How to last longer in bed – Erectile Dysfunction

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

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

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

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

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

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

Do you have Erectile Dysfunction?

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

What are the possible causes?

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

1. Stress and Anxiety

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

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

2. Unhealthy Blood Vessels

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

3. ‘T’ Deficiency

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

4. Trauma or Injury

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

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

5. Chronic Diseases

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

6. Prostate Enlargement / Benign Prostatic Hyperplasia (BPH)

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

BPH also causes problems with erection.

7. Smoking

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

8. Medicines

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

– Medicines for High Blood Pressure

– Medicines for Gastritis and Stomach Ulcers

– Medicines for High Cholesterol

– Medicines for Male Pattern Hair Loss

– Medicines for Depression

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

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


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

1. Medicines

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

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

2. ‘T’ Replacement

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

3. Change of Medicines

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

4. Electro-Shock Wave Treatment (ESWT)

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

5. Vacuum Devices

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

6. Surgical Implants

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


Need more advice?

To find out more about Penile Rash or other Men’s Health issues , please visit your doctor or visit Men’s Health Clinic.

Dr. Tan and Partners @Novena (Men’s Health Clinic)


10 Sinaran Drive,
#08-31, Novena Medical Centre
Singapore 307506

+65 6397 2095

Learn more about Andrology and Infection Centre at Novena Medical Center services.


Other clinics

Come down to Our Clinics for a discussion with Our Doctors, or call our clinics for more information:

Singapore Branches


Where to find us – here

Selected clinics are open on Saturday and Sunday.


All Our Doctors are Fully Certified and Trained to conduct specialised STD Screening,  STD Testing & STD Treatment and HIV Testing.


Related Topics:

  1. Penile Discharge (Should I be Worried?)
  2. Frenulum Breve and Penile Frenulectomy
  3. Warts
  4. Molluscum
  5. HIV Symptoms
  6. Syphilis
  7. Herpes
  8. STDs General Info
  9. Premature Ejaculation
  10. Erectile Dysfunction

About Dr. Tan
Dr. Tan graduated from the National University of Singapore in 2001. His residency was in the two largest public hospitals in Singapore; Tan Tock Seng Hospital and Singapore General Hospital.

Find the profiles of our panel of doctors.


  1. Hi Dr tan

    I have ED problem, it almost 6month I can’t have a normal sex life with my wife!

    I don’t sleep well at night due to work stress that I know and currently I’m on medication atorvastatin 30mg high Cholesterol
    does this medicine affected and I just got my blood test result today bad Cholesterol is going down everything is fine

    what should i do?

  2. garyteo

    Dr.Tan what is PDE5Is and ESWT?

    • PDE5i’s are phosphodiesterase-5 inhibitors – they are medications which increase blood flow (e.g. Viagra, Levitra, Cialis) and help to improve erectile function. ESWT is electro-shock wave therapy and has also been demonstrated to improve erectile function. Please contact our clinics should you require a consult.

  3. Japan

    Hi doctor,

    If I elect to choose a penis implant, how does it work?

    Pills dont work anymore. I have depression, diabetes (or had), and cholesterol and I think my penis is shrinking from now being used in a year. I want to go straight to the implants mainly as I’m in a serious relationship where the girl can only wait so long before being fulfilled and also we plan to have children next year.

    • Dr. Julian Ng


      Erectile dysfunction is a multi-factorial condition and can be due to depression as well and also diabetes among other factors. I would suggest your concerns with your doctor in view of your depression and diabetes. Surgical option for treating erectile dysfunction is more invasive and this needs to be further assessed by a urologist on whether if it is warranted and if you are fit enough to undergo surgery in view of your medical issues.

  4. Lord voldemort

    If i consult your doctors on ED and PE issues. Will i be prescribed medicine on the same day or will there be further test involved?

    • You can get medications the same day. If further investigations are appropriate or needed, we would let you know.

  5. Chua KT

    Hi Dr,

    Can heart patient with stents install take Levitra?
    Please advise

  6. Hi sir, I am 23 year old, I had ED and PE problems. I found that my ED problem getting more serious since half year ago. It is ED and PE can be cured? I am worrying about this.

  7. Peter Murphy

    do you have any clinics in the US

  8. Raining

    Hi Doctor, i think I might have ED and PE, can it be cured?? To get my confidence back. I am from indonesia, can i visit ur clinic? And may i know how much it all cost?? Thanks Doctor..

    • Hi,
      We have several medications and non-invasive procedures for ED and PE treatment, so do come visit us for a proper consult and evaluation. Costs will depend on your clinical situation, e.g. what blood tests are required and what therapy options would best suit you.

  9. chamberlain

    weldon for your good work

  10. Hi Dr Tan,

    I am 30 this year and been married for 3 years with no child yet. I suspected that i have azoospermia and really wished that i could cure this. Which one of your clinic can you refer me to for treatment?

    • You can visit any one of our clinics. We will likely refer you for a semen analysis first. You may then need more tests to determine what could be causing the azoospermia (if present) before we can recommend the best treatment for you. Click HERE for our locations.

  11. Dear Dr.’
    I am checking to see if my ED can be cured as I am an old man but is active.

    I am 75 years old and have High Blood Blood Pressure and Cholestrol. I have visited SGH and TTSH Urologist Dept. and they prescribe me with Viagra, Levitra and Cialis. I take as prescribe but all is not effective for my ED.

    I am on the following medication:
    1. Fenofibrate 300 mg;
    2. Nifedipine LA 30mg;
    3. Aspirin 100 mg;
    4. Simvastatin 20 mg;
    5. Enalapril Maleate 10 mg.

    Will ESWT treatment works for me?

    If workable, let me know:
    1. What is the total session and cost?
    2. What is the procedure like?
    3. What is the duration of this procedure;
    4. Can I still carry on with my daily activities.

    Please check and let me have your opinion and advice.

    Thank you for your kind assistance.

    Bill Tan

    • First of all I have to tell you that we cannot give medical advice over the internet. It is still best for you to see a doctor for a proper medical consultation.

      Going by the information you provided me, I can say the best case scenario we have is to get you to a point that you respond well to a PDE5I like Viagra.
      By using ESWT, there is a 70% chance of that.
      If not, your other options are vacuum devices or penile implants.

      For more info on the ESWT, please click HERE.

  12. Hi Dr, I have ED and has been prescribed Cialis by a GP. But the GP has cease his practice since the beginning of this year, could I get a proscription from your clinic if I provide you with the name of the Clinic.

    • What you can do is to get a memo from your GP stating that he has prescribed Cialis to you and bring that memo to see us.

  13. My pennis too small,,,got any treatment for get 7 inch pennis

  14. Hi Dr. Tan,
    I am married from past 3 years and unable to have proper sex since marriage. My GP suggested Viagra but I start vomiting after having it. I did consult a urologist as well, he did x-ray and everything was OK in that. No blockage . I have gone through low T questionnaire on your site and don’t seems to have low T problem as well. Please suggest.

    • It is best to come in for a thorough consultation and assessment. Besides Viagra, there are other alternatives that may suit you better. You are welcomed to visit any of our clinics.

  15. Islam

    Sir, I have a erectile dysfunction n PE also. My sex power very low. I’m unmarried. My age 25 .i am going to marriage but I afraid. My penis harder but very fast sperm come out about 40 to 50 second. I have a girl friend new sg. One day I sex with her but I think she not happy my sex drive. How can I come out this problem . Please please please help me doctor. I’m younger but sex very low

    • Erectile dysfunction and premature ejaculation are treatable. Sometimes, they may be due to underlying health problems. I would suggest you consult a doctor to get yourself assessed properly to identify what the exact problem is, so the best treatment option can be recommended to you. Get things sorted before your marriage.
      There are medical treatments available for both ED and PE. You are welcomed to visit our clinics to see our doctors for a consultation.
      You may find this useful

  16. I’m 51 yrs old and married with 3 children. Actually, I’m having ED serious ED problem for the past 1 year. I went to see Doctor and he gave me PDE5Is. But both medicines less effective.
    Another thing, i have been having premature ejaculation since i was teenager till now.
    I need advice and what treatments available for ED and PE.
    Thank you

    • I am assuming your doctor already excluded all chronic diseases and medicines that could be causing your ED. I am also assuming you are taking the maximum dose of PDE5Is and are taking the pills correctly. That leaves us with the issues of ‘T’ and ESWT. You are welcome to see me at my clinic at Novena to discuss this. The treatment of PE is much more straightforward. Let’s get your ED fixed first.

  17. Mohd Yunus Ismail

    Dear Sir, Im suffering with ED and I tool some PDE5Is but no help. Im suffering from diabetic and Coronary heart disease. My diabetic seem under control but my ED still there. Please help

  18. Hi sir, I’m David here 25years old and still single going to get married soon… I had premature ejaculation sir… I masturbate sooner every time when I with my partner or masturbate… Not longer stay sir… I have this problem quite long period… And when I was 19years old I can do intercourse with my partner for 6 times at one night but now even twice also a bit harder… But I don’t have sex regularly maybe can say one or twice per year… Because I don’t prefer to hook up with call girls… I just get engaged so soon I’ll planning to have intercourse with my fiancee so I scared to unsatisfying her on bed… Those days I masturbate frequently 3 or 4 times per week after I getting older I control myself to 1 or twice per week to masturbate now and I also take veg and some fruits to built stamina but seems not working sir… It is being my big problem… So I hope doctor can help me to cure my problem.. .currently I’m working at SG…. So hope sir will help me…

    • I don’t quite get it. Do you have premature ejaculation or erectile dysfunction or both? In other words, can you get and maintain a good erection? If you cannot, that is ED. Or you CAN maintain a good erection but have no control over when you ejaculate? If so, you have PE. Or you can have both. You can read my article on PE for some tips and tricks on non-medical things you can do to help it. Otherwise, you can see us for medical treatment. Click here for info on PE. Click here on medical treatment for PE.

  19. Hi Dr Tan, I Have ED problem so I went to Your Clinic novena centre. Doctor take test for regarding this issue. after that doctor said your medical test all normal so you don’t worry. but I give you medicine to take everyday, doctor give me medicine 5mg for 1 month. this tablet how long I need to take. I want to know this? thatsall. thank you very much

    • Hi. Yes I was the one who attended to you. After checking you thoroughly, the conclusion was that there was nothing physically wrong with you. The medicine will help you get a better erection. If you find that this works for you, you can actually take the medicine indefinitely i.e. as long as you need. If you find that your sexual activities are not frequent, you can switch to taking an ad-hoc treatment instead i.e. take the medicine as and when you want to have sex.

  20. Sir,
    I am chandiran 29 years old, I am unmarried i have erectile dysfunction and also premature ejaculation.because of masturbating since my age of I am totally lost my erection, and also I having only one balls.I really scare to married, some years back I had good erection, my body weight 68 kg, I requested you to , how can cure this problem!!!! It can be curable or can’t? If i masturbating at this time means I feel very pain in my peneis.please tell me something about it!!!

    • Hi Chandiran,

      We may need to consider testing for ‘T’ deficiency given your history. Fortunately there are treatments available. Feel free to come to one of our clinics.

      • Hi sir may i where is your clinic locate..

        • Hi, please click here to find out where our clinics are located.

        • I’m usually at the Bencoolen branch. We’re on 180 Bencoolen St, #02-20, just opposite Burlington Square. You can find our locations in this link.

          • Adrielraj

            Dr Prem,
            It seems that i don’t have harder erection as use to be it get soft after hard.i am a diabetic and i presume the effect is of it.i want to have great erection so i can perform well on bed.Is there any safe oral supplement as well to be consumed.


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