Erectile Dysfunction (ED)

What is Erectile Dysfunction?

Erectile dysfunction (ED), commonly known as impotence in Singapore, is a medical condition that can affect men of all ages. It is the inability to attain or maintain an erection that is hard enough for sexual intercourse or satisfactory sexual performance. While occasional difficulty with attaining or maintaining an erection is not uncommon and may not be a cause for concern, erectile dysfunction is diagnosed when the problem becomes chronic and interferes with a man’s ability to have a satisfying sexual relationship.

Erectile Dysfunction
Erectile dysfunction occurs when a man cannot obtain or sustain an erection for sexual intercourse.

What are the common causes of Erectile Dysfunction in Singapore?

An erection occurs when blood flows to the penis and fills the sponge-like tissues inside it. If this does not happen, erectile dysfunction occurs. Erectile dysfunction is usually caused by a combination of factors that ultimately result in reduced blood flow to the penis, thus making it unable to attain or maintain an erection. 

  • Vascular issues: reduced blood flow to the penis, often due to conditions like atherosclerosis (hardening of the arteries) or high blood pressure.
  • Neurological issues: nerve damage or disorders can affect the nerves that control erections.
  • Hormonal imbalances: low testosterone levels, a hormone essential for sexual function, can also lead to erectile dysfunction. 
  • Anatomical issues: structural problems in the penis or the surrounding tissues may also be one of the causes of erectile dysfunction. 
  • Medications: some medications, especially those that affect blood pressure or the cardiovascular system, can contribute to erectile dysfunction.
  • Chronic diseases: certain medical conditions like diabetes, multiple sclerosis, and Parkinson’s disease can increase the risk of erectile dysfunction.
  • Smoking: as with the rest of the body, smoking negatively impacts the penis, resulting in erectile dysfunction.
  • Alcohol and substance abuse: excessive alcohol consumption and drug use may also interfere with an individual’s sexual function. 
  • Obesity: being overweight or obese is associated with an increased risk of erectile dysfunction.
  • Lack of exercise: a sedentary lifestyle may also contribute to erectile dysfunction.
  • Performance anxiety: worrying excessively about sexual performance may also cause erectile dysfunction.
Testosterone levels
Testosterone production reduces as men age, which may contribute to erectile dysfunction.

What are the symptoms of Erectile Dysfunction?

While the primary symptom of erectile dysfunction (ED) is the consistent inability to have an erection, the symptoms may vary from one individual to another. Typical signs and symptoms of erectile dysfunction include: 

  • Difficulty getting an erection: men with erectile dysfunction may find it challenging to get an erection, even after being sexually aroused.
  • Difficulty maintaining an erection: some individuals can achieve an erection but have trouble keeping it firm enough to perform sex. 
  • Reduced libido: decreased libido or sexual desire may also be one of the signs of erectile dysfunction. 
  • Erections that do not last long enough: even if an erection is achieved, it may not last long enough for satisfactory intercourse.
  • Softer erections: in some cases, erections may be less rigid than usual.
  • Delayed or inconsistent erections: erections may take longer or may be inconsistent. 

If you are experiencing any of the symptoms stated above, make an appointment with Aare Urocare today for an accurate diagnosis and effective treatment.

Flaccid vs. erect penis
Erectile dysfunction occurs when an erection does not happen, even when sexually aroused.

Who is at risk of experiencing Erectile Dysfunction in Singapore?

Erectile dysfunction can affect many individuals; however, certain conditions and factors can increase the risk of experiencing erectile dysfunction. 

    • Age: erectile dysfunction can affect men of all age groups, but it is more common in older individuals. This is because ageing can lead to changes in blood flow, hormones, and overall health that can contribute to the condition.
    • Medical conditions: some medical conditions, such as diabetes and neurological disorders, can increase the likelihood of experiencing erectile dysfunction, as these conditions can sometimes disrupt the processes involved in erection. 
    • Lifestyle choices: poor lifestyle choices, especially excessive alcohol consumption and smoking, may also contribute to an increased risk of erectile dysfunction. 
  • Medication: some medications, including those prescribed for high blood pressure, depression, anxiety, and specific prostate conditions, may increase the likelihood of erectile dysfunction as a possible side effect.
  • Psychological factors: stress, anxiety, depression, and relationship problems can all contribute to erectile dysfunction or exacerbate existing issues.
  • Injury or surgery: trauma to the pelvic area or surgery in the pelvic region can sometimes damage nerves or blood vessels involved in erections, resulting in an increased risk of erectile dysfunction.

How is Erectile Dysfunction diagnosed?

Erectile dysfunction is diagnosed through medical history assessment, physical examination, and sometimes specialised tests. 


  • Medical history assessment: a urologist will conduct a detailed assessment of your medical history; this includes questions about your sexual history, when your symptoms started, how often you have experienced erection issues, and if there are specific triggers or patterns. There will also be questions about your overall health, medications, and lifestyle, including smoking, alcohol consumption, and physical activity patterns. 
  • Physical examination: a physical exam may be performed to identify any physical causes of erectile dysfunction. This may include examining the genitals and checking for signs of specific health issues, such as obesity, high blood pressure, or abnormal penile curvature (Peyronie’s disease).
  • Blood tests: may be conducted to check for underlying medical conditions that can contribute to erectile dysfunction (ED), such as diabetes, high cholesterol, hormonal imbalances (including testosterone levels), and other systemic issues.
  • Psychological assessment: a psychological assessment or questionnaire may be administered to evaluate the role of stress, anxiety, depression, or relationship issues in the development of erectile dysfunction.
  • Specialised tests: based on the medical history and physical examination results, specialised tests may be necessary. These tests include:
    • Nocturnal penile tumescence (NPT) test: also known as the erection self-test, it measures erections that occur during sleep. It can help determine whether erectile dysfunction (ED) is primarily due to physical or psychological factors. However, its use is quite rare and mostly restricted to hard-to-diagnose cases. 
    • Penile Doppler ultrasound: an imaging test that uses ultrasound technology to assess blood flow to the penis, which helps identify any vascular issues that may contribute to erectile dysfunction.
    • Injection test: medication is injected directly into the penis to induce an erection. This can help determine if the blood flow to the penis is adequate.
    • Cavernosography: in rare cases, a drug is injected into the penis to simulate an erection. The method helps diagnose problems with blood flow to and from the penis and identify blockages or structural issues. This invasive method is only used when other methods have proven ineffective. 

The specific diagnostic approach will vary depending on your assessment and unique circumstances. 

What are the treatment options for Erectile Dysfunction in Singapore?

Treatment options for erectile dysfunction (ED) can vary depending on the underlying cause, the severity of the condition, and individual preferences. Here are some common treatment options for erectile dysfunction: 

  • Oral medications: phosphodiesterase type 5 (PDE5) inhibitors are commonly prescribed. They work by enhancing the effects of nitric oxide, improving blood flow to the penis.
  • Testosterone replacement therapy: for men with low testosterone levels, testosterone therapy may be recommended.
  • Alprostadil: this medication can be injected directly into the base or side of the penis or as a suppository into the urethra to promote blood flow.
  • Vacuum erection devices (VEDs): VEDs are non-invasive devices that use a vacuum to draw blood into the penis, which creates an erection. A constriction ring is then placed at the base of the penis to maintain the erection.
  • Penile implants: surgical implants, such as inflatable or semi-rigid rods, can be inserted into the penis to provide an artificial erection when desired. This option is typically considered when other treatments have failed or are unsuitable.
  • Lifestyle changes: weight management, a balanced diet, quitting unhealthy habits, such as smoking and excessive alcohol consumption, and limiting illicit drug use can collectively improve blood flow, enhance vascular function, and reduce the risk of erectile dysfunction (ED).


Individuals experiencing erectile dysfunction (ED) should consult a urologist for a personalised and comprehensive treatment plan that can cater to their specific concerns. 

Schedule an appointment with Aare Urocare, where we cater to our patients’ needs with accurate diagnosis and personalised treatment.

Frequently asked questions

Yes, erectile dysfunction (ED) is often treatable. Many men find relief with appropriate treatments, and success rates vary depending on the chosen approach and individual factors.

Excessive worry and anxiety about erectile function can contribute to performance-related stress, sometimes exacerbating the condition.

Yes, it is highly recommended to have open communication with your partner about your condition, as doing so can help reduce anxiety, improve emotional support, and enhance the overall experience of seeking treatment together.

Lifestyle changes like a healthy diet, exercise, and stress reduction can help with mild erectile dysfunction, but severe or persistent cases may require medications like PDE5 inhibitors.

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Dr. Fiona Wu 2

Dr Fiona Wu
Consultant Urologist

MBBS (S'pore), MRCS (Edin), MMED (Surg),
MMED (Clinical Investigation),
FRCS (Urol) (RCPSG), FAMS (Urology)

Dr Fiona Wu is an experienced Consultant Urologist and is the Medical Director of Aare Urocare.

Prior to her private practice, she spent 15 years in public service. She was a Consultant in the Department of Urology at National University Hospital (NUH), Alexandra Hospital and Ng Teng Fong General Hospital.

She believes in treating urinary incontinence in a holistic way using minimally invasive methods – this ranges from laser treatment, neurotoxin injections, electromagnetic nerve stimulation to minimally invasive surgeries, etc. She worked closely with the gynaecology and colorectal departments to treat complex pelvic floor conditions and continues to do so in her own practice.

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