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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.

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:

 

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