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Sexual Health

Viagra® (Sildenafil) For Erectile Dysfunction (ED): Effectiveness & Where To Buy Viagra In Singapore

Viagra® (Sildenafil) For Erectile Dysfunction (ED): Effectiveness & Where To Buy Viagra In Singapore

Viagra®, also sometimes known as “the little blue pill”, is the most famous name in treating erectile dysfunction (ED). It was the first oral pill to treat ED and was approved by the U.S. Food and Drug Administration (FDA) in 1998.

In this article, we share more on how Viagra® works to treat ED, potential side effects, Viagra® alternatives, and the safest way to obtain Viagra® in Singapore.

What Is Viagra®? 

Viagra® is a brand-name prescription drug that’s approved to treat ED. With ED, you are unable to get or keep an erection firm enough for sex.

Viagra® is often mentioned alongside a drug called Sildenafil / Generic Sildenafil. While these two medications might have different names, they contain the same ingredient and work exactly the same. In comparison with Viagra®, generic sildenafil is much more affordable and wouldn’t burn a hole in your wallet.

How Does Viagra® Help To Treat Erectile Dysfunction?

An erection occurs when nerves in your penis are stimulated. This results in muscles around the penis, known as the corpora cavernosa, to relax and allow blood to flow in, causing an erection. 

Sildenafil, the active ingredient in Viagra®, is a PDE-5 inhibitor that works by relaxing the blood vessels, allowing blood to flow into your penis when you get aroused to create and sustain an erection. 

Viagra® helps you get hard. If you often find yourself climaxing too fast, you may have premature ejaculation (PE), which is treated with a different medication.

How Effective Is Viagra®?

In multiple clinical studies, between 43% and 83% of men who took Viagra® had improved erections (these success rates varied depending on the cause of their ED and the dosage of Viagra® being used).

How Long Does Viagra® Last?

According to Viagra®’s FDA label, the drug can help to produce an erection up to 4 hours after pill-talking but its effects usually start to taper off after 2-3 hours. 

As you get older, your metabolism slows down. Hence, some people notice Viagra® works for a longer period as they age. 

Can you climax more than once with Viagra?

Viagra® may not work again immediately after ejaculation. Your stamina, natural refractory period, and level of arousal are just some factors that can determine how many times you’ll be able to come before the medication wears off.

How To Take Viagra®?

Viagra® may be taken anywhere from 30 – 60 minutes before sexual activity. This is the average time needed for Viagra® to start working, but in some cases it can take up to 2 hours to work. 

Do not take Viagra® more than once a day or the dose prescribed for you.

How To Take Viagra® For Best Results?

Viagra® works best when taken in the right conditions. Below are some tips that you can use to take Viagra® more effectively and get the best possible results from each blue pill:

  1. Eat a light meal beforehand

Viagra® does not need to be taken with food to work. However, a light meal can help to prevent indigestion/stomach upset!

Avoid large meals and high-fat foods (eg. fried, greasy food) before taking Viagra®. The fat in the meal can potentially delay the absorption of Viagra® in your body, meaning it may take longer to take effect. 

Had a large meal? Wait a couple of hours to allow enough time for digestion before taking Viagra®.

  1. Try to relax

If you feel anxious, nervous, depressed, or stressed, your body may not respond well to sexual stimulation. If this is the case, try to relax, make yourself comfortable, and give yourself time for the medication to work! Viagra® usually starts to work within 30-60 minutes. You may take it up to 4 hours before sexual activity.

  1. Get in the mood

Viagra® will not work if you are not sexually aroused! 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!

  1. Avoid alcoholic drinks after taking

Alcohol can decrease blood flow to your penis, making Viagra® less effective and shorter-lasting. 

Also, Viagra® can lower blood pressure. Combining it with alcohol can increase this effect. If your blood pressure drops, symptoms like dizziness, lightheadedness, and headache could also hinder your hard-on and mood.

Potential Side Effects Of Viagra®

Viagra® is generally safe when taken under the advice and supervision of a medical professional. According to the NHS, most men have no side effects or only minor ones. 

Mild side effects

Common side effects include:

  • Headaches are mostly mild and go away quickly with rest. If the headache is bothersome, take paracetamol painkillers that can be purchased over-the-counter. 
  • Facial flushing where the skin on your face feels hot. Open a window, turn on a fan or lie down and rest to cool down if flushing occurs.
  • Indigestion or stomach pain. Take with a light meal if Viagra® causes stomach upset. However, do note that food can delay the absorption of the medication, meaning it may take longer for Viagra® to work. 
  • Stuffy nose.
  • Visual disturbances (eg. blurring of vision, blue tinge in vision).

Common side effects typically go away over time as you adjust to the medication. If you experience any of the above, keep taking the medicine, but tell your doctor if these side effects bother you or do not go away.

Serious side effects

Serious side effects from Viagra® are rare, but they can occur. Stop your medication and contact your doctor immediately if you experience any of the following:

  • Chest pain. 
  • Allergic reaction. Symptoms can include swelling of the face, eyes, lips or tongue, difficulty in breathing, or itchy skin rashes over your whole body. 
  • Priapism, a prolonged and sometimes painful erection that lasts more than 4 hours.
  • Sudden vision loss in one or both eyes.
  • Sudden hearing decrease or loss. May also involve other symptoms, such as tinnitus (ringing or buzzing in ears) or dizziness.

Alternative ED Pills To Viagra®

While Viagra® is considered to be the most common medication for ED, there are quite a few on the market. They all work the same — improve blood flow to the penis so that you can have and keep an erection long enough to have sex, but can differ in the cost, how fast they start working and how long their effects last. 

ED PillsCharacteristics
Viagra® (Sildenafil)– Taken prior to sexual activity
– Onset: 30-60 minutes
– Duration: 4-5 hours
Generic Sildenafil– Taken prior to sexual activity
– Onset: 30-60 minutes
– Duration: 4-5 hours
Spedra® (Avanafil)– Taken prior to sexual activity
– Onset: 15-30 minutes
– Duration: 6-12 hours
Cialis® (Tadalafil) – 20mg– Taken prior to sexual activity
– Onset: 30-45 minutes
– Duration: 24-36 hours
Levitra® (Vardenafil)– Taken prior to sexual activity
– Onset: 30-60 minutes
– Duration: 4-5 hours
Cialis® (Tadalafil) – 5mg– Taken daily
– Onset: Continuous
– Duration: Continuous
ED drugs: How soon they start working and how long they last

How And Where To Get Viagra® In Singapore?

The only (safest and legal) way to get Viagra® (Sildenafil) or other ED pills in Singapore is with a valid prescription from a Singapore licensed doctor.

ED pills may result in harmful physical reactions if they are not taken in the right dose, if you have certain medical conditions, or if you’re on certain medication. As such, it is important for a doctor to access your health condition before he/she can deem your suitability for Viagra® and at what dose.

Avoid counterfeit viagra

Oral medications for ED are among the most counterfeited medications in the world. A Straits Times article in 2014 reported that 11 men in Singapore have died after taking illicit sex drugs.

Never buy medication for ED from unauthorised sellers or if the medication is of unknown origin. These illegal products have no guarantee on the contents, efficacy, safety and quality. So you actually have no idea whether the pill will work or worse, if the pill will harm you. 

Where to get a doctor’s prescription for Viagra®?

A Viagra® prescription can be obtained from a General Practitioner (GP) or urologist (private and public sector). However, talking about our issues in bed may be a little awkward, and having to make a trip down to the clinic deters most men from seeking the help they need. 

With Arx — a MOH-approved digital health & wellness clinic for men, you can get a personalized ED treatment prescribed by a SG licensed doctor online and delivered discreetly to your home at $0. Simply start by answering some questions on your lifestyle, symptoms and medical history. 

The Bottomline

If ED is affecting your relationship, sex life or self-esteem, it is best to seek help from a medical professional. They’ll help you find the solution that’s right for you, and potentially catch other health problems before they become severe.

At Arx, we believe in empowering men with access, choice and knowledge to navigate health issues that matter. We provide affordable access to ED treatments, delivered conveniently to your door in discreet packaging to ensure your health remains confidential.

References

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Sexual Health

What Your Morning Boner Says About Your Health

What Your Morning Boner Says About Your Health

Many men find that as the sun rises, so do their dicks. This phenomenon is normal and often known as “morning boner”, or more scientifically, “nocturnal penile tumescence”. But what if your penis is still dozing when you’re up? Should this be a cause for concern?

What is Morning Boner?

Morning boner, scientifically termed as “nocturnal penile tumescence (NPT)” or “involuntary sleep-related erections (SREs)”, refers to when a male wakes up to an erect penis. This occurs in men of all ages, although it is most common among younger men. In fact, infants and children experience it too. What’s even more surprising and interesting is that even male fetuses in the womb get erections!

A healthy man is estimated to experience between 3 to 5 erections during a full night’s sleep (8 hours), with each erection lasting for 25 to 35 minutes. These erections occur during a sleep stage known as Rapid Eye Movement (REM) sleep, which is the period when dreams occur. The morning boner that you experience right after waking up is the last erection in the series of night-time erections.

What Causes Morning Boner?

While scientists have yet to come to an exact conclusion on what causes the morning boner, much evidence points to an interplay of three phenomenons – testosterone production, mental relaxation and physical stimulation.

1. Testosterone production

What is testosterone?

As most of you will already know, testosterone is the primary male sex hormone. It plays a key role in the sexual development of men. Some of its functions are listed below:

  • Regulates sex drive or libido
  • Controls sperm production
  • Responsible for the growth and development of the testes, penis, and prostate gland
  • Responsible for the development and maintenance of secondary male sexual characteristics, causing an increase in height, and body and pubic hair as boys transition to men during puberty

Testosterone levels are highest during sleep

So, what happens to testosterone levels through the night? When you fall asleep, testosterone levels rise, peaking when you transition from non-REM sleep to REM sleep state. After this, your testosterone levels remain consistently high throughout the night, including right after you wake up in the morning. The rise in testosterone levels itself may be enough to achieve an erection. 

2. Mental relaxation

A brief overview of corticosteroid hormones

Everyone experiences an adrenaline rush at some point in their lives. But what exactly is adrenaline? Well, it belongs to a group of hormones known as corticosteroids. These hormones are known for their function in producing fight-or-flight responses during times of stress or when you find yourself coming face to face with a threatening situation – be it rushing your work at the eleventh hour to meet a deadline, watching a horror movie or when you’re on a roller coaster. 

Corticosteroid hormones levels fluctuate according to your sleep-wake cycle

When you’re awake, your body naturally produces corticosteroid hormones, including adrenaline. These hormones constrict your blood vessels to the penis. Consequently, less blood reaches your penis, keeping your penis in a flaccid state for most periods of the day.

However, during sleep, your brain relaxes. As a result, fewer corticosteroid hormones are produced, allowing more blood to flow to your penis. This, partnered with the rise in testosterone levels as aforementioned, helps make night-time erections possible.

3. Physical stimulation

Last but not least, your morning boner can be a result of physical stimulation throughout the night. While you’re asleep, you or your partner may unknowingly touch your genitals. Your body picks up this stimulation and develops an erection in response. Even the slightest graze from your pillow or bolster can induce this response. 

What Does NOT Cause your Morning Boner

Contrary to popular beliefs, racy dreams don’t cause your morning boner. Erections are a normal part of REM sleep in males, regardless of the contents of one’s dreams.  Neither are night-time erections related to whether you had sex before going to bed or how full your bladder is. 

Your Morning Boner Indicates Good Health

Frequently waking up to a morning glory is a green flag that you’re generally healthy. It indicates that your heart, circulatory system and nervous system are in good condition. Moreover, it also indicates that your body is physiologically capable of getting and maintaining an erection. In other words, frequently getting your morning boner puts you at lower risk of physiological erectile dysfunction (ED). 

What Does It Mean If You Have No Morning Boner?

If your penis still snoozing even after you’ve awakened, it may or may not be a cause for concern.

1. Age and declining testosterone levels

Firstly, testosterone levels decrease as one becomes older, especially between the ages of 40 and 50. Thus, it’s normal for older men to have fewer morning erections compared to their youthful counterparts. 

With that being said, if you’re an older man who has noticed a lack of morning boners, don’t panic about ED just yet. A study has shown that a lack of night-time boners in older men does not correlate with the inability to achieve waking erections, which means that older men can still have healthy and firm erections during normal sex. 

2. Waking up at the “wrong time”

It’s okay to not wake up with a morning boner occasionally, even if you’re young and healthy. On most mornings, you wake up at the end of a REM cycle, which explains your morning erections. However, you may also wake up at different points in your sleep cycle, such as when you’re not in REM sleep. This is especially likely if you use an alarm to wake up in the morning. 

3. Underlying medical conditions or medicines

Besides the generally harmless reasons mentioned above, your missing morning boner may be a sign of something more serious if it occurs frequently. This can be a red flag that you have an underlying medical condition and/or physical ED. 

Physical ED can be due to many medical conditions. These conditions work against your penis by blocking blood and nerve supply to your penis in one way or another, which is required for an erection. Some of the common medical conditions include:

  • High blood pressure
  • High cholesterol
  • Diabetes 
  • Overweight or obese
  • Testosterone deficiency

Furthermore, certain medications also have a role to play in preventing your member from standing in the morning. In particular, painkillers and antidepressants are common culprits of a flaccid morning penis. 

4. Poor sleep quality

A study published by The Journal Of Sexual Medication also revealed that a man’s sleep quality can affect how often he experiences night-time erections and morning boners. Your sleep quality determines how many sleep cycles you undergo, which correlates to the number of night-time erections you will have. Essentially, having poor sleep quality means that you will undergo the REM stage of sleep fewer times, leading to fewer night-time erections and a lower probability of you waking up with an erection.

Test Yourself with Postage Stamps

Yeap, you read that right. If you aren’t getting morning boners and are unsure if you’re getting night-time erections, you can use postage stamps to help you. This is known as the nocturnal penile tumescence (NPT) stamp test, or simply the postage stamp test, and it is to be carried out over 3 consecutive nights. 

This test is easy to perform and doesn’t require any pesky, expensive and complicated equipment. All you need are a few postage stamps (the denominations of your stamps don’t matter) with perforated edges. If you aren’t sure what that means, stamps with perforated edges are connected by a row of small holes that allow them to be easily torn apart from each other. 

How it works

  1. Get a strip of 4 to 6 stamps per night. 
  2. Wrap the strip of stamps around the shaft of your penis. Make sure the strip of stamps is long enough so that the first and last stamps overlap. Moisten the top stamp and seal it over the bottom one, or use adhesive tape. 
  3. During an erection, not only does the penis become longer, but it also becomes thicker. 
  4. Check the strip of stamps in the morning after you wake up. If the perforations between the stamps are torn, it signals that you had at least one night-time erection. 

Don’t have any perforated stamps lying around at home?

Don’t worry about that. You can always make your own perforated “stamps” with a strip of paper and scissors. Click here to watch a video on how to DIY your own perforated “stamps”.

Disclaimer

It is possible for a male to move around during sleep in a way that causes the perforations between the stamps to tear without having a night-time erection. This results in a false positive.

Also, while the postage stamp test may tell you whether you’re having night-time erections, it doesn’t reveal anything about their qualities and durations. Hence, if you suspect that you may have ED, we advise that you consult a doctor.

When to See a Doctor

1. Sudden loss of erectile function

Once again, not having a morning boner occasionally isn’t a cause for concern. However, if you notice a sudden decrease in the frequency of your morning boner, or if you can’t get or sustain an erection during sex, you should see a doctor about it.

2. Painful erections and/or erections that don’t go away

Usually, most morning boners will subside on their own within 30 minutes. However, if your morning boner is still standing for 1 hour or longer after awakening, or if it becomes painful, something may be wrong. Contact a doctor immediately. 

Outlook

“People don’t ever realise that they take things for granted until it’s gone.” Indeed, not being greeted by the familiar morning boner upon awakening might come as a shock. While losing your morning boner occasionally is totally normal, especially as you age, losing it too often isn’t a good sign for your general and sexual health. 

If you are concerned about ED, fill in a simple questionnaire to get over with the awkward questions. We’ll then connect you with one of our friendly doctors for an online video consultation, and if prescribed, we’ll deliver your medication right to your doorstep!

References

  • Holland, K. (2018, September 17). What Causes Morning Wood? Healthline. https://www.healthline.com/health/mens-health/morning-wood. 
  • Youn, G. (2017). Why Do Healthy Men Experience Morning Erections? The Open Psychology Journal, 10(1), 49–54. https://doi.org/10.2174/1874350101710010049 
  • Sherer, D. M., Eggers, P. C., & Woods, J. R. (1990). In-utero fetal penile erection. Journal of Ultrasound in Medicine, 9(6), 371–371. https://doi.org/10.7863/jum.1990.9.6.371 
  • Schiavi, R. C., & Schreiner-Engel, P. (1988). Nocturnal Penile Tumescence in Healthy Aging Men. Journal of Gerontology, 43(5), 146–150. https://doi.org/10.1093/geronj/43.5.m146 
  • Zhang, Y., Chen, S., Ma, G., Lai, Y., Yang, X., Feng, J., Zang, Z., Qi, T., Wang, B., & Ye, L. (2018). 632 Consecutive nightly recordings are required for the accurate monitoring of nocturnal erections. The Journal of Sexual Medicine, 15(7), S367. https://doi.org/10.1016/j.jsxm.2018.04.539 
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Sexual Health

“Whiskey Dick”: Alcohol-Induced Erectile Dysfunction and How To Get Rid of It

“Whiskey Dick”: Alcohol-Induced Erectile Dysfunction and How To Get Rid of It
Image credit: iamkeithmiller on Deviant Art

Alcohol can calm your bedroom jitters, but have one too many and you may find yourself facing a bigger disaster – the inability to get hard. Here’s what every man needs to know about “whiskey dick”, also known as alcohol-induced erectile dysfunction.

What is “Whiskey Dick”?

“Whiskey dick”, also known as alcohol-induced erectile dysfunction (ED), is when a man is unable to get an erection after drinking alcohol. But don’t be misled by its name! “Whiskey dick” isn’t only caused by whiskey; all types of alcohol are in cahoots against your penis. 

Is “Whiskey Dick” Really True? Or is it Just a Myth?

Unfortunately, “whiskey dick” is very much a reality for many men. A study conducted by the University of Washington revealed that sober men were able to achieve an erection more quickly than intoxicated men. In fact, several men were completely unable to achieve an erection after drinking alcohol. 

How Alcohol Affects your Erection

1. CNS depressant

Alcohol is a central nervous system (CNS) depressant, causing both your brain and body to become slow and sluggish. Also, your body channels more of its resources to processing the alcohol rather than helping your willy stand.

2. Dehydration and reduced blood flow

Do you find yourself frequenting the bathroom way more often than usual during your booze nights out? That’s because alcohol causes your body’s water to be lost quickly, leading to dehydration. This reduces the total blood volume, as well as cause the release of a hormone known as angiotensin. Angiotensin constricts blood vessels, including those that travel to your penis. As a result, less blood flows to your penis, making it hard for you to get hard. 

3. Mental focus and coordination

Moreover, sexual arousal requires mental concentration, which dwindles as you drink more and more alcohol. The reduced mental focus, partnered with hampered coordination and slower reaction time, cooks up a recipe for a less than stellar performance under the duvets.

How Many Drinks Does it Take to Knock out Your Penis?

It’s a slippery slope, really. A little alcohol can help chase your nerves away, but drink a little too much and you find yourself tipping over to the disaster at the opposite end of the spectrum – ED. So, how many drinks is the limit?

There’s no magic number on how many shots you can have. It varies from person to person since not every man’s alcohol tolerance is the same. What might lead to a high in one man can be the downfall of another man’s penis. This depends on many factors, such as:

  • Age
  • Body weight
  • Body composition
  • Metabolism rate
  • Ethnicity
  • Whether you ate before drinking
  • How much water you drank
  • How fast you consumed the alcohol

Is There Anything that I Can Do About Alcohol Impotence?

There’s only one thing you can do – sober up. Alcohol-induced ED will only last as long as it takes for you to sober up. On such nights, time is your best friend. It’s best to call it a night and sleep it off! Also, do keep yourself well-hydrated too (with water, not alcohol, please!). Meanwhile, communicate well and assure your partner that it’s because of the alcohol and not a lack of attraction. 

Besides, we aren’t exactly great decision-makers when drunk. A tipsy night can lead to haughty decisions that screams regret the following morning. A 2016 study found that risky sexual behaviours, such as unprotected sex, are more common among men when under the influence of alcohol. Not only can this spiral into unwanted pregnancy, but it can also increase the risks of STI transmission. 

Can I Take ED Pills to Resurrect My “Whiskey Dick”?

If you were thinking of popping ED pills such as Viagra and Cialis as a quick solution, we’re sorry to break this to you – ED pills aren’t going to do much to toughen up your drunken wood. Waiting till you’re sober remains your best bet in this case. 

Tips for Preventing “Whiskey Dick” in Future

Well, experiencing the dreaded “whiskey dick” once is enough. Don’t let history repeat itself! You definitely don’t want to go through all that awkward pauses and bumbling apologies on a drunken night again. Hopefully, these tips will help you pull through your tipsy nights in future:

  • Set a limit for the night and go for fewer drinks (a maximum of 2 drinks for men). Any more than that and you risk your sex drive taking a nosedive. 
  • Choose drinks with lower alcohol content, such as beer and malt liquor. Otherwise, mix your drinks to make them less strong! Your “whiskey dick” depends on the total blood alcohol content in your body. That is, you’re more likely to get a “whiskey dick” within a few sips of hard liquor as compared to drinks with lower alcohol content.
  • Don’t drink on an empty stomach! This is pretty much common sense for the frequent drinkers. When you drink on an empty stomach, alcohol enters your bloodstream directly, accelerating your risk of intoxication and “whiskey dick”. On the other hand, grabbing a bite before you drink slows down alcohol absorption, hence preventing intoxication. 
  • No chugging! While chugging may help you look like a cool dude at that moment, it’s going to extinguish any potential sizzling hot moments in your bedroom later that night. Sip your drinks slowly instead.
  • Pace yourself. Other than sipping your drinks slowly, you should also alternate between alcohol and water.

Chronic Drinkers, Beware!

Sure, “whiskey dick” might be a one-off thing for some men, but chronic drinkers are way more likely to experience the long-term effects of alcohol on their dicks. In a study conducted on 100 men who were chronic heavy drinkers, 72% reported having one or more sexual dysfunction, including ED, low sexual desire, and premature ejaculation (PE). Essentially, we’re warning you that chronic alcohol consumption can mess with your penis and sex life real bad in the long run. 

What to Do if Your Partner is Having the “Whiskey Dick”

If your partner is experiencing the “whiskey dick”, don’t take it personally. “Whiskey dick” isn’t a reflection of how attracted your partner is to you. Also, don’t try to help him get it back up! This could backfire and make him feel worse about it. Instead, reassure him that you’re cool about it. You could call it a night, but if you and your partner want to keep the night going, try other techniques that don’t require a boner, such as oral sex and erogenous play.  

The Bottom Line

Less is more when it comes to alcohol on a date night. While it’s normal for men to have a “whiskey dick” after having one too many, it can be easily prevented by practising responsible drinking and sex. 

However, if you’re experiencing ED despite not drinking alcohol or drinking very little alcohol, we advise you to seek medical help. At Arx, simply fill in a questionnaire to get over the awkward questions. Shortly after, we’ll connect you with one of our licensed doctors who’ll help you find out what’s causing your ED and prescribe your medications if needed. 

References

  • George, W. H., Davis, K. C., Norris, J., Heiman, J. R., Schacht, R. L., Stoner, S. A., & Kajumulo, K. F. (2006). Alcohol and Erectile Response: The Effects of High Dosage in the Context of Demands to Maximize Sexual Arousal. Experimental and Clinical Psychopharmacology, 14(4), 461–470. https://doi.org/10.1037/1064-1297.14.4.461 
  • Scott-Sheldon, L. A., Carey, K. B., Cunningham, K., Johnson, B. T., & Carey, M. P. (2015). Alcohol Use Predicts Sexual Decision-Making: A Systematic Review and Meta-Analysis of the Experimental Literature. AIDS and Behavior, 20(S1), 19–39. https://doi.org/10.1007/s10461-015-1108-9 
  • Centers for Disease Control and Prevention. (2020, December 29). Facts about moderate drinking. Centers for Disease Control and Prevention. https://www.cdc.gov/alcohol/fact-sheets/moderate-drinking.htm
  • Benegal, V., & Arackal, B. S. (2007). Prevalence of sexual dysfunction in male subjects with alcohol dependence. Indian Journal of Psychiatry, 49(2), 109–112. https://doi.org/10.4103/0019-5545.33257 
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Sexual Health

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

Does Porn Cause Erectile Dysfunction?
Image credit: Brittany Falussy

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. 

Disclaimer

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. 

References

  • 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. https://doi.org/10.1038/sj.ijir.3900905 
  • 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. https://doi.org/10.1111/jsm.12853 
  • 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. https://doi.org/10.1111/jsm.13019 
Categories
Sexual Health

Can COVID-19 Cause Erectile Dysfunction?

Can COVID-19 Cause Erectile Dysfunction?
Image credit: Pavel Iarunichev

The COVID-19 pandemic has been plastered across the headlines for over a year, and by now, you probably are already familiar with the usual symptoms of the coronavirus – fever, cough, breathlessness, and the loss of sense of smell and taste. Well, let us present you with a surprising piece of impotent news – COVID-19 can cause erectile dysfunction (ED). 

Mask up to keep it up

A study in Italy revealed a strong association between COVID-19 and ED. Men infected by the COVID-19 virus are almost six times more likely to experience ED. While more tailored research needs to be done to confirm the long-term impacts of the virus on sexual health, it’s better to be safe than sorry. 

Healthy circulation, healthy erection 

During a normal erection, blood flows into the spongy tissues of your penis, causing your penis to become firm. However, the COVID-19 virus can cause detrimental impacts on your heart and blood flow, affecting your ability to get or sustain an erection. 

Here’s what happens when the COVID-19 virus invades your body:

  1. Firstly, your body attempts to defend itself by launching a massive immune response against the virus. 
  2. This leads to dangerous levels of inflammation in your heart and its surrounding muscles, as well as on your blood vessels. 
  3. Next, the walls of your blood vessels become damaged and stiff, and their ability to push blood throughout the body becomes hindered.
  4. This disrupts the blood flow to your penis, especially since blood vessels to your penis are very small and narrow to begin with. 
  5. Eventually, with insufficient blood filling up the spongy tissues of your penis, your penis remains flaccid. This is known as erectile dysfunction (ED).

Mental exhaustion from the pandemic

The pandemic has affected everyone in many ways – some have lost their jobs, some are working longer hours due to WFH (work from home) measures, some are deprived of social interaction, and some may simply be having a hard time adjusting to the new normal. Whatever it is, the COVID-19 pandemic has undoubtedly taken a toll on many people’s mental health, whether or not they have had the virus. In fact, a recent study conducted by AIA revealed that 9 in 10 Singaporeans are still struggling with their mental health one year into the pandemic, with men and young people are the most affected.

Unfortunately, when your mental health deteriorates, so does your sexual health. Stress, anxiety and depression are known risk factors of ED, interrupting your brain signals that are usually responsible for producing an erection. Hence, if your sex life has been underwhelming and disappointing recently, the COVID-19 pandemic may be the culprit. 

Stay away from the pandemic and the flaccid penis panic

Here are some tips on how you can cope with the COVID-19 pandemic and reduce your risks of ED. 

  1. Mask up and get vaccinated: Masks and vaccines are your best friends that protect you from the COVID-19 spread. Need we really say more? 
  2. Stay active: Physical activity promotes blood circulation around your body, including to your penis. You can slowly build up an exercise routine, aiming towards at least 30 minutes of exercise on most days of the week. 
  3. Relax: Amidst the stress and anxiety stemming from the pandemic and WFH measures, it’s important to be kind to your mind. Good mental health also reduces your risk of ED. Take deep breaths, meditate and make some time to do the things that you enjoy. You can also confide in your loved ones about your concerns. 

Experiencing ED but cringing at the thought of visiting the doctor for this? Let Arx help you. Speak with one of our doctors now to explore your ED treatment options, all from the comfort of your own home. 

References

  • Sansone, A., Mollaioli, D., Ciocca, G., Colonnello, E., Limoncin, E., Balercia, G., & Jannini, E. A. (2021). “Mask up to keep it up”: Preliminary evidence of the association between erectile dysfunction and COVID‐19. Andrology. https://doi.org/10.1111/andr.13003
  • 9 in 10 Singaporeans still struggling with their mental health one year into the pandemic, men and younger adults most worried. (2021, April 15). AIA Group. https://www.aia.com.sg/content/dam/sg/en/docs/press-releases/2021/aia-health-matters-survey-2021.pdf.
  • Nazario, B. (2021, May 14). COVID-19 and Erectile Dysfunction: What to Know. WebMD. https://www.webmd.com/lung/covid-erectile-dysfunction.
  • Kresch, E., Achua, J., Saltzman, R., Khodamoradi, K., Arora, H., Ibrahim, E., Kryvenko, O., Almeida, V. W., Firdaus, F., Hare, J. M., & Ramasamy, R. (2021). COVID-19 Endothelial Dysfunction Can Cause Erectile Dysfunction: Histopathological, Immunohistochemical, and Ultrastructural Study of the Human Penis. The World Journal of Men’s Health, 39. https://doi.org/10.5534/wjmh.210055
  • Smith, J. (2021, March 5). Why COVID-19 Might Lead to Erectile Dysfunction in Some People, According to Doctors. Prevention. https://www.prevention.com/health/health-conditions/a34963722/erectile-dysfunction-covid-19-coronavirus/.
Categories
Sexual Health

Erectile Dysfunction (ED): Symptoms, Causes, Treatments & More

Erectile Dysfunction: Symptoms, Causes, Treatments & More
Image credit: Adrià Ramírez

Are your erections, or rather, lack thereof, causing disappointing nights for you? We’ve got you covered! Here’s a comprehensive guide on everything you need to know about erectile dysfunction.

What is erectile dysfunction?

Erectile dysfunction (ED), sometimes known as impotence, refers to the inability to get or sustain an erection that is firm enough for sex. It is one of the most common sexual problems that men encounter. In fact, a study published by the Singapore Medical Journal has revealed that among Singaporean men above the age of 30, about 1 in 2 of them have had ED at some point in their lives. 

Symptoms of erectile dysfunction

If your penis fails to perk up very occasionally, chances are it is completely normal, especially if you’re recently feeling a little stressed out. However, if you routinely have difficulty getting or maintaining your erection, you might want to get it checked out – it may be ED. Some men also find themselves losing interest in sexual activities or having lower self-esteem about their erections. These psychological factors may ultimately result in ED.

The mechanics of erectile dysfunction

Imagine someone filling up a balloon with water. The balloon expands in size and becomes more turgid. Likewise, when a man is sexually aroused, your brain sends signals which cause blood to flow into your penis. Blood fills up spongy tissues, known as corpora cavernosa, causing the penis to become more rigid.

Now, imagine if the tap that you are using to fill the balloon is faulty. Water flows out so slowly that there isn’t enough force to stretch and fill up the balloon. That’s exactly how ED works. When blood flow to your penis is blocked or slowed down, your penis remains flaccid. Other causes of ED may be a disruption in brain signals arising from depression, anxiety or stress. 

Causes of erectile dysfunction

You might have heard that ED is “all in your head”. For many years, experts believed that emotional and psychological problems were the sole causes of ED. Well, this is partially correct and partially wrong. Here’s the truth – ED can be caused by a multitude of factors, including emotional, physical, lifestyle factors and many more. 

Psychological and emotional causes of erectile dysfunction

Your brain plays a key role in a good erection. It is responsible for feelings of sexual excitement, as well as transmitting nerve signals to allow blood flow to your penis. The common psychological culprits of poor erection include: 

  • Depression
  • Anxiety
  • Stress
  • Low self-esteem
  • Guilt
  • Performance anxiety
  • Relationship conflicts

Physical causes of erectile dysfunction

Contrary to popular beliefs, ED is not “all in your head”. Any chronic disease that decreases blood flow can result in ED. If you have any chronic diseases, it is important to keep it under control. Common diseases include:

  • Diabetes
  • High blood pressure
  • High cholesterol

Besides those mentioned above, there are also other less common, albeit more serious diseases that can contribute to ED. These include: 

  • Hormonal imbalance
  • Parkinson’s disease
  • Alzheimer’s disease
  • Benign prostate hyperplasia (BPH)

Does old age cause erectile dysfunction?

Is age just a number in the onset and progression of ED? Well, maybe, maybe not. Although ED becomes more common with age, growing old does not always cause ED. Some men remain sexually functional, even in their 80s. On the other hand, younger men, including teenagers, can have ED due to their lifestyle factors such as drinking, smoking and overall health.

Treatments for erectile dysfunction

Depending on what caused your ED, you may be recommended for different treatment options. Most ED pills belong to a class of medication known as “phosphodiesterase type 5 inhibitors (PDE5 inhibitors)”. To put their mechanism of action in simple terms, these pills cause your blood vessels to relax, increasing the blood flow to the penis. 

Different pills follow different treatment schedules. Generally, ED pills can be categorised into two groups: the as-needed pills and the daily pills. 

As-needed pills

These pills are taken prior to any sexual activity. They are recommended for men who are able to predict when they have sex or men who do not wish to take pills daily. 

  • Viagra® (Sildenafil), also known as the blue pill. These pills have a long history and were the first FDA-approved oral treatment for ED. 
  • Generic Sildenafil. These pills contain the same ingredient and work exactly the same as its branded option, Viagra®. In comparison with Viagra®, generic sildenafil is much more affordable and wouldn’t burn a hole in your wallet. Generic sildenafil is also the most popular treatment option at Arx.
  • Spedra® (Avanafil). These pills are great for men who prefer spontaneity. They are fast-acting and are effective just 15 minutes after taking them.
  • Cialis® (Tadalafil)*. These pills are long-lasting and are effective for up to 36 hours after taking them. 
  • Levitra® (Vardenafil). These pills are the branded alternatives to Viagra®, the blue pill.

Daily pills

These ED pills are to be taken every day. They work best for men who don’t like to plan ahead and want to be ready around the clock.

  • Cialis® (Tadalafil)*. These pills are for daily use and provide greater flexibility in terms of sexual activity schedule. 

*Cialis® (Tadalafil) may come in the form of both as-needed pills or daily pills, depending on the strength of the pills.

Other treatment options

Other options include testosterone therapy if you have low testosterone, penile injections, vacuum erection devices, intraurethral medications, penile implants or even surgery. 

Lifestyle changes for better performance

Keeping a healthy lifestyle not only boosts your overall health, but also your sexual health. Here are some tips that you can follow: 

  • Keep a heart-healthy diet: A poor diet that is full of fats and sugars can lead to clogged arteries, diabetes and heart disease, which eventually spirals into ED. Reduce fats and sugars while incorporating more vegetables and fruits into your diet. 
  • Stay within your healthy weight range: If you are overweight, it’s best that you shake off that excess weight.
  • Exercise regularly: Not only does exercise promote blood circulation, it is also amazing at alleviating stress. In short, exercise targets both root causes of ED. Having 30 minutes of exercise for at least 5 days a week is bound to boost your health and energy, both in and out of the bedroom.
  • Quit smoking and drinking: As both smoking and drinking increases your risk of ED, we recommend that you sever your ties with them. Trust us, your body and penis will thank you. 

Finding the best treatment for erectile dysfunction

There is no one-size-fits-all treatment for ED. To choose the best treatment option for yourself, take into account your lifestyle, preferences, medical history and affordability. If you’re experiencing ED, it’s a good idea to speak to a doctor at Arx. They’ll help you find the solution that’s right for you, and potentially catch other health problems before they become severe.

References

  • Tan, J. K., Hong, C. Y., Png, D. J., Liew, L. C., & Wong, M. L. (2003). Erectile dysfunction in Singapore: prevalence and its associated factors – a population-based study. Singapore medical journal, 44(1), 20–26.
  • Lakin, M., & Wood, H. (2018, June). Erectile Dysfunction. https://www.clevelandclinicmeded.com/medicalpubs/diseasemanagement/endocrinology/erectile-dysfunction/. 
  • Urology Care Foundation. (n.d.). Erectile Dysfunction (ED). Erectile Dysfunction (ED): Symptoms, Diagnosis & Treatment. https://www.urologyhealth.org/urology-a-z/e/erectile-dysfunction-(ed). 
  • Bandukwala, N. Q. (2019, June 10). A Visual Guide to Erectile Dysfunction. WebMD. https://www.webmd.com/erectile-dysfunction/ss/erectile-dysfunction. 
  • Santos-Longhurst, A. (2017, December 29). Lifestyle Changes and Natural Treatments for Erectile Dysfunction. Healthline. https://www.healthline.com/health/type-2-diabetes-lifestyle-factors-and-erectile-dysfunction.