It often starts as an off day – a moment brushed aside as stress, fatigue or simply bad timing. But when performance concerns in the bedroom begin to recur, they can quietly take a toll on confidence, relationships and overall well-being.
In Singapore, erectile dysfunction (ED) may be more widespread than many realise. A 2003 study in the Singapore Medical Journal found that about 51 per cent of men aged 30 and above could experience some degree of it.
A large proportion of men with erectile concerns never seek professional help, often due to embarrassment or a lack of awareness about available treatment options, notes Dr Akira Tan, an executive doctor at SL Aesthetic Clinic, which also offers men’s health services.
Dr Tan says that while male sexual dysfunction becomes more common with age, it is certainly not limited to older men. Younger men, too, can experience performance issues.
“An erection depends on healthy nerves and good blood flow,” he explains. “Nerves release nitric oxide, which helps blood flow into and stay within the penis, creating firmness. When blood flow is reduced or blood vessels are not healthy, it can affect erection quality, which is why conditions that impact the heart and blood vessels are often linked to ED.”
Lifestyle factors that can contribute to ED include smoking, sleep apnea, as well as mental health issues such as stress and depression, he says.
Performance issues may also point to underlying conditions such as diabetes, chronic kidney disease, high blood pressure and high cholesterol. ED may also be a feature of hormonal imbalances, although this is less common, adds Dr Tan.
“Seeking help early can arrest underlying medical or psychological causes. It may uncover risk factors that can be managed or changed, such as diabetes, hypertension, high cholesterol, smoking, poor sleep or side effects of medication,” he notes. “And untreated ED can fuel anxiety, relationship strain and a self-reinforcing cycle of performance anxiety.”
Oral medications are a common first-line treatment for ED, says Dr Tan.
He adds: “Medication alone has limits. It works by enhancing the pathway triggered by nitric oxide, which helps improve blood flow for an erection, but it does not correct every underlying cause.
“There may also be some side effects, such as flushing, headaches, a blocked nose, gastric discomfort, bluish tinge to vision and low blood pressure, especially when combined with blood pressure or certain chest pain medications.”
Traditional non-medication treatments include vacuum erection devices, directly administered medication or injections, counselling and surgery.
SL Aesthetic Clinic offers extracorporeal shockwave therapy (ESWT), a non-invasive, medication-free erectile dysfunction treatment that may be used on its own or alongside other treatments.
Dr Tan explains that ESWT uses low-intensity acoustic waves to gently stimulate the treatment area. This triggers biological signals that may help blood vessels function better and improve penile blood flow.
At SL Aesthetic Clinic, extracorporeal shockwave therapy is offered as a non-surgical, clinic-based option for suitable patients, following a broader men’s health assessment.
PHOTO: SL AESTHETIC CLINIC
During a typical ESWT session, patients first undergo a consultation to assess both physical and psychological factors.
“This usually involves a detailed medical and sexual history, along with a review of lifestyle factors and medications. Where appropriate, a focused examination and selected blood tests may be done to identify any underlying contributors,” he adds.
During treatment, the patient lies comfortably while a coupling gel is applied and the shockwave pulses are delivered to predefined treatment points.
This lasts about 15 to 20 minutes and no anaesthesia is required, as patients usually feel only a tapping or pulsing sensation.
Six sessions are often recommended at the start, though variations in protocols exist.
“Depending on the treatment protocol, an initial course typically involves about six to 12 sessions. As the effects may not be permanent, maintenance treatments may be recommended thereafter,” says Dr Tan, although he adds it should not be considered a permanent cure.
He adds: “While some patients experience sustained improvement, response durability varies over time.”
There is generally no significant downtime, although some may experience temporary mild discomfort or transient skin redness.
However, ESWT is not appropriate for those with active infection or open wounds at the treatment site, or known cancers in the treatment area, and may be less suitable for patients with clearly identifiable primary causes such as hormonal imbalances that require targeted medical management.
Dr Tan’s advice? “If the issue is recurring or affecting your confidence or relationships, it is worth seeking medical advice. These concerns are common, and early assessment can help address any underlying factors.
“Sexual health is an important part of overall well-being. Consultations at SL Aesthetic Clinic are handled with care, confidentiality and without judgment, with the aim of supporting you in a comfortable and respectful setting,” he adds.
For more information, visit SL Aesthetic Clinic.
