Erectile Dysfunction Symptoms, Causes and Treatment in Singapore
by: Dr. Paul Chang, General Practitioner, Regis Medical
Erectile dysfunction is commonly referred to as ED and occurs in about 1 in 10 adult males on a long-term basis.
What is Erectile Dysfunction (ED)?
ED refers to an inability to have or sustain an erection firm enough for sexual intercourse. This is sometimes referred to as impotence. This condition can be occasional or frequent. Occasional ED is a common condition and may be a result of stress or recent nutritional or lifestyle changes. Frequent ED, on the other hand, may be the sign of an underlying health problem requiring treatment. It may also be a sign of emotional or relationship difficulties that you may want to address.
Prevent and Manage Erectile Dysfunction with Regis Medical
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Symptoms of ED
Symptoms of ED include:
- Experiencing difficulty getting and maintaining an erection during sexual activities.
- Premature ejaculation
- Delayed ejaculation
- Anorgasmia, a condition that prevents the patient from achieving orgasm even after ample stimulation
It is advised that you consult a doctor if you have experienced the above symptoms, especially if they have lasted for 3 or more months. These symptoms may be a sign of an underlying health problem which may require treatment. A doctor can help to identify underlying conditions and prescribe treatment if necessary.
Causes and Risk Factors of ED
Sexual arousal in men involves the brain, hormones, emotions, nerves, muscles and blood vessels. This means that ED can be caused by a variety and combination of reasons, ranging from chronic illnesses to psychological factors.
Physical Causes
Common physical causes of ED include:
- Heart disease
- Atherosclerosis
- High cholesterol
- High blood pressure
- Diabetes
- Obesity
- Metabolic syndrome — a condition involving increased blood pressure, high insulin levels, body fat around the waist and high cholesterol
- Parkinson's disease
- Multiple sclerosis
- Certain prescription medications
- Tobacco use
- Peyronie's disease
- Alcoholism and other forms of substance abuse
- Sleep disorders
- Treatments for prostate cancer or enlarged prostate
- Surgeries or injuries that affect the pelvic area or spinal cord
- Low testosterone
Psychological Causes
Common psychological causes of ED include:
- Mental health conditions such as depression and anxiety
- Stress
- Relationship problems
Risk Factors for ED
The following may increase your risk of developing ED:
- Age. As you grow older, erections will take longer to develop and may not be as firm.
- Medical conditions, especially diabetes or heart conditions.
- Tobacco use. Tobacco use can lead to reduced blood flow to your veins and arteries which can lead to chronic health conditions contributing to ED in the long run.
- Certain medical treatments. Medical treatments such as prostate surgery or radiation treatment for cancer can contribute to ED.
- Injuries. Injuries that damage the nerves or arteries that control erections can cause ED.
- Medications. Certain types of medications may affect your ability to have and maintain an erection.
- Psychological conditions. These include stress, anxiety or depression.
- Drug and alcohol use. Long-term abuse of drugs or alcohol may increase your risk of developing ED.
Diagnosing ED
To diagnose ED, your doctor will need to conduct a physical examination, examine your health and sexual history. Additional tests may be prescribed if deemed necessary.
Physical Examination
During the physical examination, your doctor will:
- Listen to your heart and lungs
- Check your blood pressure
- Examine your penis and testicles
- Check for reduced blood and nerve function in the pelvic region
- A rectal exam to examine your prostate may be recommended.
Psychosocial History
Your doctor may ask questions regarding your symptoms, health history and sexual history for a better understanding of your condition and its severity.
Additional Tests
Tests recommended will assess your:
- Blood count
- Urinalysis
- Lipid profile/Blood Sugar/Fasting glucose
- Measurements of creatinine and liver enzymes
- Testosterone in your blood
Treatment for ED
Treatment for ED may include:
Lifestyle Changes
Lifestyle changes may help to improve your condition or recover your sexual function. These include:
- Quitting smoking
- Losing excess weight
- Increasing physical activity
- Changing your Medication
- Reducing the dosages of medication causing your ED or replacing them with an alternative can help you recover your sexual function.
Psychotherapy
Therapy can help alleviate psychological factors affecting you during intercourse. This could help treat your ED.
Medication
The following medication may be used to treat ED:
- Phosphodiesterase inhibitors can help with relaxing the muscles in the penis during sexual stimulation, increasing blood flow in the penis. These drugs are taken orally.
- Prostaglandin E1, papaverine hydrochloride, and phentolamine can be injected into the shaft of the penis. This helps to relax the muscles of the corpora cavernosa, causing it to become engorged with blood.
Vacuum Erection Devices
These devices create a partial vacuum, which draws blood into the corpora cavernosa, causing the penis to be erected. An elastic ring at the end of the cylinder can be moved to the base of the penis while removing the cylinder to maintain the erection.
Surgery
- Penile implant. These devices are known as prostheses and can restore erection in men with ED. These implants are malleable or inflatable. However, once implanted, a device must be used to have an erection.
- Vascular surgery. Surgery to repair arteries with blockages can be performed to treat ED. Ligation, a surgery that blocks off veins can be performed to reduce the leakage of blood affecting the rigidity of the penis during an erection.
Preventing ED
To prevent ED, you should adopt healthy lifestyle choices and manage any existing health conditions. This includes:
- Managing chronic illnesses such as diabetes and heart diseases
- Going for regular check-ups and medical screenings to detect potential health problems
- Exercising regularly
- Quitting smoking
- Controlling your intake of alcohol
- Not abusing drugs or other substances
- Reducing stress
- Seeking help for mental health conditions such as anxiety and depression
Consulting a Doctor Regarding Your Condition
You may not feel comfortable discussing your condition with a doctor, but it is important to seek help from a medical professional as ED is often caused by an underlying health condition. For most conditions, early detection and treatment can increase the chances of treating your condition successfully.
Prevent and Manage Erectile Dysfunction with Regis Medical
Patient-first, Holistic, Dedicated Healthcare
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