Erectile Dysfunction

Erectile Dysfunction (also known as ED or "male impotence") is a sexual dysfunction characterized by the inability to develop and/or maintain a penile erection.

The type of treatment will depend on how severe is the erectile dysfunction and whether there are any other medical conditions present e.g. diabetes, heart disease.


Drugs (pharmacological)


Tablets


In the GP setting, the first-line treatment is Phosphodiesterase-5 Inhibitors (PDE5Is). This medication works by increasing blood flow within the penis during sexual intercourse. They are usually taken on-demand, that is, as and when the patient wants to have sexual intercourse.

Side effects can include flushing, nasal congestion, headache, abnormal vision, backache, stomach upset, dizziness and rashes.

Penile injections


Self-administered Penile injections are available (Alprostadil). This form of treatment is started in a specialist clinic.

Side effects can include mild bleeding from the injection, prolonged erection (priapism), and rarely, development of fibrous tissue at injection site.

This treatment is also available as a urethral suppository.

Side effects can include pain, minor bleeding from the tip of penis and rarely, development of fibrous tissue inside penis.

Testosterone replacement


Low testosterone levels may contribute to erectile dysfunction. When symptoms of low testosterone are present, and confirmed by blood tests, testosterone replacement might be recommended as a first step or given in combination with other treatments.



Counselling (psychological)


Sexual Counselling & Therapy


Majority of cases of erectile dysfunction are caused by both medical and psychological factors such as anxiety, depression, sexual naiveness etc. This may be done in a GP setting. More complex issues may need counselling from a sexual therapist.



Non-surgical devices


Vacuum Erection Devices


A penis pump is a hollow tube with a hand-powered or battery-powered pump.
Side effects can be minor bruising, due to the tension ring. Ejaculation will be restricted.


Low-intensity extracorporeal shockwave therapy (Li-ESWT)


This is a new type of treatment where shockwaves, applied to the penis, trigger neovascularization with the subsequent improvement of the blood supply within the penis. It is generally safe and painless. However, it is not effective for all patients and the improvements may ware off within 1-2 years after treatment.


Surgery


Should all the above treatment options fail, penile prosthesis surgery may be considered. An erection is achieved by mechanical means.

For more details on different types of treatment you may visit the following websites:

https://www.ttsh.com.sg/urology/articles/male-wellness/
https://www.mayoclinic.org/diseases-conditions/erectile-dysfunction/diagnosis-treatment/drc-20355782


The doctors at Cross Street Medical are experienced in managing erectile dysfunction. We are located at Blk 531 Upper Cross Street #01-35
Singapore 050531. We offer pharmacological treatment, alongside counselling for ED. Please call or email us for an appointment.