Health Information by Dr Tan And Partners (Singapore)

Dr. Tan & Partners was established in 2005 with a vision to provide quality medical services with competency and care to our community - Health Information on Men's Health, Women's Health, Public Health and Sexual Health (HIV/STD)

What is Electro Shock Wave Therapy (ESWT) for Erectile Dysfunction (ED) ?


What is Electro Shock Wave Therapy (ESWT) for Erectile Dysfunction (ED) ?


What is Erectile Dysfunction?

Erectile dysfunction (ED) is the inability to get or keep an erection firm enough to have sexual intercourse. It is also sometimes also referred to as impotence.

Occasional ED is not uncommon. Many men experience it during times of stress. However, frequent ED can be a sign of health problems that need treatment. It can also be a sign of emotional or relationship difficulties that may need to be addressed by a professional. 

How does ESWT work for ED?

One of the causes of Erectile Dysfunction is the poor flow of blood into the penis caused by unhealthy blood vessels.

By shooting multiple low-intensity shockwaves into the penis, new and healthy blood vessels develop. This is known as neo-vascularization.


Who will benefit from ESWT?

Since this treatment is specific for blood vessel problems, only people with ED due to unhealthy blood vessels will benefit. These are usually old patients (40 to 70 years old) and may have chronic diseases such as Diabetes, High Blood Pressure or High Cholesterol.


If your ED is due to other factors such as stress or side effects of medicines, then you will not benefit from this treatment.

ESWT can potentially cure patients with mild to moderate ED. For patients with severe ED, it will make them respond better to ED medicines.


What is the success rate?

Studies have shown that 76% of patients will have an improvement in their IIEF score by more than 5 points. Another study showed that 21 out of 29 patients treated had an improvement of their Erection Hardness Score from 2 to > 3.

In very severe cases of ED where the patient could not get an erection even with medicines for their ED (i.e. PDE5 inhibitors), after the ESWT treatment, 72.4% of them were able to get an erection with their medicines.

Overall, it is fair to say more than 70% of people will benefit from this treatment. Of course 70% is not a 100% and this success rate has to be balanced against the cost of the treatment.


Videos on ESWT for ED

Electro Shock Wave Therapy (ESWT) for Erectile Dysfunction (ED)


Chinese Translation:





这些治疗有许多有许多问题,包括不方便 (真空泵),太侵入(阴茎假体)或太短暂的效果(伟哥)。









一般上,我们建议 6-12 次疗程。








Sexual Transmitted Infections: The Causes Symptoms and Treatments

Sexual Transmitted Infections: The Causes Symptoms and Treatment 

STIs are caused by viruses, bacteria and other micro-organisms that you can catch if you have sex with someone who is carrying one of these infections.

Symptoms can be classified into urinary symptoms, skin symptoms and general symptoms, and it can start to appear as early as 3 days after sex or can take weeks to months. Some people get infected but never develop any symptoms.

Treatment depends on the type of STI you have. Some can be treated by antibiotics and some such as Herpes and HIV are lifelong infections that have to be managed. STIs such as HPV and Hepatitis can be prevented with vaccines.

Remember, as long as you are having sex, you can have an STI. Most STIs can lead to serious complications if left untreated.

See your doctor for regular screening tests and treatment if necessary. Talk to him about getting vaccinated against Hepatitis and HPV.

Speak to our doctors if you suspect that you have had any high risk exposure to HIV.


Be safe. Be nice.




The UN has reached its goal to treat 15 million people living with HIV.

The UN has reached its goal to treat 15 million people living with HIV.

According to an article written by BBC news, the UN has achieved its target of treating 15 million people living with HIV as of March 2015 – 9 months before the planned schedule end. This landmark target has been reached thanks to global efforts to get anti-retroviral drugs to those who need it most including those living in the poorest parts of sub-Saharan Africa.

The UN first started their plan in 2000, where fewer than 700,000 people living with HIV were receiving adequate treatment.

A recently release UN Aids report states that the global response to HIV as prevented.

30 million new HIV infections and just short of 8 million AIDS related deaths since the year 2000. Over the last fourteen and a half years the number of new HIV infections has fallen from 2.6 million per year to 1.8 million. AIDS related deaths have dropped from 1.6 million per year to 1.2 million. UN Aids still feels that this is too high but it is a substantial step to reduce the impact of HIV and AIDS.

Part of this improvement has been due to greater money investment which sat at US$4.8 billion in 2000 and has now increased to US$20 billion as of 2014.

UN Aids is optimistic that continued effort may be able to end the AIDS epidemic by 2030 but the next 5 years will be vitally important.


f:id:drtanandpartners:20150721163138j:plainVineeth, 7 months old male kid, reported HIV-positive lying at an orphanage in Madras, India, Tuesday 29th November, 2005. Vineeth abandoned by his parent at Guild of Service and transfered to Community Health Education Society (CHES), an orphanage for HIV/AIDS infected, affected and Vulnerable Children, funded by Family Health International, Washington D.C. More than 40 million people worldwide are living with HIV/AIDS, according to latest figures from UNAIDS. World Aids Day will be observed on Dec. 1. (AP photo/ M.Lakshman)

Area for improvement

Despite all the good news there have been certain areas that lag behind. One such area is the awareness of HIV as people who do not know they are infected are not going to seek treatment.

Treatment for children has also faltered but is showing signs of improvement. Children receiving antiretroviral treatment increased from 14% in 2010 to 32% in 2014.

Those most in need

Sub-Saharan Africa has suffered the most with regards to HIV and AIDS accounting for 66% of all new worldwide HIV infections in 2014. When last checked 25.8 million people in this area were confirmed as living with HIV – that is almost five times the total population of Singapore! Also something to bear in mind is that the worldwide number of people living with HIV is estimated at 36.9 million so we can see that Sub-Saharan Africa makes up a staggering 70% of worldwide infections.

Onwards march

So the UN Aids report is strikingly positive showing that globally we are making huge strides to reducing the burden of HIV and AIDS but as with any battle we must not be complacent.

Should you have any concerns on HIV or AIDS you can always speak to one of our doctors at any of our clinics here.

"The world has delivered on halting and reversing the Aids epidemic” - Ban Ki-moon, Secretary General of the United Nations




Is it really possible to get infected with HIV by your Dentist?



Yesterday (July 2015), breaking news in Sydney reported that “up to 12,000 people” were asked to got for HIV and Hepatitis testing after it was revealed that the dental practices they received treatment at were under investigation for “poor hygiene practices.”

Apparently, the dentists were using “poor cleaning and sterilisation techniques.” Of course, one of the dentists claimed that the complaint was made by a patient whom he had an argument with and wanted to put him out of business.

So as usual, all of us wait with bated breath as the patients are tested and meanwhile, postpone our dental appointments.

This is sounding all too familiar. The Internet is awash with news on HIV infection scares from dentists. Here are just 2 examples:

- In 2013, a Scottish dentist was found to be HIV +ve and 3000 of his patients were asked to undergo HIV testing.

- In 2014, a lady named Amy Duffield mysteriously died from a viral heart infection after a visit to her dentist Dr. D’Mello. It was later found that her dentist had “poor hygiene practices.” This is actually putting it mildly. What he did was he did not change gloves between patients, used the same equipment and gloves for 32 years and stored his dental equipment in the toilet! More than 20,000 of his patients were asked to come back for HIV and hepatitis testing.

In spite of so many scary stories, one common thread runs through all of them. Although thousands upon thousands of patients had to undergo a very heart pounding and anxiety causing HIV test, the fact was NONE of them were found to be HIV +ve.

So is it really possible to get infected with HIV from your dentist?

So far, there have been 2 “proven” cases of HIV infection from dental treatments. I have the word “proven” in quotation marks because although these cases are rather convincing, there are many sceptics who still believe these patients did NOT get infected with HIV from their dentists and that investigations by the US CDC were flawed. Let’s put that aside for now and look a little more closely at the cases.

The case of the Florida Dentist

This is by far the most famous case of HIV infection from a dentist. In 1990, the US CDC published a case report on a lady named Kimberly Bergalis. She was diagnosed with HIV but denied doing anything that would put her at risk of HIV. She never had any tattoos, blood transfusion, intra-venous drug use or even acupuncture. She had 2 boyfriends and both of them tested negative for HIV.

It was later found that she had 2 teeth pulled out 2 years before she was diagnosed with AIDS and that the dentists who pulled her teeth out was himself diagnosed with AIDS 3 months before that! This now infamous dentist was called Dr. David Acer. Genetic testing on Kimberly’s and Dr. Acer’s HIV strains were not a perfect match but according to the CDC “were closer than what has been observed for pair-wise comparisons of sequences taken from the other North American isolates studied.” In other words, close enough to prove that Dr. Acer was the one who infected Kimberly.

What was more chilling was that after a huge investigation, 5 more patients of Dr. Acer were found to be infected with HIV!

Read the CDC reports here:

The case of the Tulsa Dentist

In 2013, a patient was found to be infected with Hepatitis C after visiting his dentist Dr. Scott Harrington. This prompted the state health department to raid his office. And lo and behold, they found what can only be described as nightmarish conditions. Dr. Harrington was found to be using old and rusty instruments and had the habit of pouring bleach on his patients’ wounds until “they turn white”!

More than 7,000 of his ex-patients were tested and 3 were found to have HIV, 4 had Hepatitis B and 70 had Hepatitis C!

When they finally found him, he was hiding out at his second home in Arizona.

My own experience

In my career, I have seen 2 cases of possible HIV infection from dentist visits.

One was a young lady from Malaysia. She tested positive for HIV during a routine annual medical checkup to renew her work permit. Just like Kimberly Bergalis who was infected by the Florida Dentist, she too denied any activities that could put her at risk of HIV. She never had any blood transfusions, never did drugs, never had any tattoos and in fact, she never even had sex before! Prior to her HIV diagnosis, she visited 2 dentists. One was in Singapore and one was in Malaysia. The dentist in Singapore was investigated by the Ministry of Health and was found to be clear of HIV and had good infection control practices.

Another case was that of a young man also from Malaysia. Just like the young lady, he denied any risky behaviour that would expose him to HIV. And just like the young lady, he visited a dentist prior to being diagnosed.

These 2 cases were never properly investigated by the authorities so were never proven.

Find out more:


Is your Estrogen too low?


Estrogen and its links with testosterone.

Estrogen is a hormone within the body, more commonly associated with women. However it is true that men also produce a degree of estrogen; the reverse applies to women as they also produce a degree of testosterone.

Testosterone and estrogen are structurally very similar but their difference in action is vastly different. Testosterone performs 'masculine' tasks within the body, such as improving muscle mass and bone density as well as having a significant effect on male libido. There is also some belief that testosterone can help combat heart and vascular disease as well.

Estrogen is converted from testosterone by an enzyme called aromatase. This enzyme can be found in many tissues of the body including the liver, muscles, and fat. The last point is the concern in modern society as worldwide population in devloped (and some developing) countries show increasing trends of obesity. Other factors affecting the activity of aromatsde include age, insulin and alcohol – all of which increase activity.

If estrogen levels become too high in men then chronic health problems may follow.

Symptoms/Issues of high estrogen.

  1. Gynecomastia/breast growth – Male breast growth is known as gynecomastia and can occur when estrogen levels are too high. But this may sound strange as many believe that men don't have breasts. However, all men have a small amount of breast tissue which enlarges in the presence of estrogen. Statistics in the UK show that appoximately 1% of newly diagnosed breast cancer cases will involve men.
  2. Low sex drive/libido – high estrogen may lead to lower sex drive as well as erectile dysfunction.
  3. Sub/infertility – Estrogen is known to lower sperm mobility. If sperm have abnormally low mobility it will be more challenging to achieve fertilisation as the sperm may not meet the egg at the right time or place to allow for fertilisation and implantation.
  4. Stroke risk and heart attack – Estrogen also increases the clotting chance of blood. This means that high estrogen increases the risk of blood clots blocking important vessels within the body.
  5. Weight gain – this is a bit of a vicious cycle as increased weight leads to higher estrogen which in turn leads to more weight gain. This can be a tough cycle to break.
  6. Prostate cancer – some studies show that there may be a link between higher estrogen and prostate cancer.

Methods to reduce estrogen.

  1. Weight loss – by losing body fat estrogen levels can be lowered which in turn will also allow for further weight loss – a positive cycle.
  2. Reduce alcohol – Alcohol has been shown to increase the amount of estrogen in the body so cutting down can reduce estrogen levels.
  3. Avoid foods high in estrogen; the list can be fairly extensive but listed below are some common ones.
  • Flax seeds.
  • Soy products.
  • Legumes (like chick peas), 
  • sunflower seeds, 
  • sesame seeds.

Certain animal products such as dairy food (cheese and milk) or other foods that have been injected with hormones to aid growth and production.

  • Foods that inhibit estrogen/aromatase or increase testosterone:
  • Certain fruits such as grapes, pears and pineapples.
  • Vegetables such as broccoli, cauliflower, cabbage, and celery.
  • Certain raw nuts like cashews and almonds.
  • Red wine – although moderation is required.
  • Olive oil
  • White button mushrooms.
  • Oysters
  • Parsley.

Aromatase inhibitors.

These drugs inhibit the action of the enzyme aromatse and help reduce the level of estrogen within the body. Two classes exist; steroidal and non-steroidal.

Steroidal aromatase inhibitors such as formestane and exemestane help to inhibit aromatase by mimicking androstenedione (which is a precursor to testosterone and subsequently estrogen). Since the medication is not converted to estrogen it helps reduce overall estrogen levels by saturating the activity of the aromatase enzyme. The second class (non-steroidal_ includes drugs such as anastrozole and letrozole. This class actively inhibit the aromatase enzyme by binding directly to it and hindering its action.

Anastrozole and lestrozole are the latest 3rd generation aromatse inhibitors which are believed to produce close to 100% inhibition of aromatase.




DASH Diet! DASH Diet! The #1 diet for Women!


Dieting is a dreadful word.

It starts with bright eyed optimism on New Year's Day, and typically dissolves in tears, and an additional 3 pounds by June.

And it seems that everyone is on a diet these days - diets for weight loss, for better skin, for gluten intolerance, for detoxification... The list is endless, and to the average person out there, the choices are positively mind boggling.

To help you break this information down, we're going to share one of our favourite diets to promote weight loss, wellness and all-round healthy living.

Ever heard of the DASH Diet? If you haven't, it's about time!

This snazzy-sounding diet is an all-star, coming out tops as 'Best Overall Diet' in the 2015 U.S. News and World Report "Best Diet Rankings".

The annual list, curated by an expert panel of 32 reviewers from the fields of nutrition, dietics, diabetes care and heart health, is selected based on factors including nutritional completeness, diabetic and heart health compatibility, effectiveness of weight loss, and sustainability.

The DASH diet didn't just top the list this year, it's been in top spot for its FIFTH year running!

As further testament to its health promoting capability, the DASH diet is endorsed by the American Heart Association, the National Heart, Lung and Blood Institute, and the Mayo Clinic.

What is the DASH diet exactly?

Originally formulated for patients with high blood pressure, this diet has evolved into a one stop solution for those not only looking to lose weight, but combat high cholesterol and diabetes as well. The additional health benefits of this diet are endless, with research showing that it reduces the rate of strokes, heart failure, heart disease, kidney disease and even some forms of cancer!

The principles of the DASH diet are simple - it's the anti diet, really. No complicated recipes with obscure ingredients, no unreasonable food group elimination, no tedious calorie counting.

Instead, the DASH diet advocates the use of simple meal plans, with an emphasis on fruits, vegetables, whole grains, lean meats and fish, and heart healthy fats. Each meal plan contains optimal servings of all food groups, effortlessly fulfilling the daily requirements for nutrients like potassium, calcium, protein and fibre, thus helping to achieve healthy and fully balanced nutrition.

So how does one use the DASH diet?

It's simple!

First, you start by calculating your daily calorie requirement.

A person's daily calorie needs are calculated by factoring in age, height, activity level, and current weight.

On average, a sedentary 50kg woman requires approximately 1500 calories a day, but if you're an active person, your calorie allowance could actually be nearer to 1800 a day.

Try it out - calculate your daily calorie needs here

In order to achieve weight loss, your body needs to be in negative energy balance.

So once you have your estimated daily calorie requirement, simply refer to the pre-set DASH meal plans, and pick the one that's less than, but closest to your calculated daily needs.

The DASH meal plan is simple and intuitive. Each meal plan displays the total calories, divided up into daily servings of several food groups. For example, if you're on a 1200 calorie diet plan, you are allowed 4-5 servings of grains, 3-4 servings of vegetables and 3 servings of meat.

The plan also provides examples of a normal serving size, for you to better estimate the amount you're allowed to eat per serving.
Click here for more details on the meal plan, and examples of serving sizes on the DASH diet.

This diet is great for all of us busy women!

It allows for plenty of flexibility - simply spread out your food group allowance across the day, mixing and matching the food groups within each meal.

Some tips to make the best of the plan?

1. Mix things up

Include lean protein and vegetables in most meals - vegetables increase volume without piling on added calories, and protein increases satiety.

Together, they keep you fuller for longer, helping you to avoid reaching for the cookie jar or that bag of chips at tea time.

2. Get active

Add some physical activity in your new routine.

Start with a short walk around the block, and slowly work your way up to 30 minutes of moderate activity a day. Exercise burns calories, contributing to your daily negative calorie balance. But it also promotes lean muscle mass growth, which helps to raise your basal metabolic rate - these are the calories that your body burns even when you're at rest.

The higher your lean muscle mass, the more calories you burn, even when you're asleep, or vegging in front of the telly.

3. Limit the salt

Too much salt is bad for the body, and your waistline!

Excess salt prompts your body to retain water, leading to bloating and puffiness, and increased weight. It also raises your blood pressure, which in the long run can lead to strokes and heart disease.

Opt for low sodium options wherever possible, and for fuller flavour, swap out the salt for herbs and spices in your food prep.

So that's the DASH diet in a nutshell!

It's easy and fuss free - give it a go! It will not only whittle your waist down, it'll make your body healthier and happier too!

Author Bio: Dr Rachel Ng is extremely passionate about promoting women's health and wellness in Singapore. As a female herself, she fully understands the concerns and needs of women as patients, and works actively towards optimising their general health. Stay tuned for more of her articles on women's wellness, and in her ongoing Heart Health Series!



MOH guidelines on Haze


Haze – new general advisory guidelines

The haze is an ongoing issue here in Singapore and authorities believe it may get worse this year due to the increasingly dry season. As such, MOH have release some guidelines to help doctors as well as the general public to minimise any negative effects.

Haze effects will be dependant on a variety of issues; health status, PSI, duration and intensity of outdoor activity among other. Those who feel unwell, are elderly or very young, or have other chronic health problems should seek medical attention.

How will the haze affect me?

Haze can be harmful to the heart and lungs, particularly those with pre-existing heart or lung problems (e.g asthma, COPD, heart failure). However, symptoms may not be immediate and there may be a period of 1-3 days before symptoms appear.

With healthy individuals, haze exposure over a few days may lead to irritation of the nose, mouth and throat but these usually subside once exposure to the haze is minimised. Individuals with pre-existing health problems should seek medical attention should they notice worsening of their symptoms.

Thankfully we do not experience the long term effects of the haze here in Singapore.

What does MOH recommend?

MOH firstly recommends that the general public stick to the boxed guidelines seen above. In most cases of haze here there should not be an issue of continuing outdoor activity but PSI numbers will change on a daily basis and public service announcements will be made if the haze reaches an unhealthy level.

Staying well hydrated is also important as this helps reduce symptoms such as dry cough and itchy throat.

Those with chronic conditions are advised to keep their medications available so that they can be taken if needed. For example those with asthma are encouraged to have their inhalers on their person in case they need to use it.

Every individual will experience the haze differently but the key is to limit exposure to the haze should you be experiencing any symptoms or discomfort. Those with chronic conditions should lower their threshold for symptoms before seeking reprieve from the haze.

Should I be wearing a mask?

For short exposure such as short commutes to school or work then an N95 mask is not necessary. N95 masks are also not needed when indoors.

A healthy person who may have to spend several hours outside when the PSI is in the hazardous range (>300PSI) may benefit from an N95 mask as this will reduce the exposure to haze.

The best way for vulnerable people, which includes pregnant ladies, to protect themselves is to minmise outdoor activity when the air quality is unhealthy (>200 PSI). If they do need to be outdoors then an N95 mask is recommended. Those who have lung or breathing problems prior to using an N95 mask should seek medical attention first.

What is PM2.5 and will the N95 mask protect me?

PM2.5 stands for particle matter smaller than 2.5 micrometres. These particles are important because there has been reported increased risk of symptoms and long term complications like heart and lung problems. With current measuring methods the Singapore 24 hour PSI takes the PM2.5 into account so this does not need to be stated separately.

First note of mention is that the N95 mask will only work if the seal around the nose and mouth is secure. If there are any gaps then much bigger particles will still be able to bypass the mask rendering it less useful. However, if a good seal is formed and all the air is moving through the filter correctly then then mask is 95% efficient. The mask can even filter out particles as small as 0.1 to 0.3 micrometres in size.

What effects may I experience if I wear the N95 mask?

The nature of air filtration means that effort of breathing will be much greater. This is why those with pre-existing breathing problems should seek medical advice before using the mask. Even if you are generally healthy you may experience discomfort in breathing, tiredness, and headache after prolonged use.

If you are beginning to feel uncomfortable with the mask you should take a break by removing the mask when you are in an environment that is safe to do so.

So where can I get a mask?

Most major pharmacies and supermarkets will stock the N95 mask. Do not worry about stock shortage because MOH holds a large stockpile that is distributed to pharmacies in times of greatest need.

Are all masks the same?

There are many other masks similar to N95 which are also useful at reducing exposure to haze and if you are unsure then please ask your local healthcare professional. Please bear in mind that the regular surgical masks, which are becoming increasingly popular are not suitable for haze as the filter size is too large and they do not form a seal around the nose and mouth. 

So I have got an N95 mask. How do I check it is fitted properly?

Correct fitting will be different for every user. The size needs to be suitable and the nose and mouth need to be covered without any air leak. The Health Promotion Board (HPB) has a step-by-step guide on how to ensure good fitting:

Can I reuse the mask?

Yes the mask is reusable. However, it should be changed once a good seal can no longer be formed or it has been visibly soiled. Please remember not to share your N95 mask – everyone should have their own mask.

For more information on haze please visit any of these sites:




Are pesticides killing your sperm?

It is an established fact that men who are exposed to pesticides in their work or in the environment they live in have a higher risk of sub-fertility. But what about the pesticides found on the fruits we eat?

A recent study on 155 men detailed exactly how much and what kind of fruits and vegetables they ate. This data was then compared to the US Department of Agriculture's data on how much pesticide residue is found on particular produce. For example  peppers, spinach, strawberries, apples, and pears tend to have high levels of pesticide residue, whereas peas, beans, grapefruit, and onions have low-to-moderate levels.


It was found that the men who ate at least 1.5 servings of high-pesticide produce per day had about half as many sperm in their semen, and two-thirds as many normal-appearing sperm, as men who ate less than half a serving of high-pesticide produce per day.


Although this does not necessarily mean these men are less fertile, it would be logical to assume there is some impact on their fertility.


Also logically, this should not be surprising as pesticides are designed to harm pests reproduction so it should have sort of impact or effect on human reproduction also.


This study did not specify or differentiate which kinds of pesticides are worse.


So if you are struggling with fertility, one thing you may want to do is to switch to organic fruits and vegetables. Or at least choose fruits and vegetables that are known to have less pesticide residue.




Causes and treatments Erectile Dysfunction (Impotency)


Hey guys, if you're not lasting as long as you would like in bed, it could be only be due to 2 reasons:

1. You cannot get hard. Or you can get hard but it gets soft very quickly. Maybe even before you can penetrate your partner. Or you can get hard but its not as hard as you would like it to be. This is called Erectile Dysfunction.

2. You have absolutely no problems getting hard but you ejaculate much sooner than you would like to. This is called Premature Ejaculation.

Of course, these 2 issues are not mutually exclusive. You could be suffering from both at the same time. Also, one problem can lead to the other.

It is not surprising that this can lead to a lot of distress not only for you but also for your partner.

In this article, we are going to talk about certain things you can do to help with Erectile Dysfunction. We will discuss Premature Ejaculation in a separate article.

Do you have Erectile Dysfunction?

Well, this really should be rather obvious. If you cannot get hard enough to enjoy sex then you have Erectile Dysfunction. There are 2 questionnaires that attempt to semi-quantify the severity of the problem. These are the International Index of Erectile Function (IIEF) and the Erection Hardness Score. They are both rather self explanatory. Basically the lower the score you have, the bigger a problem you have.

Impotence or Erectile Dysfunction: Causes and ...

What are the possible causes?

Not being able to get an erection can just be due to stress or can be due to more serious problems. Some of the possible common causes are listed here.

1. Stress and Anxiety

I have seen many fit young men with absolutely no problems at all until their wives start stressing them about getting a baby. Then out of the blue, they cannot get an erection. Although they do not conciously feel stressed or anxious, subconciously this could be affecting their erections.

Of course Erectile Dysfunction can also be related to more serious Psychological Illness like Depression or Post-Traumatic Stress Disorder (PTSD).

2. Unhealthy Blood Vessels

Having unhealthy blood vessels can impede blood flowing into the penis. It can also lead to blood leaking out of the penis. Both of which can lead to ED. Unhealthy blood vessels can be related to Chronic Diseases like Diabetes and High Blood Pressure.

3. 'T' Deficiency

As men age, the main male hormone known as 'T' will drop. Sometimes, it drops to such a low level as to start causing problems. Being overweight and having chronic diseases like Diabetes can cause the 'T' to drop faster and further. Having a low 'T' can lead to many issues including ED.

4. Trauma or Injury

Surgery to the Prostate can injure nerves in the pelvic region leading to problems with erection. Surgery to the brain or spinal cord can also injure nerves leading to the penis.

Of course any trauma or injury to the pelvic / genital region can lead to ED issues. Even an activity as benign as cycling can injure the prostate and pelvic nerves. Some bicycle seats these days are specially designed to minimze this problem.

5. Chronic Diseases

Erectile Dysfunction could be the first sign that you have a more serious problem. Medical illnesses that are commonly associated with problems with erection are Diabetes, High Blood Pressure, High Cholesterol and Thyroid problems. So when you see a doctor for ED, he/she will usually screen you for all sorts of general heatlh issues.

6. Prostate Enlargement / Benign Prostatic Hyperplasia (BPH)

All men, as we age, our prostate gets bigger. This can lead to urinary problems like poor flow, leaking, dribbling, getting up lots of times at night to urinate etc

BPH also causes problems with erection.

7. Smoking

Smoking causes blood vessels to close up. This reduces the blood flow into the penis and can lead to erectile problems.

8. Medicines

Many types of medicine can cause Erectile Dysfunction. Common ones are:

- Medicines for High Blood Pressure

- Medicines for Gastritis and Stomach Ulcers

- Medicines for High Cholesterol

- Medicines for Male Pattern Hair Loss

- Medicines for Depression

A simple home test you can do is the so-called "Nocturnal Penile Tumescence Test".

Basically you want to know if you are getting erections while you are in REM sleep. If you can, this means your ED is more likely psychological then organic. What you do is buy a string of stamps and stick them around your penis before you go to sleep. The stamps should have perforated links. If you find the string of stamps broken apart in the morning, you probably had some erections during your sleep. Of course the other easy thing to do is to ask your partner sleeping with you if you get erections in the middle of the night.


Deciding on which treatment you need depends on what the underlying problem is.

1. Medicines

There are now many medicines available for the treatment of ED.

Collectively they are known as PDE5 inhibitors. They work by increasing a chemical called Nitric Oxide in the blood vessels of the penis. This causes the blood vessels to dilate and brings more blood into the penis leading to a stronger erection.

2. 'T' Replacement

If your 'T' is low (this is determined with a blood test), you might benefit from 'T' Replacement Treatment. This can be done with injections, gels or pills.

3. Change of Medicines

If you are on medicines that can cause ED, you can consider alternatives that will not cause ED. Of course this should not compromise the treatment of your other medivcal problem for which you were taking the medicine in the first place.

4. Electro-Shock Wave Treatment (ESWT)

Recently, there has been a lot of research into using ESWT in the treatment of ED. This treatment involves sending shockwaves into the base and shaft of the penis. This stimulates the penis to make new and healthy blood vessels thereby curing the ED.

5. Vacuum Devices

Vacuum devices work by mechanically drawing blood into the penis. The blood is then kept in the penis with a constricting device at the base, usually a rubber band.

6. Surgical Implants

Surgical implants have come a long way. One of the newest techniques involves placing silastic plastic tubes within the shaft of the penis. The reservoir is placed near the bladder and the pump is placed in the scrotum. Pressing the pump in the scrotum will create an erection.

You are welcome to visit Our Doctors at Our Clinics anytime during our opening hours.

We have 4 locations conveniently located at Robertson Walk, Bencoolen Street, Novena and Scotts (Pacific Plaza).


Robertson Walk            6238 7810

Bencoolen Street          6884 4119

Novena                           63972095

Scotts                              66942348 (Opening April 2015)

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We are now Open on Weekends.

You can also visit our free STD, HIV and Sexual Health Forum.

Read our earlier blog entry on Erectile Dysfunction.

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