and better erections.
Each treatment session lasts about 15 minutes and is completely painless. A patient can resume his normal activities immediately after the treatment.
Usually, 6 to 12 treatment sessions are recommended.

If you think you may be suffering from ED, please visit your doctor for further assessment and treatment at our men’s clinics.

Watch next: HOW DO YOU INJECT CAVERJECT?

Caverject is a medication that is used for Erectile Dysfunction (ED). Here’s a step by step video on how you can accurately administer Caverject.

Other Reads: