“Cheap” Viagra

From time to time, there has been reports on the news about people suffering ill effects after taking unlicensed, unverified health products which claim to boost the “virility” and “sexual prowess” of men.

In fact, these illegal products often contain different pharmaceutical compounds. In 2008, 10 people died after taking them for sexual enhancement. Diabetes medications were found in these tablets, resulting in people experiencing low blood sugar, dizziness and fainting, cold sweats and eventually loss of consciousness. 

Furthermore because the compounds of the drug are unknown, many have also experienced side effects such as loss of hearing, strokes and extremely painful erections. Not the outcome one would be looking for when wanting to boost their own libido. In fact if left untreated, these painful erections caused by the engorgement of blood can lead to Permanent Impotence.

Image taken from Immigration & Checkpoints Authority Facebook.


These illegal products are often bought from street peddlers, online pharmacies or even from other countries with no prior Health Sciences Authority (HSA) Singapore approval. That being said, here are the top 5 reasons why “Cheap” Viagra may end up costing you so much more than just the money you think you might be saving.

1. You can get severe side effects from unknown doses or what is in the drug

The tablet may contain any combination of medicines to boost erections, other medications that may have adverse side effects such as the diabetes medications i described above. Ultimately leading to organ damage and eventually  death.

The main way medications boost erections are by enlarging the blood vessels in the penis, allowing more blood to flow in. If these engorgement of blood is not regulated and the blood flow is not reversed after a while, it can lead to priapism (engorgement of blood in the penis), painful erections and ultimately impotency. 

Without medical supervision, the penis may eventually have not enough new oxygen from new blood, and after a few hours, critical damage to the penis can start to occur. This is dangerous and is a medical emergency.

2. You could be paying for a dud

Don’t be fooled by catchy packaging names such as King Power, Black Gorilla, Tiger King. Many times, for the sake of selling the tablet, the peddler has no idea what goes into it.

You would be lucky to have avoided an adverse health event, and in this case, have completely no effect at all after taking the tablet. In fact, the scary thing is you might end up taking an additional one or two to get a better effect and end up overdosing on the toxic components of the tablet as well. 

3. You have no idea how these drugs are made

Because there is HSA approval of these illegal drugs, there is no guarantee they are made under the proper conditions. This means you might think you are buying a new Ferrari, but after getting the keys, you realize that either there is no engine or that they have given you a Toyota engine instead. Worse still, they could have given you a spoilt ferrari engine, and after driving for 5mins, the engine explodes and you get caught in the explosion.

4. You may not be getting to the root of your problem

You might also think that these sexual enhancement medications may address your poor erections, but instead there are other root causes or even more effective and safer treatments available that need to be addressed. Testosterone Deficiency Syndrome | Andropause

ESWT For Erectile Dysfunction

This is a novel mode of treatment for Erectile Dysfunction which uses low-intensity shock waves directly to penile tissues to help stimulate the growth of new blood vessels. It has been shown to be safe, painless, and effective for the treatment of vasculogenic Erectile Dysfunction (caused by blood vessel problems such as in people with diabetes and high blood pressure).

If you think you may have Erectile Dysfunction, the first step is to speak to your doctor. There are many safe and effective treatments now available for Erectile Dysfunction, but recommended treatments may vary depending on the underlying cause, age and comorbid conditions such as heart disease.

5. You might think it is very difficult to see a doctor and get real HSA approved medications

With DTAP Teleconsult, we are one call away from addressing your erection concerns in full privacy, medical supervision and support with 3 breezy steps. Furthermore, you do not even need to leave the comforts of your own home to receive the medications you require with DTAP Delivery. All within the same span of the day. This convenience and assurance should be no excuse for you to put your health and life at risk by taking “Cheap” Viagra.

With 15 years of caring, our doctors at DTAP clinic will support you through your men’s health journey professionally, discreetly, and effectively.


Diabetes in Men & 5 Associated Men’s Health Conditions

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.


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


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.


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Erectile Dysfunction (ED) Singapore – In a Nutshell

In this video, 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

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

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.

Avanafil For Erectile Dysfunction

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?

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

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)


Find a doctor | Make an appointment

5 Things a Weak Erection is Telling You

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 or call us for an appointment.
Take Care.


Other Read:

 

Causes of Erectile Dysfunction & Treatment Options (Video)

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:

Penile Surgery: Penile Anatomy & Aesthetic Problems

When we think about men’s health, we recognize the importance of enhancing sexual function and symptom improvement.
Penile anatomy and aesthetic (problems) can affect one’s performance during sexual intimacy, one’s confidence or even one’s partner. These problems may also hinder a couple’s fertility planning.

What are the Conditions & Symtopms?

The symptoms one may experience from penile anatomy or aesthetic problem include painful erections, unable to maintain an erection.
This can also come from problems of a flaccid or soft penis, curved penis or bent penis. Some men may also experience a tight foreskin, inability to retract the foreskin, recurrent foreskin infections (balanitis). Some men may also notice, in the absence of STDs, warts or infections, small bumps on the penis.

Frenulum Breve

Painful Erections can be caused by Frenulum Breve, where the external elastic band of tissue which connects the penis to the foreskin is too short, resulting in the restriction of the foreskin movement. Some people also develop a bent penis during erection as the frenulum pulls down the head.  This condition can also further prevent the full retraction of the foreskin or even tearing of the frenulum causing bleeding and pain during sex or erection.
This problem is treated with a simple painless procedure called a Penile Frenulectomy.

Phimosis

Another cause of a painful erection is Phimosis where the foreskin is too tight and does not allow for a complete retraction to expose the glans penis. This can cause pain during an erection and can cause difficulties during sexual intercourse as well. Furthermore during episodes of pain, one may lose their erection, resulting in an unpleasant sexual experience.
The treatment for Phimosis is Circumcision. There are numerous benefits for Circumcision, such as the prevention of infections, also known as balanitis, and the reduction of sexually transmitted diseases.
Shang Ring is a Circumcision Method that is this painless and quick 15min procedure in this YouTube Video: “How Does Shang Ring Circumcision Work

Peyronie’s Disease

Bent or Curved Penis can be caused by a buildup and growth of fibrous plaque tissue in the penis. These scar tissue can also cause pain during an erection. Bent or curved penis is also known as Peyronie’s disease and results in difficult penetration during intercourse.
Peyronie’s disease is treated with Electroshock wave therapy (ESWT) that breaks down these fibrous plaque tissue allowing for a normal straight erection.

Pearly Penile Papules (PPP)

Small bumps around the penis head but without other sexually transmitted disease symptoms can be a cause for concern to men or their partners. The best way to confirm this is through a clinical assessment by our doctors.
If the diagnosis turns out to be benign pearly penile papules (PPP), then there will be no cause for alarm as this is not an STD and does not get transmitted.
However, some men or their partners will be concerned about these spots as they may look “unsightly and unacceptable”. Although this is an “aesthetic” problem, at DTAP clinic, we understand how this can also affect the sex life between a couple or a man’s confidence.
The definitive treatment of PPP is through electrosurgery which is quick painless and takes about half an hour.
Read: Pearly Penile Papules (PPP) Removal

Erectile Dysfunction

Ultimately, Penile curvature and size have a huge effect on penis’ aesthetic aspect; that is a major concern for most men. This may in turn affect a man’s confidence, performance and ultimately enjoyment of sex.
Last but not least, if erectile dysfunction is a concern as a result of any of the above conditions, you can also address it with more than just pills, but also with ESWT for Erectile Dysfunction.
Penile Rejuvenation with a painless, quick and convenient treatment that restores the natural erection mechanism in a man.
We believe in a holistic approach in addressing men’s health concerns both from the inside and also externally. No two treatments are the same for each man, and a tailored approach; understanding your concerns and addressing your worries will always be our priority.

Take the first step and give us a call to get started on your treatment journey.
Our Andrology Clinic in Singapore focuss not just on the inside but also on the outside, a complete picture. One important aspect easily overlooked is penile health and the related problems that are found externally on the Penis.

Take care.


Related Read:

  1. 7 Ways to Last Longer in Bed : Premature Ejaculation
  2. 10 Ways to Improve Sexual Performance for Men
  3. ElectroShock Wave Treatment for Erectile Dysfunction in Singapore
  4. Weak Erection? Erectile Dysfunction? Improv Erection with Pills
  5. Weak Erection: Does Size Matters?
  6. What Do You Need to Know about Prostate Massage
  7. Pearly Penile Papules (Bumps On Penis)
  8. What Causes Men’s Pattern hair loss (Androgenic Alopecia)
  9. Pills That Prevent HIV – HIV PrEP & HIV PEP
  10. 5 Ways to Fight Depression

Does Penis Size Matter? Sexual Confidence in Man

TLDR: Size isn’t everything.

3 Broad Areas Affect Sexual Confidence in Man,

  1. Penis Size,
  2. What to Do in Bed,
  3. Having Lasting and Strong Erections.

via GIPHY

Penile Implant?!

Addressing penis size requires surgery or implants, both with surgical risks, learning what to do in bed can be done over time however, without guarantees of success. And lastly what most men can readily address – strong lasting erections.

Erection Problems

Many ways to treat and prevent erection problems – lifestyle changes, pills, shockwave therapy. Not many want to depend on pills, shockwave can prevent and also treat erection problems.
Choosing between shockwave treatment options, choosing a superior product for a superior outcome. What separates famous top brands from daily brands is the value of the product – history and heritage, behind the scenes man hours, craftsmanship, superior product.

Read: Are All Electro-Shockwave Therapy (ESWT) Machine the Same?

So which Electro Shockwave Treatment Should I ask for? Comparing between 2 commonly used shockwave treatment machines for Erectile Dysfunction: between ED1000 and machine A (Other electromagnetic ESWT machines) – the verdict is clear that ED1000 comes out TOP across ALL domains compared.
When it comes to your sexual confidence, don’t settle for anything less than the best.

Does Penis Size Matter?

That is the eternal question that partners think about but may not openly discuss it with each other. A quick google search on this question pulls up many surveys, research and questionnaires.

“Too long and it just ‘hits bottom’ and that hurts, a total moodkill. But too thick and it hurts too.”

“I find that men are far more worried about size than I am. I do kegel exercises on a daily basis, so the size feels good to me no matter what. The important thing for my enjoyment is more what they do with their hands and mouth, rather than the penis being the only sexual effort!”

These are some of the interesting opinions found online, but whilst opinions and research findings differ across the spectrum, one thing they do agree on is that size alone does not guarantee a good time for either or both couples.

Reading a little deeper, one can then infer that having the confidence of knowing what to do in bed, and of course, having the libido and erection to go along with it, are both critically important.

To build his confidence, a man could learn new moves and how to pamper his partner with no guarantee of results, but to alter his penile size, short of surgery or implants, is not something one could easily do. That leaves us with the last pillar that we can easily address and treat.
That’s right, treatment and prevention of Erectile Dysfunction.

What Can I Do For My Sexual Confidence?

This then leads me to my next point, with so many “proven” treatments out there, how does one decide which treatment works? How does one decide which treatment to explore?

The latest treatment modality for this is Shockwave therapy. It is one of the limited treatment options that allow for the improvement of natural erections and furthermore potentially restore and rejuvenate the physiological mechanisms of erection.

What is Angiogenesis & Rejuvenation of Penile Smooth Muscle Tissue?

Angiogenesis allows for more blood flow into the penis and subsequently better achieving and sustaining an erection, where rejuvenation of the penile smooth muscle tissue allows for the inflammatory response repair of any previously or potentially damaged venoocclusive mechanism in the penis, allowing blood to be sustained in the penile tissue.
Read: Penile Rejuvenation with ESWT

This non invasive and painless procedure takes 20 mins to complete and has numerous benefits such as treating  Chronic Pelvic Pain Syndrome (CPPS)Peyronie’s Disease (Bent Curved Penis) and Erectile Dysfunction.
Read: Shockwave Therapy (ESWT) for other Men’s Health Issues

Shockwave Therapy (ESWT) is only available at all our Men’s Health ClinicNovena, Somerset, Holland Village, Siglap & Raffles Place branches.

Do speak to any of our doctors to find out if ESWT is suitable for you.

You can drop us an email at hello@dtapclinic.comor walk-in or call our clinics for an appointment.


Related Read:

  1. 10 Ways to Improve Sexual Performance for Men
  2. Weak Erection? Erectile Dysfunction? Improv Erection with Pills
  3. 8 Thing You Didn’t Know About Your Penis
  4. Pearly Penile Papules (Bumps On Penis)
  5. Premature Ejaculation Treatment – What You Need to Know
  6. 10 Causes of Penile Pain
  7. Micropenis – What You Need to Know
  8. What Causes Men’s Pattern hair loss (Androgenic Alopecia)
  9. Pills That Prevent HIV – HIV PrEP & HIV PEP
  10. What are the Causes of Foreskin Infection?


More useful links: std test singapore, std testing

 

Are All Shock Wave Machines For Erectile Dysfunction The Same?


What is ElectroShockwave Therapy (ESWT) for Erectile Dysfunction (ED)?

Are All Shock Wave Machines the Same?

Not all ESWT treatments are created equal, and not all ESWT treatments will yield the results you expect.

Take for example buying a coat, the quality, craftsmanship of a product from Hermes will far exceed one bought from Giordano. Or buying a car, a Ferrari will outpace a Toyota anytime. Or even buying a timepiece where a Rolex is associated with class, exclusiveness, meticulous engineering, compared to a simpler Casio.

What separates these famous top brands from other brands is its intrinsic and extrinsic value. The history and heritage of the product, behind the scenes man hours, craftsmanship, superior materials, trust of the brand.

ED1000 vs Machine A (electromagnetic ESWT machine)
– Why the Ferrari of Shockwave therapy should be your choice for Erectile Dyfunction Treatment

In the same vein, comparing the ED1000 versus Machine A, especially when you want to build your sexual confidence by having strong lasting erections – one will definitely gravitate towards the Hermes, Ferrari, Rolex.

Indulge me as I share both the clinical and technical differences between the Ferrari of shockwave treatment for Erections versus perhaps the Toyota. And of course, if all these technical details bore you, you can skip right to the verdict at the end.

 Large Energy in Large Focal VolumeLower Energy in Lower Focal Volume
RCTS – Clinical Trials (Clinicaltrials.gov) 6 clinical Trials
(2010, 2011, 2012, 2013, 2013, 2013)
2 Clinical Trials
(2016 and 2018)
– data not fully published
Number of Patients 399 (29+20+20+200+70+60) 77
(23 + 54)
Medical Evidence as Meta Analysis 5 1

Reviewing the technical details, the ED1000 uses an electrohydraulic method for shockwave generation, which gives a true shockwave at all energy settings. Furthermore, this original gold standard shockwave technology offers long term reliability.  This in turn gives a large energy output in a large focal volume which results in a superior treatment.

If we look at Machine A (other electromagnetic ESWT machines), the generation of the shockwave is akin to a loudspeaker effect and true shockwave is only generated at high energy settings. This, in turn, leads to a lower energy in smaller focal volume, requiring many more pulses to deposit equivalent energy as compared to the electrohydraulic method of shockwave generation by the ED1000.

Apart from the technical aspects, the ED1000 has been studied across 6 clinical trials since 2010, comprising nearly 400 patients. These data were also further published and medical evidence presented in 5 different meta-analysis: the strongest form of medical data evidence. This in comparison with machine A (other electromagnetic ESWT machine), studied across 2 clinical trials, earliest in 2016 and only involving 77 patients, where the results have not been published. However, this has not stopped machine A (the other electromagnetic ESWT machines) from being included in 1 meta-analysis study.

Clearly, the ED1000 has a long proven track record since 2010, studied across more than 4 times the patients of machine A (the other electromagnetic ESWT machines) and data presented more extensively in 5 different meta analysis studies.

*Figure: In hierarchy for medical evidence, meta analysis comes in at the top of the pyramid as the strongest form of medical evidence

The verdict: ED1000 comes out top across the technical comparison, clinical trials and patient studies comparison. It is the superior choice compared to machine A (other electromagnetic ESWT machines).

So yes, you may not know all the latest bedroom moves, or you may even compare yourself with your mates or the online opinions and have doubts… But one thing you can definitely do for yourself is treat yourself right.

Speak to our doctors today, ESWT Erectile Dysfunction Treatment (ED1000) is Only Available in Our

  1. Novena Branch
  2. Holland Village Branch
  3. Siglap Branch (914 East Coast Road)
  4. Raffle Place Branch

You can call us or drop us an email at hello@dtapclinic.com for an appoinment at our Men’s Health Clinic in Singapore.


References:

Effect of Low-Intensity Extracorporeal Shock Wave on the Treatment of Erectile Dysfunction: A Systematic Review and Meta-Analysis.
Dong L, Chang D, Zhang X, Li J, Yang F, Tan K, Yang Y, Yong S, Yu X.
Am J Mens Health. 2019 Mar-Apr;13(2):1557988319846749. doi: 10.1177/1557988319846749.

Clinical studies on low intensity extracorporeal shockwave therapy for erectile dysfunction: a systematic review and meta-analysis of randomised controlled trials.
Sokolakis I, Hatzichristodoulou G.
Int J Impot Res. 2019 Jan 21. doi: 10.1038/s41443-019-0117-z.

Low-intensity Extracorporeal Shock Wave Therapy for Erectile Dysfunction: A Systematic Review and Meta-analysis.
Man L, Li G.
Urology. 2018 Sep;119:97-103. doi: 10.1016/j.urology.2017.09.011. Epub 2017 Sep 27

Short-term efficacy and safety of low-intensity extracorporeal shock wave therapy in erectile dysfunction: a systematic review and meta-analysis.
Zou ZJ, Tang LY, Liu ZH, Liang JY, Zhang RC, Wang YJ, Tang YQ, Gao R, Lu YP.
Int Braz J Urol. 2017 Sep-Oct;43(5):805-821. doi: 10.1590/S1677-5538.IBJU.2016.0245.

Effects of Low-Intensity Extracorporeal Shockwave Therapy on Erectile Dysfunction: A Systematic Review and Meta-Analysis.
Clavijo RI, Kohn TP, Kohn JR, Ramasamy R.
J Sex Med. 2017 Jan;14(1):27-35. doi: 10.1016/j.jsxm.2016.11.001. Epub 2016 Dec 13.

Low-intensity Extracorporeal Shock Wave Treatment Improves Erectile Function: A Systematic Review and Meta-analysis.
Lu Z, Lin G, Reed-Maldonado A, Wang C, Lee YC, Lue TF.
Eur Urol. 2017 Feb;71(2):223-233. doi: 10.1016/j.eururo.2016.05.050. Epub 2016 Jun 16.