The Basics Of Male Pattern Baldness: Symptoms, Causes and Prevention

Is your head feeling a little empty, literally? Whether you’ve just noticed your hair thinning, or you’ve been desperately attempting to salvage and cover up your bald spots for years, hair loss can be bothersome at best, and embarrassing at worst. 

What Male Pattern Baldness Looks Like

Male pattern baldness, also known as androgenetic alopecia, is the most common form of hair loss in men. Hair loss occurs over a period of time. 

  • It usually starts with thinning of the hair on your scalp.
  • It then evolves into a bald spot on the crown of your head and a receding hairline that resembles an “M” shape. 
  • If left untreated, it may eventually progress into partial or complete baldness.

Norwood Scale

The severity of male pattern baldness is often assessed using the Norwood Scale as shown below. 

Image credit: Medical News Today

How Much is Too Much Hair Loss?

If you’ve noticed some strands of hair lying around your floor or clogging up your bathroom drain, don’t panic or jump to conclusions immediately! It’s completely normal for you to shed some hair every day. In fact, a normal person may shed 50 to 100 strands of hair per day, and this number varies from person to person. However, if you are losing more than 100 strands of hair per day or 700 strands per week, you may want to get it checked out. 

You’re Not Alone in the Crowd

Male pattern baldness is a common phenomenon among men. In fact, a study in Singapore found that more than half of Singaporean men between 17 and 86 years of age suffer from male pattern baldness. Moreover, hair loss becomes more common with age, and about 69% of men experience some form of male pattern baldness by the time they hit their 36th birthday. 

Causes of Male Pattern Baldness

“Am I too stressed lately? Is my junk diet at blame? Or maybe I’m not eating enough nutrients?” Are these thoughts constantly running through your head as you try to pinpoint the cause of your hair loss? Well, you may be surprised to hear that the main culprit that’s stealing your hair aren’t any of those. Instead, let’s point your fingers in the right direction – unfavourable genetics and imbalanced hormones. 


Male pattern hair loss can be hereditary, and it can be inherited from either of your parents. Some men who are extremely lucky with their genes do not experience male pattern baldness. Besides deciding your likelihood of having male pattern baldness, your family history also decides how severe your hair loss is. 


Don’t go around lamenting about your genetics just yet! A bigger culprit may be at play – dihydrotestosterone (DHT). DHT is a male sex hormone that is usually responsible for male sex characteristics, such as the development of the male genitals, deepening of your voice, and growth of body hair. Simply put, DHT contributes to every male’s development during puberty. 

However, too much of anything isn’t going to do you any good. Excessive DHT can shrink your hair follicles, making them less conducive for supporting healthy hair growth. Furthermore, DHT messes with your hair growth cycle. Not only does this cause your hair to fall out faster, but it also causes new growing hair to be thinner and more brittle. 

Battling Hair Loss

We’re about to break to you some bad news and good news. Hold your breath – the bad news is, there’s no magical permanent cure for hair loss yet. Yikes, that sounds terrible. The good news? It’s still possible to reduce future hair loss. The sooner you act, the more hair you can preserve. After all, prevention is always better than cure, and it is more difficult to revive a hair follicle that is already “dead”. Next, let’s discuss the two most common hair loss medical treatments – minoxidil and finasteride. 


A popular choice among balding men is minoxidil, which usually comes in the form of a topical solution or lotion. Applying minoxidil to your scalp can help to slow down the progression of hair loss and restore some of your hair that you thought was gone forever. 


Another crowd-favourite treatment option is finasteride, which comes in the form of oral tablets. Finasteride reduces the level of DHT hormones, which is the main cause of male pattern baldness. This eventually helps to reduce hair loss and possibly regrow some of your hair. 

A combination of minoxidil and finasteride

A 2015 research revealed that using a combination of both minoxidil and finasteride is more effective than using either one alone. If you are unsure about your treatment options, don’t hesitate to connect with our doctors

Good Things Come to Those Who Wait 

We’re sorry to break this to you, but hair loss treatments aren’t magical and they don’t work overnight. Worse still, there might be an initial increase in hair loss, better known as “shedding”, when you first start on medical treatment. 

However, it’s important to remember that shedding is normal and will eventually go away by itself as your body adjusts to the treatment. It’s even a good sign that your treatment is working, as shedding indicates the start of a new hair growth cycle. During shedding, your older and more brittle hair will fall out, making way for new and stronger hair to grow. Normally, shedding lasts any time between 2 to 8 weeks, although this duration may vary across different individuals. If you’re lucky, you may not even experience it! 

It may take 4 months or longer to notice an improvement in hair density. Consistency is also key when it comes to hair loss treatment; your hair loss treatment is only effective if you maintain a regular treatment schedule. 

How We Can Help 

If you can’t decide on a treatment option, or if you find trudging to the clinic and waiting for your turn way too cumbersome and time-consuming, we’re here to help you. At Arx, you simply need to fill in a short questionnaire and connect with one of our friendly doctors online. You don’t even need to step out of your house – Arx promises to deliver your medications right to your doorstep in discreet packaging. 


  • Ho, C. H. (2021, May 5). Androgenetic Alopecia. StatPearls [Internet].
  • Tang, P. H., Chia, H. P., Cheong, L. L., & Koh, D. (2000). A Community Study of Male Androgenetic Alopecia in Bishan, Singapore. Singapore Medical Journal 2000, 41(5), 202–205.
  • Jewell, T. (2019, January 10). DHT: How It Causes Hair Loss and How to Slow It. Healthline.
  • British Association of Dermatologists. (2019). Male Pattern Hair Loss (Androgenetic Alopecia).
  • Chandrashekar, B. S., Nandhini, T., Vasanth, V., Sriram, R., & Navale, S. (2015). Topical minoxidil fortified with finasteride: An account of maintenance of hair density after replacing oral finasteride. Indian Dermatology Online Journal, 6(1), 17–20.

Tips for Healthier And Stronger Hair In Men

Getting strong and healthy hair isn’t tough at all; it can be achieved by tweaking your daily lifestyle. Discover new tips to help you fight against hair loss and maintain a voluminous and lustrous mane. 

You are What You Eat

Firstly, an improper diet can lead to a lack of nutrients, causing your hair to become brittle and fall out more easily. Here are some foods that will help you maintain a lush-looking head. 

1. Mediterranean diet

Research has shown that the Mediterranean diet decreases the risk of male pattern baldness, the most common form of hair loss among men. So, what’s in the Mediterranean diet? The most significant aspects of this diet are fresh vegetables and herbs. One easy-to-make dish that you can try is fresh salad. Simply toss into a bowl some fresh vegetables such as carrots and tomatoes, as well as fresh herbs such as rosemary, sage, parsley or basil. Munching on these fresh vegetables and herbs at least 3 times a week has proven to reduce the risk of male pattern baldness. 

2. High-protein foods

Proteins do wonders for both building muscle and maintaining strong and healthy hair. In fact, every strand of your hair is 95% keratin, which is the hair protein. High-protein foods are ubiquitous and are most likely already part of your daily diet. 

These include: 

  • Eggs
  • Lean meat
  • Seafood
  • Tofu
  • Greek yoghurt

3. Iron-rich foods 

According to the World Health Organisation (WHO), iron deficiency is the most common form of deficiency in the world. Unfortunately, too little iron can lead to hair loss. Thankfully, hair loss that is due to iron deficiency is easily reversible. Replenish your body’s reservoir of iron with these iron-rich foods: 

  • Lean beef
  • Beans
  • Eggs
  • Green leafy vegetables such as kale and spinach 

You should also strive to consume more vitamin C as it helps your body absorb iron more efficiently. Foods rich in vitamin C include:

  • Oranges
  • Strawberries
  • Melons
  • Tomatoes
  • Broccoli

4. Foods rich in omega-3 

You might have already heard of rumours about omega-3 and fish oil being great for your health. While many health benefits of omega-3 remain debatable till today, it has been scientifically established that omega-3 are beneficial for hair growth and hair loss prevention. 

Omega-3 works by supplying your hair follicles and skin with the nutrients and proteins that it needs. It also promotes blood circulation in your scalp, triggering hair growth. Furthermore, it helps prevent inflammation in your hair follicles, which is often a direct cause of hair loss.

Omega-3 fish oils can be easily bought off the shelves. Not so keen on those? The good news is that there are many other sources of omega-3 that you can incorporate into your daily diet. These include:

  • Fatty fish such as salmon and tuna
  • Egg yolks
  • Walnuts
  • Flax seeds

Scrutinise Your Hair Product Labels

The next time you use your hair care products, you might want to read the ingredient labels first. Some hair care products, ironically, aren’t that caring for your hair after all. If your hair care products contain any of the following ingredients, it’s time to ditch them and shop for a new one.

  • Sulfate
  • Parabens
  • Fragrance
  • PEG
  • Formaldehyde
  • Hexachlorophene
  • Phthalates 

Don’t Forget Your Hair Conditioner 

After shampooing your hair, remember to use a hair conditioner. Conditioners are essential for maintaining the moisture and natural oils of your hair, ultimately helping to keep the shine in your hair. 

Here’s how to use your shampoo and conditioner correctly.

While shampooing, it is more important to massage your scalp instead of completely focusing on the lengths of your hairWhen using a hair conditioner, it’s best to avoid the scalp and apply the conditioner only to the lengths of your hair.

Keep Your Hair on Your Head, Not on Your Comb

If you’ve just stepped out of your shower, resist the temptation to brush your hair immediately. That’s because brushing your hair when it is still wet can lead to significant damage and breakage. If you really need to brush your hair when it is still wet, switch to a brush that has its bristles spaced further apart.  

Stop Smoking

Has anyone ever nagged you to quit smoking? Well, brace yourself, as we’re about to nag you further. Many studies have shown that smoking is associated with male pattern baldness since tobacco damages your hair follicles. 

Smoking is also terrible for your general blood circulation as it causes plaque to build up in your blood vessels. Not only does this increase your risk of stroke and heart attack, but it also hinders the blood supply to your scalp, causing your hair follicles to be deprived of nutrients that are usually transported by blood. Moreover, a study in 2013 also discovered that smoking causes your grey hair to sprout out before you even turn 30 years old. 

Essentially, smoking is terrible for your health, including your hair’s health. Don’t smoke your hair and health away! For more information and support on quitting smoking, check out the smoking cessation programmes by the Health Promotion Board (HPB). 

Embrace It

Balding doesn’t necessarily make you less attractive. Don’t believe us? Dwayne Johnson, better known as “The Rock”, has literally been rocking the bald look. There’s a long list of bald celebrities that still look great and charming, including Pitbull, Howie Mandel and Bruce Willis. 

If you need more solid evidence on the attractiveness of baldness, a study conducted by the University of Pennsylvania revealed that bald men were perceived to be more dominant, taller and stronger. Whatever it is, confidence is key to looking and feeling fabulous. Learn to love the way you look and don’t compare yourself with others!

How We Can Help

Arx offers hair loss treatments for men who are having signs of male pattern baldness. It’s simple, convenient and you don’t even need to leave your house. Ready to embark on your journey towards a fuller head of hair? Click here to find out more!


  •  Fortes, C., Mastroeni, S., Mannooranparampil, T., Abeni, D., & Panebianco, A. (2017). Mediterranean diet: fresh herbs and fresh vegetables decrease the risk of Androgenetic Alopecia in males. Archives of Dermatological Research, 310(1), 71–76.
  • World Health Organization. (2020, April 20). WHO guidance helps detect iron deficiency and protect brain development. World Health Organization. 
  •  Gavazzoni Dias, M. F. R. (2015). Hair cosmetics: An overview. International Journal of Trichology, 7(1), 2–15.
  • Su, L.H., & Chen, T. H. H. (2007). Association of Androgenetic Alopecia With Smoking and Its Prevalence Among Asian Men. Archives of Dermatology, 143(11), 1401–1406. 
  • Zayed, A. A., Shahait, A. D., Ayoub, M. N., & Yousef, A. M. (2013). Smokers′ hair: Does smoking cause premature hair graying? Indian Dermatology Online Journal, 4(2), 90–92. 
  • Mannes, A. E. (2012). Shorn Scalps and Perceptions of Male Dominance. Social Psychological and Personality Science, 4(2), 198–205.
Sexual Health

Does Porn Cause Erectile Dysfunction?: What Every Man Needs To Know

Today, we have an irony in question – could streaming sex on your browser’s incognito mode be detrimental to your own sex life? 

Sexual Dysfunction and its Demographic Trend Across the Years

Up until the last decade, the rate of erectile dysfunction (ED) among younger men (below the age of 40) was relatively low. A 2002 meta-analysis found that the rate of ED among men below the age of 40 was only 2%.

In 2011 (a decade after the 2002 meta-analysis), another study was conducted using the same assessment as before. Shockingly, this study showed a radical rise in the rate of ED among young men. ED rates among younger men had skyrocketed to between 14% to 28%.

The Simultaneous Rise of Porn and Erectile Dysfunction Cases: A Coincidence?

So, how did the rates of ED climb so rapidly within a decade? Is porn a driving force? This topic is still highly contentious and requires more scientific research before we can take a solid stance. Here’s what we have gathered so far regarding both sides of the argument.

Proponents: “Porn has led to an increase in ED rates”

In 2006, “porn tube sites” were introduced, enabling wide and easy access to sexually explicit videos. Viewers no longer needed to download content as the videos could be conveniently streamed online. 

A 2015 study revealed that it was common for men who frequently “use pornography and masturbate” to have ED and low sexual desire with a partner. Porn is speculated to induce ED through its psychological impacts, which we will further explore later in this article. 

Opponents: “Porn is just a scapegoat for other legitimate factors that cause ED.”

However, some critics have explained that porn itself may not cause ED. Instead, the apparent association between porn and ED may be due to other factors, such as the increase in public awareness of ED as a disease. We will also delve deeper into these reasons later.

What is Porn-Induced Erectile Dysfunction (PIED)?

Before we let the debate begin, let’s first understand what exactly is porn-induced erectile dysfunction (PIED). PIED occurs when:

  • A man can achieve an erection and have orgasms when watching porn but finds it difficult to do the same when having sex in real life.
  • A man takes a long time to have an orgasm when having sex in real life.
  • A man’s partner complains that he seems uninterested during sex.

Next, let’s move on to discuss how porn might induce ED.

Porn Leads to Desensitization

Watching porn too frequently can render real-life sexual interactions no longer fulfilling. Porn is highly addictive and affects your brain the same way as addictive substances such as drugs and alcohol would. Here’s the science behind how porn numbs your emotions surrounding sex:

  • Watching porn induces pleasure, causing dopamine, the happy hormone, to be released explosively. The release of dopamine is further heightened due to masturbation. 
  • The brain continuously craves for more pleasure, motivating the man to compulsively watch even more porn, similar to how a drug addict would repetitively seek out cocaine to achieve the same high over and over again. 
  • Ultimately, the brain becomes “overloaded” with dopamine and builds tolerance against porn. The man now has to watch increasingly hardcore porn to achieve the same high as before. 
  • Unfortunately, the authentic reality almost never measures up to the unrealistic fantasies portrayed by porn. As such, real-life sexual encounters with a partner are insufficient to arouse the man, eventually escalating into PIED.

Porn Causes Unrealistic Expectations

From impossibly perfectly well-sculpted physiques of porn stars to extreme position and inflated moans, porn is the epitome of unrealistic sex. However, porn has also become a one-stop solution for sex education for many youths. Therefore, the repeated exposure to porn, especially at an impressionable age, leads to unrealistic expectations on what sex and your body should be like. The pressure to meet these expectations and the despair that befalls when one fails to meet them can ultimately lead to performance anxiety.

Amidst the scramble to replicate porn scenes, men often forget that real-life sex is supposed to have an emotional aspect that porn lacks. The self-inflicted pressure to perform like a porn star only serves as a distraction that blinds one from the mutual emotions of lovemaking. 

Performance Anxiety of Trying to Replicate Porn’s Portrayal of Sex in Real Life

Porn sets the bar high, in fact, too high for the average man to reach. However, the ubiquity of porn has led to a common misconception that the sex portrayed in porn is normal and easily attainable. It’s natural for most men to fail to achieve porn-like sex, but this often results in a feeling of inadequacy. In general, porn can induce and elevate performance anxiety due to the following reasons:

1. Increased dissatisfaction in one’s own body

Porn paints a rosy picture of what the “perfect macho” looks like – dashing faces, ripped bodies, and huge (and surgically enhanced) genitals. 

2. Pressure to replicate unrealistic sexual performances

The undying stamina of porn stars allows their action to be dragged on for way longer than normal humans can. Together with exaggerated shrieks and difficult positions, these elements of porn videos are rarely recreated in real life. However, this misleads frequent consumers of internet porn to believe that sex that doesn’t look like porn is underwhelming. 


Performance anxiety isn’t only caused by internet porn. Many other factors also contribute to performance anxiety. To learn more about performance anxiety and how to alleviate it, check out our previous blog article

Guilty Pleasure

Frequent consumers of porn may also be washed with a sense of guilt and shame, especially since porn is often shamed as sinful and frowned upon by many religions. Unfortunately, moral and religious qualms of watching porn can spiral into moral panic, inducing ED. 

The Other Side of the Story

There isn’t a unanimous consensus that porn causes ED. Some experts remain doubtful of the relationship between porn and ED. Moving on, let’s explore their side of the argument.

The supposed ED may actually be caused by the refractory period

After orgasm or ejaculation, every man undergoes what is known as the “refractory period”. This is regardless of whether the man performed masturbation or partner sex, or whether or not he had watched porn. During the refractory period, the man will be unable to achieve another erection. 

Refractory periods increase with age. Hence, as one grows older, he may need to wait for long periods before being able to raise his wood again. For some men, this may be several hours, but it’s also normal for men above the age of 60 to have a refractory period of 12 hours or longer. 

Essentially, when one watches porn and orgasms or ejaculates because of it, he naturally slips into the refractory period. In other words, while porn isn’t the one that is killing erections, porn may be an extremely convenient scapegoat for the lack of erections. 

The increase in reportings of ED may simply be due to greater awareness of ED as a legitimate medical concern

In the early days, ED was commonly passed off as a joke and was considered humiliating. Then, Viagra’s® grand introduction in the late 90’s changed everything. “Impotence”, the stigmatised label of erection problems, was relabelled as “erectile dysfunction”. This led to an unprecedented increase in awareness of ED as a treatable medical concern. Thanks to that, more men suffering from ED are willing to come forward to seek treatment for it. Naturally, the number of ED cases reported in medical research papers would increase. 

Coincidentally, internet porn saw its success as a lucrative business. With its popularity skyrocketing during this time, it may have mistakenly taken the blame for the increase in the number of ED cases reported on papers.  

Is it really porn usage that is causing ED, or could it be ED that is causing porn usage?

That’s like the ever famous question – which came first, the chicken or the egg? There isn’t a definitive answer, as men with PIED may be trapped in an endless feedback loop: If they can’t have satisfactory partnered sex due to ED, they turn to watch porn, which in turn, worsens their ED. 

The Simple Solution to PIED

The solution is an obvious one – stop watching porn. Many men reported that abstaining from porn helped them get back in the saddle in 90 days. While this number may differ across individuals, it is a good gauge to keep you motivated throughout your journey. 

Tips to abstain from porn

However, removing porn from your life is easier said than done in reality. Here are some tips that may help you abstain from porn:

  • Install a porn blocker software.
  • Change your password on porn streaming websites to something complicated. Write it down and lock it somewhere that isn’t easily accessible. Remember to clear out your web browser’s bookmarked porn sites as well!
  • Address any underlying issues. If you’re watching porn out of boredom, try out new hobbies, hang out with your friends more often, or hit the gym to preoccupy yourself! On the other hand, if you’re indulging in porn due to an ebbing sex life, talk to your partner about both of your needs. 

Outlook and Conclusion

The ongoing debate on whether porn really causes ED calls for more scientific research. Till then, it may be difficult to firmly say that watching porn is either inherently good or bad for your sexual health. 

While porn may be a contributing factor to ED, many other factors can result in ED as well. To learn more, check out our blog article that covers the symptoms, causes and treatments for ED.  

If you’re experiencing ED, it’s a good idea to chat with a doctor about it. Feeling a little reluctant at the thought of having a face-to-face chat with a doctor at the clinic? Arx is a safe haven, away from judgement and stigma regarding sexual health. Simply connect with one of our licensed doctors at Arx for an online consultation for your ED with our licensed doctors. 


  • Prins, J., Blanker, M. H., Bohnen, A. M., Thomas, S., & Bosch, J. L. (2002). Prevalence of erectile dysfunction: a systematic review of population-based studies. International Journal of Impotence Research, 14(6), 422–432. 
  • Landripet, I., & Štulhofer, A. (2015). Is Pornography Use Associated with Sexual Difficulties and Dysfunctions among Younger Heterosexual Men? The Journal of Sexual Medicine, 12(5), 1136–1139. 
  • Klein, V., Jurin, T., Briken, P., & Štulhofer, A. (2015). Erectile Dysfunction, Boredom, and Hypersexuality among Coupled Men from Two European Countries. The Journal of Sexual Medicine, 12(11), 2160–2167. 
Sexual Health

Male Sexual Performance Anxiety And How To Overcome It

What happens when a man thinks of sex as a performance? He gets nervous, really nervous. Soon, his mind becomes filled with negative thoughts and paranoia. “Is my penis too small?” “Will I be able to perform well?” “What if my partner doesn’t like the sex?” Unfortunately, these racing thoughts often become a self-fulfilling prophecy, eventually translating into unsatisfactory sexual performance.

Performance Anxiety in Our Daily Lives 

Performance anxiety, or “stage fright”, has hit most of us at some points in our lives. Perhaps, some of you can vaguely recall being so nervous during a school play that you forgot your lines on stage. Many of us have also had butterflies in our stomachs as we fumble through an important presentation at work. Even well-trained athletes may fail to perform their best when under stress. Indeed, it’s not uncommon for humans to choke under pressure in many scenarios, and for some of us, this includes sex.

What is Sexual Performance Anxiety?

It’s normal to feel jittery about sex sometimes, especially if it’s your first time. However, to some men, sex, or even just the thought of having sex, is a persistent source of anxiety instead of pleasure. Unfortunately, the mind is a dominant force in controlling men’s sex drive and erections. Therefore, anxiety affects sexual performance. Inevitably, the dissatisfactory sexual performance calls for more panic and anxiety, which once again, becomes the bane of one’s sexual performance. As a man becomes trapped in the vicious cycle of anxiety and poor sexual performance, he despairs and may possibly abandon the idea of sex altogether. 

How Common is Sexual Performance Anxiety?

Sexual performance anxiety affects both men and women, although it is less prevalent in the latter population. According to population-representative surveys, sexual performance anxiety is more common among men, affecting about 9-25% of men while affecting only 6-16% of women. 

Symptoms of Sexual Performance Anxiety

To identify if you are suffering from sexual performance anxiety, look out for these common signs the next time you engage in sexual activities: 

  • Raised heart rate
  • Panic attacks
  • Guilt 
  • Reluctance to engage in sexual activity, or avoidance of sexual activities altogether
  • Loss of sexual desire
  • Difficulty getting aroused
  • Premature ejaculation (PE), or ejaculating faster than you and your partner desire
  • Delayed or blocked ejaculation
  • Erectile dysfunction (ED), or the long-term inability to get or maintain an erection

Causes of Sexual Performance Anxiety

A multitude of factors can contribute to sexual performance anxiety. It’s not the same for everyone, so getting an idea of what’s causing your performance anxiety is the first stepping stone towards conquering it. 

  • Poor body image
  • Worry about penis size
  • Low confidence and self-esteem
  • Negative sexual experiences in the past
  • Lack of previous sexual experience
  • Relationship conflicts
  • Fear of not being able to perform sexually
  • Worry about not being able to satisfy the partner
  • Stress 
  • Depression or anxiety disorders
  • Watching internet porn excessively (Stay tuned to our next blog article on internet porn’s effect on erectile function to find out more!)

The Science Behind Sexual Performance Anxiety

Your mind plays a big role in determining your ability to get aroused and perform well in bed. When you feel anxious or stressed over not being able to perform well, your brain sends signals to your body to release stress hormones – adrenaline and noradrenaline. These stress hormones narrow your blood vessels, including those in your penis. As a result, less blood flows into your penis, making it more difficult to achieve an erection. That’s how anxiety and stress can lead to poor or dissatisfactory sexual performance in men. 

Association with Erectile Dysfunction (ED) and Premature Ejaculation (PE)

A study in 2015 has promising evidence that points towards a connection between performance anxiety and ED, which is the persistent inability to get or sustain an erection. 

Another study that was conducted between January 2012 and January 2013 in India revealed a high rate of anxiety (70%) in patients with the acquired (secondary) form of PE. Men with the acquired (secondary) form of PE previously had normal ejaculations but later developed PE due to factors such as anxiety.

If you are suffering from ED or PE, Arx can help you with that. Connect with one of our friendly doctors here to find out more!

How to Overcome Sexual Performance Anxiety

1. Practice mindfulness

Get out of your head and get into the moment! Try shifting your focus off those negative thoughts and forget about evaluating your sexual performance. Instead, focus your attention on the pleasurable sensations that you are experiencing – touch, sight, sound, smell and taste. Enjoy the moment and focus on the pleasant emotions that you may feel, such as enjoyment, excitement and affection.   

2. Cognitive-behavioural therapy (CBT) 

This involves cognitive restructuring or changing your negative attitudes during sex and masturbation. Identify the thoughts that are causing your sexual anxiety. It can sound something like “If I don’t perform well, my partner and I won’t enjoy the sex.” Now that you are mindful of your negative thoughts, it’s time to turn those thoughts into something more positive! Write down a constructive alternate attitude, such as “As long as I focus on the pleasant sensations, feelings and experiences, my partner and I will both enjoy the sex, no matter how the performance is like.”

3. Talk to your partner

Opening up to your partner about your sexual performance anxiety can take a big weight off your mind. Perhaps, you may come to understand that your partner is in fact, very understanding, and that your worries and anxieties may have been unfounded. Talking can also strengthen the bonds between you and your partner as you try to come up with solutions together. 

4. Explore other ways of intimacy

Getting intimate doesn’t always involve penetrative sex. Try giving each other a sensual massage or taking a warm bath together. Extend your foreplay, and you may even want to try role-playing to shake things up a little!

5. Distract yourself from your negative thoughts

Taking your focus away from your sexual performance will remove the huge burden that hinders your sexual excitement. Try playing some romantic music or lighting up scented candles to set the mood. Otherwise, you can invite your partner to “Netflix and chill” with you; simply turn on a sexy movie in the background while you make love. 

6. Set realistic expectations

With internet porn being only one click away, it’s easy to get carried away and develop an unrealistic view of sex. However, keep in mind that porn is an exaggerated portrayal of sex and is vastly different from what normal sex looks like. Porn is also simply a sexual act for commercial purposes, devoid of the context of a loving relationship. Porn sets unrealistic expectations surrounding sex and your body. As such, taking lessons from porn may not be wise. Porn doesn’t give you better sex, but embracing your body does!

Our next blog article will cover porn-induced erectile dysfunction (PIED), so stay tuned for it!

7. Relaxation and meditation

Stress and anxiety in your daily life can spill over into your sexual life. While removing stressful factors from your life isn’t always possible, you can always try to cope with them! Try meditation or meditative exercises such as yoga. Remember to practice mindfulness not just under the sheets, but also as you go about your day. 

Friendly Reminder: Your Sexual Performance Doesn’t Define Your Masculinity

Your bedroom isn’t a stage, and neither are you a performer. There is no need to scrutinize and evaluate your sexual performance, which will only cause you to beat yourself up. For a happier and healthier sex life, try focusing on the things that you can do, instead of what you cannot do.


  • Pyke, R. E. (2020). Sexual Performance Anxiety. Sexual Medicine Reviews, 8(2), 183–190. 
  • Rajkumar, R. P., & Kumaran, A. K. (2015). Depression and anxiety in men with sexual dysfunction: a retrospective study. Comprehensive Psychiatry, 60, 114–118. 
  • Park, B., Wilson, G., Berger, J., Christman, M., Reina, B., Bishop, F., Klam, W., & Doan, A. (2016). Is Internet Pornography Causing Sexual Dysfunctions? A Review with Clinical Reports. Behavioral Sciences, 6(3), 17. 
  • Rajkumar, R. P., & Kumaran, A. K. (2014). The Association of Anxiety With the Subtypes of Premature Ejaculation. The Primary Care Companion For CNS Disorders. 
  • Male Sexual Performance Anxiety. National Social Anxiety Center. (n.d.). 
Sexual Health

9 Tips To Keep Your Penis In Tip-Top Health

Having something go wrong with the penis is every man’s nightmare. The good news is, it’s not that hard to keep your penis healthy. Keep your family jewels well-polished with these simple lifestyle tips! 

What is Penis Health?

Before we begin, let’s ensure that everyone is on the same page regarding what constitutes penis health. Penis health encompasses the following:

  • Ability to get and keep an erection
  • Ability to ejaculate
  • Fertility, or ability to reproduce
  • Ability to urinate comfortably
  • No lesions or warts on the penis
  • No abnormal discharge
  • Colour of the penis should be similar to the surrounding skin, although it’s normal to be a shade lighter or darker 

1. Healthy diet

A healthy diet, well, is obviously great for your health. A well-balanced and nutritious diet reduces the risk of diabetes and heart disease, which are risk factors for erectile dysfunction (ED). Furthermore, a study in 2016 revealed that maintaining a diet rich in fruits and vegetables reduces the risk of ED in men under 70 years old. 

Next, if you’re interested in the science behind this, it’s largely because many fruits and vegetables contain flavonoids, which makes your blood vessels more flexible. This improves blood flow to the penis, ultimately leading to a healthier penis and firmer erection. 

There is a wide range of fruits, vegetables and grains that are rich in flavonoids. The next time you go shopping for your groceries, remember to load your cart with these ingredients!

  • Berries
  • Grapes
  • Citrus fruits
  • Spinach
  • Kale
  • Parsley
  • Onions
  • Red cabbage
  • Tea
  • Dark chocolate
  • Soybeans
  • Red wine (drink in moderation, please!)

2. Hydrate yourself

Water works wonders for a youthful erection. According to a study published in The Journal Of Sexual Medication, drinking water inadequately causes your volume of blood cells and plasma to plunge. Blood supply that is rich in oxygen and nutrients to your penis is reduced, leading to a disappointing erection. 

Additionally, when your fluid levels fall, your body responds by producing a hormone known as “angiotensin”. Angiotensin constricts your blood vessels, compromising the blood supply to your penis even further. 

A drought causes withering plants. Likewise, a drought in your body can lead to a withering penis. Show your penis some love and water it well! To keep your penis healthy and perky, ensure that you drink at least 2 litres of water per day.

3. Exercise

Pump up your love pump with some exercise! Exercise helps you keep your weight within the healthy range, hence reducing obesity-related sexual health concerns. Furthermore, a 2011 meta-analysis involving 385 participants proved that aerobic exercise helped improve the erections of men who were suffering from ED. Another research in 2015 published in The American Journal of Cardiology studied whether regular walking could improve ED in men who had a recent heart attack. 71% of the subjects saw a decrease in ED symptoms. 

With many studies corroborating and pointing to a common conclusion that exercise improves ED, it’s wise to heed our advice and get your body moving. For a healthier body and a healthier penis, take part in aerobic exercise for 30 minutes a day, three to four times a week. If you absolutely hate the idea of running or jogging, brisk walking works well too!

4. Hygiene matters

Smegma is a natural, cheesy-looking lubricant that your body produces to keep the penis moist. However, an accumulation of smegma in the foreskin can stink up your penis and become a home for bacteria. If you don’t clean it up, it can eventually escalate into pain and inflammation, known as balanitis. Give your penis a good wash by gently pulling back the foreskin and using mild soap and warm water to wash the area. 

Maintaining good penis hygiene is especially important if you are residing in a warm and humid environment, such as Singapore. Unlike vaginas, your penis doesn’t have a self-cleaning mechanism and is more prone to bacterial and yeast infections. Furthermore, if you have just exercised in your spandex workout clothes, remember to change your clothes shortly after to prevent a build-up of sweat. If you also own tight-fitting pants or underwear, it’s time to ditch them too! Tight clothes can lead to poor ventilation, causing your sweat to accumulate down there. 

5. Sleep well

Squeezing in enough shuteye into a hectic schedule isn’t always easy. However, sleep deprivation can cause your testosterone levels to fall, decreasing your libido and ability to get an erection. Get a good night’s rest to allow your body and testosterone levels to rebalance. 

6. Drink in moderation

Going on too many alcoholic adventures with your bros? We have some bad news for you. Excessive alcohol can interfere with your body’s production of male hormones, possibly leading to ED and infertility. Cut down on the booze for better sexual health.  

7. Quit smoking

Smoking isn’t only detrimental for your lungs – it’s bad for your penis health too. Smoking damages the blood vessels in your penis, leading to ED, decreased libido, or worse, infertility. For those who seek more information or support on smoking cessation, the Health Promotion Board (HPB) of Singapore offers smoking cessation programmes.

8. Practice Responsible and Safe Sex

Having unprotected sex or multiple sexual partners will increase the risk of sexually transmitted infections (STIs). Unless you are trying to have a baby, it’s best to use a condom during sex. A condom serves as a physical barrier against STIs. Also, limit the number of sexual partners you have too. Remember, it’s always better to be safe than sorry.

9. Regular sexual health screening

It is advisable to undergo sexual health screenings together with your partner(s) every once in a while. This allows the early detection and control of sexually transmitted infections (STIs). 

Number of sexual partners you haveHow often should you get a sexual health screening?
1Once a year
MultipleEvery 3 to 6 months


Keeping your penis clean and healthy is important to protect your manhood, and shows manners towards your partner. Thankfully, these tips are easy to follow. On top of that, many of them are also great for your general health and well-being! 

Lastly, if you are experiencing any health concerns regarding your penis, such as erectile dysfunction (ED) or premature ejaculation (PE), feel free to reach out to our friendly doctors at Arx.


  • Cassidy, A., Franz, M., & Rimm, E. B. (2016). Dietary flavonoid intake and incidence of erectile dysfunction. The American Journal of Clinical Nutrition, 103(2), 534–541. 
  • Thornton, S. N. (2009). Hydration Increases Tissue Perfusion and Thus Erectile Function. The Journal of Sexual Medicine, 6(9), 2621–2622. 
  • Lamina, S., Agbanusi, E., & Nwacha, R. C. (2011). Effects of aerobic exercise in the management of erectile dysfunction: a meta analysis study on randomized controlled trials. Ethiopian journal of health sciences, 21(3), 195–201.
  • Begot, I., Peixoto, T. C. A., Gonzaga, L. R. A., Bolzan, D. W., Papa, V., Carvalho, A. C. C., Arena, R., Gomes, W. J., & Guizilini, S. (2015). A Home-Based Walking Program Improves Erectile Dysfunction in Men With an Acute Myocardial Infarction. The American Journal of Cardiology, 115(5), 571–575. 
  • Ferguson, S. (2019, March 26). Everything You Need to Know About Penis Health. Healthline. 
  • Fletcher, J. (2020, April 2). What to know about penis health. Medical News Today. 
  • Brennan, D. (2020, October 30). 10 Foods High in Flavonoids and Why You Need Them. WebMD. 
Sexual Health

Conquering Premature Ejaculation (PE): Natural Ways To Last Longer In Bed

If I asked you to grab a bottle of cola and drop a piece of mentos into it, you’d probably say: “What?! No! It’s going to explode immediately!” 

In men with premature ejaculation (PE), any sexual stimulation is just like that piece of mentos, capable of causing an almost immediate eruption of semen from the penis. But while it is easy to avoid tossing mentos into a cola bottle, it’s not as easy for men with PE to avoid sex altogether. In this article, we will explore some natural ways to keep that fizz under control and put a stopper to PE. 

What is Premature Ejaculation (PE)?

Check out our previous blog post that covers the basic things that every man should know about PE, including its symptoms, causes and treatments. 

Simply put, PE is when a man ejaculates sooner than he or his partner would like, typically within 1 minute of entering his partner. 

8 Natural Ways to Last Longer in Bed

1. The stop-start method

Also known as “edging”, you can perform this method solo during masturbation or with your partner. It involves sexual stimulation until you feel that you are approaching “the point of no return”. Then, stop the stimulation for about 30 seconds or until your urge to climax passes. Afterwards, start the stimulation again. Try to repeat this process a few times before finally allowing yourself to orgasm. 

This method improves your control over the timing of ejaculation. A study has shown that while long-term benefits of this method have not been conclusive yet, about 45 to 65 percent of men who tried this method saw short-term benefits in prolonging their time to ejaculation. 

2. The squeeze method

Similar to the previous method, you can perform this method solo or with your partner. It involves sexual stimulation until you recognise that you are approaching orgasm and ejaculation. At this point, get your partner or yourself to squeeze the tip of your penis for a few seconds or until your urge to climax passes. Repeat this process as many times as you desire. This method improves your awareness of the sensations that lead up to climax, allowing you to gain better control in future. 

While Masters and Johnson, the founders of the squeeze method, maintain that the majority (more than 85 percent) of men with premature ejaculation can be successfully treated with the squeeze method, other clinical trials have shown more varied results. However, it’s still worth the try, as the squeeze method is still highly raved about and often used amongst men with PE.

3. Getting busy before really getting busy

Some therapists advise younger men to masturbate 1 to 2 hours before sex.  However, do note that this technique is less effective in older men, as they may find it more difficult to achieve an erection later on during actual sexual intercourse. Not only can this lead to secondary impotence, but it can also damage the man’s confidence greatly. 

Another downside of this method is that in reality, sex can be spontaneous and you’re not always able to predict when you have sex. Consequently, it would be difficult for you to plan when to masturbate. 

4. Using condoms 

Use a condom to help reduce sensation and desensitize your penis sufficiently so that you can last longer. The thicker the condom, the better it is. If you’re not planning to start a family, this method also prevents pregnancy, duh, killing two birds with one stone. Some condoms are also specially designed for climax control. These condoms are lined with lidocaine, providing an additional numbing effect for your penis.  

An important thing to note is that you have to put on the condom early enough. If you wear it only after you have been excessively stimulated, or are very close to the point of no return, even putting on the condom can cause you to ejaculate, nulling all your efforts.

5. Let your mind wander around

Another common technique is to distract yourself by thinking of something else that is non-sexual while you’re sexually stimulated. It can be as simple as naming the players of your favourite soccer team or naming all the brands of cereal that you know. Really, it could be anything. 

While some men find this useful, others find that their erections weaken or disappear completely. Depending on personal beliefs, some men also feel that distracting themselves with other thoughts during sex is dishonest to their partner. 

6. Switch up your sex position

Studies have shown that passive positions, most commonly the “woman-on-top” position, are effective in delaying ejaculation. With your partner on top, she can easily pull away when you are close to the point of no return. If you are going for active positions, get your partner to lie on her back while you enter standing up. Your penis should be facing downwards slightly and rubbing against her pubic bone. While this may not be the most comfortable position, the discomfort actually helps delay ejaculation. Taking shorter thrusts has also been proven to be very effective in prolonging your time to ejaculation. 

7. Pelvic floor exercises (Kegel exercises)

Contrary to popular belief, these exercises aren’t only for people with vaginas. Stronger pelvic floor muscles will strengthen your ability to delay ejaculation. Follow these simple steps to perform these exercises: 

  • Identify the correct muscles. In order to find your pelvic floor muscles, stop urinating midstream or tighten the muscles that stop you from farting. The muscles that you have just squeezed are your pelvic floor muscles. Once you have identified these muscles, you can do pelvic floor exercises in any position, although many men find it easier to start off with lying down.
  • Do the exercises correctly. Squeeze and tighten your pelvic floor muscles and hold the contraction for 3 seconds. Remember to concentrate on using your pelvic floor muscles, and not your glutes, thighs or hip muscles. Avoid holding your breath while doing this exercise. Instead, you should breathe freely. Then, release and relax for 3 seconds. Try this a few times in a row. When you feel that your muscles are getting stronger, you can try this exercise in other positions, such as while sitting, standing, or even walking. 
  • Repeat. You can’t possibly expect to go from having a flabby tummy to having a rock hard six-pack within 1 day of exercise, right? Likewise, don’t treat your pelvic floor exercises as a one-off thing! These muscles can only be strengthened through consistent efforts. For best results, you should aim for at least 3 sets of 10 repetitions a day. 

A study published in the 2014 Therapeutic Advances in Urology found that the majority of men that they studied managed to gain control over their ejaculatory reflex after 12 weeks of pelvic floor exercises. However, every person is different. If you don’t see a large improvement after 12 weeks, don’t be too disheartened! Continue the exercise regularly and combine it with other methods to help you last longer.

8. Practice, practice, practice!

Even if practice does not make perfect, it will at least, make progress. Some men may simply not have enough sexual practice to have good control over their ejaculation. Openly explore pleasure via masturbation. This will help you familiarise yourself with the sensations that lead up to orgasm. With that, you can slowly regain control over your ejaculation. 

Let’s Put a Stopper on that Exploding Soda Bottle

While PE is not life-threatening, it is relationship-threatening. You may feel ashamed, upset or even angry, while your partner may feel hurt and less connected to you. Sex is a fundamental block to many couple’s relationships. Don’t let PE destroy that. PE is a medical condition and it’s not your fault. Talk to your partner openly about it and deal with it together. Many couples also find sex therapy and counselling very helpful.

Another option is to seek medical treatment. With Arx, you don’t have to leave your house at all. Simply fill up a short questionnaire about your symptoms and medical history, and connect with one of our friendly doctors. Goodbye, long waits and judgemental looks at the clinic!