Erectile Dysfunction (ED)
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Erectile dysfunction or ED as it is commonly known is a very common problem.
Most men at some point in their lives have some problem getting or maintaining an erection.
Even if you do get an erection but it is not as hard as it was, this is also considered to be ED.
A useful partially objective way to determine how good your erection is is the IIEF Questionnaire or the Erection Hardness Score
|Grade 1||Grade 2||Grade 3||Grade 4|
|Penis is larger but not hard||Hard but not hard enough for penetration||Hard enough for penetration but not completely hard||Completely hard and fully rigid|
Erectile Dysfunction (ED) should not be confused with Premature Ejaculation (PE) although they can both be related.
Men with ED requires a lot of stimulation to maintain their erections and this could then make them ejaculate faster then they would like thereby causing PE.
So you would find that the medicines used to treat ED can also work rather well in treating PE.
Erectile dysfunction might be an indicator of more serious underlying medical problems like:
- High Blood Pressure
- High Cholesterol
- Blocked Arteries
- Low Thyroid Hormone Level
- Low Testosterone Level
- Medication Side Effects
When you see our doctors, we will take a careful history and conduct a physical examination to determine if you have any medical conditions that might be contributing to the erectile dysfunction problem. You might also need some blood tests to help with your diagnosis.
Treating any underlying medical problem will help with ED.
What are the options to treat erectile dysfunction?
There are many treatment options currently available for erectile dysfunction. The most popular are the medications known as PDE5 Inhibitors.
Levitra, Cialis and Viagra are all known as PDE5 Inhibitors. They all inhibit an enzyme called PDE5 (phosphodiesterase 5) and this causes the blood vessels to dilate. Dilated blood vessels provide better blood flow and thereby helping erection. By this same mechanism, they all can potentially cause side effects like flushing, headache etc.
Viagra – Marketed to cause the best HARDNESS. Onset about 30 to 45 mins lasts for about 24 hours. Also has the most reported side effects. Its absorption is greatly affected by food and should be taken on an empty stomach.
Levitra – Most POTENT and SAFEST. Very good for people with diabetes or after prostate surgery. Onset about 15 to 30 mins lasts about 12 hours. Also the only PDE5 that has been shown to increase DURATION. It’s absorption is not as affected by food as Viagra but maximal effect is still achieved when it is taken on an empty stomach.
Cialis– last LONGEST. Usual favourite of young people with no problems but want an extra kick. Onset about 30 mins lasts about 36 hours. Taking 5mg everyday has exactly the same effect as taking 20mg when you need. This method of dosing disassociates the taking of pills with sex. It is very good value for people who take more than 2 tablets of 20mg a week. At the same time, this method of taking the pills will improve the lining of your blood vessels.
The 5mg Cialis low dose once-per-day pill has several advantages:
1. There is no need to plan and time when you take the pill and when you will have intercourse.
2. When taken daily, the effect of Cialis 5mg is MORE than 5mg. In other words, just because the dose is only 5mg, you do not get only a quarter of the effect of the 20mg.
3. If a patient is taking 2 or more 20mg pills per week, it is cheaper to take the 5mg pill daily.
4. The Cialis 5mg once-a-day pill has been found to be very effective in treating symptoms due to prostate enlargement.
5. The Cialis 5mg once-a-day pill has been found to be very effective in treating Premature Ejaculation when taken with Dapoxetine (Priligy).
These medicines are not addictive like morphine or cocaine BUT they might cause a psychological dependence.
These medicines CANNOT be taken with any medicines that contain Nitrates. Nitrates are commonly found in medicines for the heart or blood pressure. Please let our doctors know of any medication you are on.
The other options for treating erectile dysfunction include:
- Vacuum Pumps
- Penile Injections
- Implanted Pumps
Conclusion and Summary
If you are suffering from ED, please seek medical help. There is no need to suffer in silence. Getting treatment not only improves your sex life, it will also improve your overall quality of life and likely improve your relationship with your partner.
There is no shame or harm in taking medicines for ED. In fact, some of these medicines like the Cialis 5mg low-dose once-a-day pill has other health benefits like on your prostate and blood vessels and not just cure your ED.
ED might also be an early warning sign of a more serious illness like Testosterone Deficiency. This is another good reason to see a doctor.
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About Dr. Tan
Dr. Tan graduated from the National University of Singapore in 2001. His residency was in the two largest public hospitals in Singapore; Tan Tock Seng Hospital and Singapore General Hospital.