Erectile Dysfunction (ED)
Erectile dysfunction or ED as it is commonly known is a very common problem.
There 2 self tests that you can do to determine if you have erectile dysfunction.
- International Index of Erectile Function (IIEF)
- The Sexual Health Inventory for Men or IIEF-5
- Erection Hardness Score
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 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.
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
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.