Erectile Dysfunction Treatment

What is erectile dysfunction treatment?

Erectile dysfunction is when a man is unable to sustain a penile erection that is rigid enough to support satisfactory sexual intercourse.

Why should I consider getting erectile dysfunction treatment?

You may think erectile dysfunction is a rare condition and can be embarrassing to admit. Contrary to your belief, erectile dysfunction is actually more common than you think among men in Singapore. In a study among Singapore men, it was estimated that 51.3% of men over the age of 30 reported some degree of erectile dysfunction.¹

Getting proper treatment for erectile dysfunction from a urologist is not only important for satisfactory sexual intercourse, but it may also be related to other medical conditions. Erectile dysfunction is commonly seen in people with low testosterone levels, and low testosterone levels have been attributed to major conditions such as heart disease or high blood pressure.

Erectile dysfunction is also seen in people with diabetes and depression, so getting treatment for erectile dysfunction will also give a person a chance to see whether the underlying condition is properly managed.

Did you know?

Age was associated with the prevalence of erectile dysfunction. The prevalence of those who reported severe erectile dysfunction increased from 9.1% of men in their forties to 43.5% of men in their sixties.¹

What are the risks of erectile dysfunction treatment?

There are three main categories of treatment options for erectile dysfunction.

The first line of treatment is a medication class called phosphodiesterase-5 inhibitors or PDE-5 inhibitors. These medications work by improving blood flow in the penis therefore creating a sustained erection. There are however some risks to these medications. Because these medications work by improving blood flow into the penis by relaxing your blood vessels, it may negatively cause low blood pressure, especially if you are taking certain kinds of blood pressure pills. Be sure to ask your urologist about drug interactions.

Second line therapies include a vacuum pump or injection of medication into the penis. A vacuum pump is a mechanical device that uses pressure to create an erection. It is quite safe overall but because it can be inconvenient to use and requires a restraining ring, it is therefore not used often.

The medications that are injected into the penis are used less often than the PDE-5 inhibitors as they are much more cumbersome and have greater risks. These medications can cause penile pain, infection, and a condition called priapism. Priapism is a medical emergency where an erection is sustained for more than 4 hours and unable to subside.

In some cases, there are surgical options to treat erectile dysfunction. A penile prosthesis can be implanted. These can either be semi-rigid or inflatable. Another surgical option to rewire some of the blood vessels in the penis to allow for better blood flow.

With any surgery, there is a risk of infection, blood clots, or excessive bleeding. Specific to the blood vessel operation, there may be a risk of numbness in the penis and shortening of the penis. Your urologist will have experience with these procedures and the necessary facility to carry out these options.

How should I prepare for my appointment?

Whether you have an appointment to see your urologist for an initial appointment or follow-up, you should always prepare a list of questions ahead of time. Bring all your relevant medical history or documents with you and a list of your current medications.

Management of erectile dysfunction can have a social impact as well, so it may be important to have your loved one’s support during your treatment process.

What can I expect during erectile dysfunction treatment?

When a PDE-5 inhibitor medication is used to treat erectile dysfunction, it is taken on an as needed basis. Generally, these medications can be taken 60 minutes before anticipated sexual activity.

A vacuum pump is a mechanical device that uses vacuum pressure to create an erection. There is also a restraining ring that needs to be placed onto the penis to sustain the erection by concentrating the blood flow into the penis. A vacuum pump should only be applied for a maximum of 30 minutes.

There are many variations of inflatable penile prosthetic devices. The general principle to these devices are two hollow cylinders placed inside of the penis and a pump control is used to inflate the cylinders.

How do I maintain my sexual health?

Erectile dysfunction can have significant emotional impact for both the male patient and their partners. There are many ways a man can maintain a healthy sexual lifestyle and these options do not require medications or surgery.

Erectile dysfunction can be caused by certain medications. Antidepressants, certain types of water pills, and antifungal medications can cause erectile dysfunction. Speak to your urologist about your medications and whether it is causing erectile dysfunction.

Erectile dysfunction can be caused by a variety of other conditions. Stress, depression, stroke, back injury, or dementia (memory problems) can cause erectile dysfunction. Speak to your urologist if you have any of these conditions and think you may have erectile dysfunction.

To maintain sexual health, there are a few lifestyle recommendations. Firstly, if you are currently smoking, you should consider stopping as smoking can worsen erectile dysfunction.² Exercise has also shown to be effective for better sexual performance.³

Erectile dysfunction is not an uncommon condition in men, especially with increasing age. If you are concerned about erectile dysfunction, speak to an urologist who can provide you with proper care.

[1] Tan JK, Hong CY, Png DJC, Liew LCH, Wong ML. Erectile Dysfunction in Singapore: Prevalence and Its Associated Factors – A Population-Based Study. Singapore Med J 2003 Vol 44(1):020-026

[2] Wu C, Zhang H, Gao Y, Tan A, Yang X, Lu Z, Zhang Y, Liao M, Wang M, Mo Z. The association of smoking and erectile dysfunction: results from the Fangchenggang Area Male Health and Examination Survey (FAMHES). J Androl. 2012;33(1):59-65. doi: 10.2164/jandrol.110.012542.

[3] Simon RM, Howard L, Zapata D, Frank J, Freedland SJ, Vidal AC. The association of exercise with both erectile and sexual function in black and white men. J Sex Med. 2015;12(5):1202-10. doi: 10.1111/jsm.12869.