Insights Into Erectile Dysfunction With Dr Ronny Tan

In a world that is increasingly open about health, erectile dysfunction (ED) remains a somewhat taboo topic. 

Despite evolving societal norms, erectile dysfunction (ED) remains a topic shrouded in silence in many Asian communities. We get insights into erectile dysfunction with Dr Ronny Tan, consultant urologist and andrologist from Advanced Urology.

Recent studies suggest a notable increase in ED cases across the region, bringing to light the need for awareness and open dialogue.

Unveiling the Numbers

According to a study across Asia, the prevalence of ED in various Asian countries is a significant problem. Philippines and Thailand have the highest prevalence rate at 65%.

In Singapore, over half of men aged between 30 to 70 are grappling with Erectile Dysfunction (ED). This prevalent issue is not just a hurdle for sexual intimacy, but it throws a spanner in the works for couples aiming to expand their family.

Medical Insights

Dr Tan stated that “ED is defined as the persistent inability to have an erection strong enough for successful penetrative intercourse. If the condition is recurring and not resolving on its own, the man should seek medical attention.”

Treatment Options

Treatment options for Erectile Dysfunction (ED) are diverse, tailored to the individual’s underlying cause, severity of the condition, and overall health. Here are several approaches

Lifestyle Modifications

• Healthy Diet: Consuming a balanced, nutritious diet helps improve overall health, including circulatory and heart health.
• Regular Exercise: Regular physical activity can enhance blood flow, reduce stress, and improve energy levels.
• Weight Management: Maintaining a healthy weight reduces the risk of conditions like diabetes and cardiovascular disease. These conditions can contribute to ED.
• Alcohol Moderation & Smoking Cessation: Both excessive alcohol and smoking can impair erectile function, so moderation or cessation is advised

Psychological Counseling

• Therapy: For individuals where the cause is psychological, therapy or counseling can help address anxiety, depression, stress, or relationship issues.
• Couples Counseling: It can help in managing relationship dynamics and improving communication.

Medication

• Phosphodiesterase Type 5 (PDE5) Inhibitors: Drugs like Sildenafil (Viagra), Tadalafil (Cialis), and Vardenafil (Levitra) enhance the effects of nitric oxide, facilitating blood flow to the penis.
• Other Medications: Healthcare professionals can administer alternatives like Alprostadil through injection or urethral suppositories when PDE5 inhibitors are not suitable.

Vacuum Erection Devices (VEDs)

• These devices create a vacuum around the penis, drawing in blood and inducing an erection. A constriction ring is then used to maintain the erection.

Penile Implants

• In cases where other treatments are ineffective, surgically implanted devices can be considered. These can be inflatable or semi-rigid rods that provide rigidity for intercourse.

Vascular Surgery

• This is reserved for men with vascular damage or blockages, particularly younger men who have sustained pelvic or perineal trauma.

Testosterone Replacement Therapy

• Testosterone replacement therapy may be an option, especially for men with low libido and fatigue.

Dr Tan added that “Oral medications have been shown to be effective and these days there are long-acting and short-acting PDE5 inhibitors which are safe for most men who have ED. These are prescription drugs which are not available over the counter, hence the need for a formal consultation by a healthcare professional. The understanding of testosterone deficiency (TD) and metabolic syndrome and the association with ED has also led to a more comprehensive treatment of ED in men who have TD. The use of LiESWT (low intensity extracorporeal shockwave treatment) has also been shown to be a viable treatment modality for ED.”

Erectile Dysfunction as a prelude

Dr Tan also cautioned that ED can be a sign of latent cardiovascular disease, undiagnosed DM or even pre-diabetes. He stated “As the calibre of the artery that supplies the penis is smaller than the arteries that supply the heart, decreased blood flow to the penis manifesting as ED can be a sign of atherosclerosis which can be a harbinger for ischaemic heart disease and stroke. 

As DM affects the nerves and the blood vessels in general, ED may be a sign of undiagnosed DM or even-diabetes.”

Conclusion

Addressing the escalating ED rates in Asia is a collective effort involving individuals, healthcare professionals, and society. We can make significant strides to tackle this silent crisis by fostering awareness, promoting healthier lifestyles, and encouraging timely medical intervention. Real data, continued research, and open dialogue are essential in charting the way forward.