Erectile Dysfunction Treatment in Singapore

Erectile dysfunction (ED) is the persistent inability to achieve or maintain an erection sufficient for sexual intercourse. It affects millions of men globally, with the prevalence rising with age. While occasional ED can occur due to stress, fatigue, or temporary factors, frequent or chronic occurrences often signal an underlying health issue. Beyond the physical effects, ED can have significant emotional and psychological impacts, affecting self-esteem, relationships, and overall quality of life. Fortunately, ED is treatable through a range of interventions, including lifestyle changes, therapy, and medical treatments.

Dr. Lie Kwok Ying

Medical Council Certified Urological Specialist

BA MBBChir (Cantab)|MRCS (Edin)|FRCS (Urol)(Glasg)|FAMS

Erectile Dysfunction Treatment in Singapore

Symptoms Causes Diagnosis Treatment Prevention FAQ

Symptoms of Erectile Dysfunction

Men experiencing erectile dysfunction may notice several distinct signs that vary in frequency and severity depending on individual circumstances and underlying causes.

Difficulty achieving erections

The inability to get an erection despite sexual stimulation and arousal. This may develop gradually or occur suddenly.
Trouble maintaining erections

Erections may be achieved initially but cannot be sustained long enough for sexual activity. The erection may weaken or disappear before completion.
Reduced sexual desire

A noticeable decrease in libido or interest in sexual activity, which may occur independently or alongside erectile difficulties.
Performance anxiety

Recurring concerns about sexual performance can arise after experiencing erectile difficulties, creating a psychological cycle that further affects erectile function.

Erectile Dysfunction Causes and Risk Factors

Erectile dysfunction stems from various physiological and psychological factors that affect blood flow, nerve function, or hormonal balance necessary for normal erectile function.

Vascular disease: Conditions such as atherosclerosis can restrict blood flow to the penis, making circulatory issues one of the most common physical causes of erectile dysfunction.
Neurological disorders: Conditions like multiple sclerosis, Parkinson’s disease, and spinal injuries can disrupt nerve signals required for erections, interfering with communication between the brain and reproductive organs.
Hormonal imbalances: Low testosterone and endocrine disorders like thyroid disease or diabetes can affect hormonal regulation and contribute to erectile difficulties.
Medications: Certain drugs, including some antidepressants, antihistamines, blood pressure medications, and treatments for prostate conditions, list erectile dysfunction as a potential side effect.
Psychological factors: Depression, anxiety, stress, and relationship problems can cause or worsen erectile dysfunction, often creating a self-reinforcing cycle of worry about sexual performance.
Lifestyle factors: Smoking, excessive alcohol consumption, substance abuse, obesity, and physical inactivity increase the risk of erectile dysfunction by affecting vascular health, hormonal balance, and overall physical condition.

Erectile Dysfunction Diagnostic Methods

Medical History Assessment

A detailed evaluation of symptoms, including their onset, progression, and impact on sexual function, is conducted by a urology specialist in Singapore. This includes a review of general health, medication use, and lifestyle factors that may contribute to erectile dysfunction. Questions about the quality and frequency of erections in various situations help differentiate potential underlying causes.
Physical Examination

A focused examination assesses the genitourinary system, cardiovascular health, and neurological function. Signs of hormonal imbalances, vascular issues, or anatomical abnormalities that may contribute to erectile difficulties are evaluated. Blood pressure measurement and assessment of secondary sexual characteristics, such as body hair distribution and testicular size, are also included.
Blood Tests

Laboratory testing measures key hormone levels, particularly testosterone, and screens for conditions like diabetes, high cholesterol, and kidney disease. These tests help identify systemic health factors that may impair vascular health or hormonal balance, both of which are crucial for erectile function. Additional blood markers may be ordered based on the suspected cause.
Specialised Diagnostic Tests

These tests help identify the cause of erectile dysfunction. A duplex ultrasound evaluates penile blood flow, while a nocturnal penile tumescence (NPT) test assesses spontaneous erections during sleep to differentiate physical and psychological factors. An intracavernosal injection test measures erectile response by injecting medication into the penis. These tests aid in determining the appropriate treatment approach.

Erectile Dysfunction Treatment Options

Management of erectile dysfunction involves various approaches tailored to underlying causes and individual patient needs. Both non-surgical and surgical treatments are available, depending on the severity and cause of the condition.

Non-Surgical Treatment

Oral Medications: Phosphodiesterase type 5 (PDE5) inhibitors, such as sildenafil, tadalafil, vardenafil, and avanafil, enhance nitric oxide effects, relaxing penile muscles and increasing blood flow. These medications typically take effect within 30–60 minutes, require sexual stimulation, and vary in effectiveness based on the underlying cause.
Vacuum Erection Devices: These mechanical pumps create a vacuum around the penis, drawing blood into the erectile tissues. A tension ring placed at the base helps maintain the erection by preventing blood outflow. This non-invasive option is effective for many men and can be combined with other treatments.
Penile Injections: Self-administered injections of vasodilating medications directly into the penis induce erections lasting 30–60 minutes by relaxing smooth muscles and increasing blood flow. Often recommended for those who do not respond to oral medications, this method allows for more spontaneous erections.
Testosterone Replacement Therapy: For men with clinically low testosterone levels, hormone therapy may help improve erectile function and sexual desire. It can be administered via injections, patches, gels, or pellets and requires regular monitoring to manage hormone levels and potential side effects.

Surgical Treatment

Penile Implants: Surgically placed devices allow men to control their erections. Inflatable implants use a fluid-filled system to create an erection, while malleable rods provide continuous firmness. This method is typically reserved for cases that do not respond to other treatments.
Vascular Surgery: In select cases where erectile dysfunction is caused by arterial blockages or venous leakage, surgical procedures can restore blood flow to the penis. This specialised approach is usually considered for younger patients with discrete vascular abnormalities, often due to trauma.

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Prevention and Management

Men can support erectile health and manage dysfunction through lifestyle modifications. Regular exercise improves circulation, while a balanced diet and weight management reduce ED risk. Limiting alcohol and avoiding tobacco helps preserve vascular function. Stress reduction techniques, such as meditation or counselling, address psychological factors. Proper management of chronic conditions like diabetes or hypertension through medication and check-ups can prevent complications. Open communication with partners fosters understanding and reduces performance anxiety.

Frequently Asked Questions

Can erectile dysfunction signal heart disease?

Yes, erectile dysfunction can be an early sign of cardiovascular disease, often appearing 3–5 years before cardiac symptoms. Both share risk factors like hypertension, high cholesterol, diabetes, and smoking. Atherosclerosis, which restricts blood flow, affects the smaller penile arteries before the larger coronary arteries, making ED an early warning sign.

Are erectile dysfunction treatments in Singapore permanent?

Most non-surgical treatments provide temporary effects. Oral medications last 4–36 hours, while vacuum devices and injections work for a single encounter. Long-term improvements depend on addressing underlying causes through lifestyle changes or disease management.

How does diabetes affect erectile function?

Diabetes increases ED risk by causing nerve damage (diabetic neuropathy), blood vessel disease, and hormonal imbalances. It accelerates atherosclerosis, restricting penile blood flow. Men with diabetes face twice the ED risk, often with earlier onset and greater severity.

Dr. Lie Kwok Ying

Senior Consultant Urologist in Singapore

BA MB BChir (Cantab)|MRCS (Edin)|MMEd (Surg)|FRCS (Glasg)(Urol)|FAMS

Dr. Lie Kwok Ying is a Senior Consultant Urologist and pioneered the use of HoLEP (Holmium Enucleation of Prostate) for benign prostatic hyperplasia (BPH) in Singapore.

He graduated from Queens’ College in Cambridge University with triple First Class Honours and subsequently qualified in 2001 with degrees in Medicine and Surgery.

Clinical Interests in Urology