Erection Dysfunction

Is insufficient rigidity / ED just a part of old age?

Insufficient rigidity / erection dysfunction does not have to be a part of getting older. It is true that as you age, you may need more stimulation (such as stroking and touching) to get an erection. You might also need longer time to get an erection after the last one. However, older men should still be able to get an erection and enjoy sex.

 

My erection seems to be not as strong as before, how can I know if I have insufficient rigidity / ED?

Not being able to achieve or maintain an erection can be early symptoms of insufficient rigidity / ED. If you have this problem and it persists on and off for more than 3 months causing troubles to your life, you should consult a doctor for the matter. The earlier you receive the treatment, the higher chance is for you to recover from insufficient rigidity / ED. It is believed that insufficient rigidity / ED can be an early sign of other illnesses, such as heart diseases.

 

I have insufficient rigidity / ED because of low libido (low sex drive). Is there any suitable treatment for me?

There are lots of possible causes for low sex drive, such as stress, tiredness, relationship problems, sexual boredom, low testosterone level, psychological factors and others. Sometimes, it is hard for patients to tell if they have insufficient rigidity / erectile dysfunction problems or simply low sex drive since both causes can lead to erection difficulty in men. If insufficient rigidity / erectile dysfunction problems left untreated, some patients may lose their sex drive entirely after a period of time. Our doctor will consider all possible causes of your problem and recommend the most suitable treatment to you.

 

What is the best treatment for insufficient rigidity / ED?

There is not any single best treatment for insufficient rigidity / ED. Our experienced medical professionals will do assessment tests to find out underlying causes to their patients’ insufficient rigidity / erection dysfunction problems. Base on the test results, our medical experts will tailor-make treatment programs catering to their patients’ special needs.

The popular oral medications, such as Viagra, Cialis and Levitra, may help some patients with their erection problems (said to be effective on 60 to 80 percent of patients who have tried it); however, not all of them are suitable for such treatment, especially those who have chronic heart diseases, liver and kidney problems. Moreover, oral medications do not cure the problem. That said, they will not help to alleviate patient’s psychological burden.

 

Should I try medicine treating insufficient rigidity / ED without a prescription?

Patients are strongly advised NOT to try any drugs without a prescription. There is no guarantee if these drugs are safe, effective, or if their ingredients are pure to use. These drugs may cause severe health problems, such as hypotension (low blood pressure), hypoglycemia (low blood glucose), acute renal and liver failure, and even death.

 

Are there any other reliable and medically proven methods available if oral medications for insufficient rigidity / erectile dysfunction are ineffective for me?

Our experienced doctor will help you find the most suitable treatment program if oral medications are ineffective for you.

 

Are there any reliable and medically proven methods available for patients who have prostate cancer surgeries earlier, or those who have other chronic illnesses?

We have served many insufficient rigidity / ED patients who also suffer from other illnesses. Most of them successfully regained their healthy sexual life after having treatments with us.

 

Is there any reliable and safe treatment for elderly men at his 80s?

Yes. We have successfully helped patients at their 80s to regain satisfaction in their sexual life. It is perfectly normal for any elderly people to have an active sex life.

 

Is there any relationship between uncontrollable ejaculation (PE) and insufficient rigidity (ED)?

Uncontrollable / premature ejaculation (PE) may be a feature of insufficient rigidity / erectile dysfunction (ED), or may be the other way round. Patients can start having PE, which can be further developed into ED.

 

Is Chinese or herbal medicine used in your center for treating ED / PE?

We prescribe only registered Western medicine to our patients. Recent studies showed that herbal supplements are either ineffective or can cause adverse side-effects in patients. Earlier in 2008, the U.S. Food and Drug Administration issued a consumer warning regarding dangerous ingredients in certain dietary supplements. Prior to this, a local article titled “Analogues of erectile dysfunction drugs: an under-recognized threat” also pointed out un-registered medications for ED / PE available on the market or over the internet can be hazardous to health.

 

Premature Ejaculation

Can we control ejaculation?

Normally, men can control ejaculation. However, those who suffer from uncontrollable / premature ejaculation may not be able to or face difficulties in doing so. You are advised to consult our doctors if you encounter such problem. 

 

What is Delayed Ejaculation (Retarded Ejaculation)?

Delayed ejaculation is the inability to ejaculate or the persistent difficulty in achieving orgasm either during intercourse or with manual stimulation. Normally, a man can achieve an orgasm within 0 to 5 minutes after the onset of active thrusting during intercourse, whereas a man suffering from delayed ejaculation either does not have orgasms at all or cannot have orgasms until after prolonged intercourse which might last for more than 30 to 45 minutes. In most cases, delayed ejaculation presents the condition in which a man can achieve orgasms with masturbation, or foreplay, but not during sexual intercourse.

 

Causes

Delayed ejaculation can result from psychological or physical causes.

Psychological Causes

• Lack of attraction for a partner
• Anxiety about pleasing a partner
• Fear of causing pregnancy
• Overly frequent masturbation may reduce the ability to ejaculate because pressure, angle and grip during masturbation can create an experience so different from sex with a partner
• Traumatic events (such as being discovered in masturbation or learning one’s partner is having an affair)

Physical Causes

• Use of certain drugs, particularly antidepressants
• Excessive use of alcohol
• Neurological diseases, such stoke or Spinal Cord Injury; endocrine diseases, such as diabetes and prostate problems, which may affect men’s ability in achieving orgasms during sexual activities

 

Consequences

When men are younger, delayed ejaculation may not pose as a problem for them. However, this may develop into a major problem for men when they get into stable relationships, especially when they wish to have their own children.

Delayed ejaculation problems frustrate both men and women. As for female partners, they often feel resentful or even insulted if their men do not ejaculate during sexual intercourse. If the problems are not addressed or remedied, they may lead to marital stress, sexual dissatisfaction, inhibited sexual desire and avoidance of sexual contact. 

 

Treatment

At present, there is no medication that helps trigger an orgasm in men. If a man has never ejaculated through any forms of stimulation (such as vaginal or anal intercourse, oral sex, masturbation or wet dreams), he should consult an urologist to check if there is a congenital or physical cause for the problem. If the patient’s delayed ejaculation problem is caused by a disease, he is advised to seek treatment to clear the disease first. And if delayed ejaculation problem is a side effect of medication, the patient should check with doctors to see if there is any medication options for him. For some patients, they may reduce masturbation, which is an effective and easy way to raise sensitization of the nerves in penises for achieving more rapid orgasms during sexual intercourse.  

Most of the cases, it involves both partners in the treatment. It is common to include a series of homework assignments for the couple to practice at home, where privacy helps them reduce performance anxiety and concentrate on seeking pleasure. 

If there are existing problems in the relationship, such as inhibited sexual desire, between a couple, our medical professionals will try to improve their emotional intimacy as the first step to enhancing their sexual relationship.

Instead, the partner should create a relaxed atmosphere in which her man will feel free and enjoy sexual pleasure without worrying about any ejaculation issues. 

The therapist will usually educate the couple about the fundamentals of sexual response and how to communicate and guide the partner to provide ideal stimulation, rather than trying to make a sexual response occur.  A man should concentrate on the pleasure he gets rather than worrying about when and whether his ejaculation is going to occur.  The partner should also be tactful and should not put pressure on the man by asking him whether he has ejaculated or not.  Instead, a partner should create a relaxed atmosphere in which a man will feel free and enjoy sexual pleasure without worrying about ejaculation.

Open discussion of anxieties and fears contribute to better sexual relationships and normal sexual satisfaction. Sex Therapy Service Details

Please click here for details of our Certified Sex Therapist.

You are advised to make an appointment in advance. For booking and enquiries, please call 2375-3322.

 

Can uncontrollable / premature ejaculation develop later in life?

Uncontrollable / premature ejaculation (PE) can occur at any age. Surprisingly, aging does not appear to be a cause of PE. However, the aging process typically causes changes in erectile function and thus, ejaculation. Erections may not be as firm as they once were. Erections may be maintained for a shorter period of time before ejaculations occur.

 

Is uncontrollable / premature ejaculation merely psychogenic?

Uncontrollable / premature ejaculation can be caused by psychological or physical factors, or a combination of both. The most common cause is the oversensitivity of glans in young patients.

 

Is there any relationship between uncontrollable ejaculation (PE) and insufficient rigidity (ED)?

Uncontrollable / premature ejaculation (PE) may be a feature of insufficient rigidity / erectile dysfunction (ED), or may be the other way round. Patients can start having PE, which can be further developed into ED.

 

Why uncontrollable / premature ejaculation seems to be improved after taking alcohol or recreational drugs?

The time of ejaculation may be delayed for some patients after they become desensitized by taking alcohol or recreational drugs. However, it will be harmful to health in the long run if patients become dependent on them.

 

Is there a promising treatment for uncontrollable / premature ejaculation?

From our experience, combining medication, counseling and behavioral therapy in treating patients is the best approach. However, if uncontrollable ejaculation (PE) is caused by other physical factors, such as insufficient rigidity / erectile dysfunction, the underlying factors should be handled first. PE will improve gradually when such underlying causes are dealt with.

 

Is Chinese or herbal medicine used in your center for treating ED/PE?

We prescribe only registered Western medicine to our patients. Recent studies showed that herbal supplements are either ineffective or can cause adverse side-effects in patients. Earlier in 2008, the U.S. Food and Drug Administration issued a consumer warning regarding dangerous ingredients in certain dietary supplements. Prior to this, a local article titled “Analogues of erectile dysfunction drugs: an under-recognised threat” also pointed out un-registered medications for ED / PE available on the market or over the internet can be hazardous to health.

When do I need to receive circumcision?

If your foreskin is redundant or too tight, you may need to receive circumcision when the following conditions occur:

• Phimosis
• Foreskin Infection
• Urinary Tract Infection
• Lowered quality of sex life
• Paraphimosis

 

What is the suitable age for circumcision? Is there any limitation for children? Is general anesthesia required?

Circumcision is suitable for males aged 1 year or above. For children aged 10 years and under, general anesthesia is recommended during surgery. General anesthesia needs to be done in hospitals, while local anesthesia can be conducted in clinics.

 

Should babies receive circumcision at birth?
Circumcision for new born babies has the benefit of less bleeding and faster recovery. On the flip side however, early circumcision may sometimes result in foreskin being too short which might affect the development of children. Parents should consult Specialist in Paediatrics before making a decision.

Foreskin which cannot be retracted to expose the glans is common in new born infants. Usually around the age of 5, the glans will be exposed naturally. If the foreskin is still not retractable by that time, or if inflammation occurs regularly due to a tight foreskin, a circumcision should be considered.

 

What are the differences between the new version of laser circumcision and traditional circumcision?

Surgical scalpel is used for excision in traditional circumcision; a laser beam and a specialized mental ring is used in the new version of laser circumcision (patent application for this treatment has been filed). The use of laser beam in the latter not only allows a fast cut, but also minimal bleeding and a very tidy wound. Further, new version of laser circumcision results in less post-operative pain when compared with the traditional counterpart, which also has a higher risk of bleeding. High dose of pain-killer is not necessary in the new version of laser circumcision.

The surgery will be completed in 15-20 minutes with the new version of laser circumcision while the traditional one requires 30 minutes. One shot of local anesthetic at the bottom of the penis shaft is applied in the former while three shots of local anesthetic are applied in the latter, two in the back of the penis shaft and one in the bottom.

 

How are the procedures charged?

The consultation fee of circumcision by our surgical specialist is HK$600. The service charge is HK$8,500-10,500 for laser circumcision. The consultation fee will be deducted from the charge of surgery if our clients receive the procedure within the day of consultation.

 

Is surgical charge inclusive of medication fees?

Medicine is excluded from the surgical charge. Pain-killers, anti-inflammatory drugs (if applicable) and drugs that suppress erection are charged additionally.

 

Do I need to return to clinic for follow-up?

You would need to return for follow-up and having the wound checked. The charge is HK$600.

 

What should I take notes on before receiving circumcision?

• Fasting for 4 hours is required (except drinking water) before surgery
• Clean the foreskin completely before surgery
• Pubic hair needs to be shaved by patients themselves before surgery
• Bring along tight underwear or swimming trunk to support the wound in position after surgery
• Expose the glans frequently a week before surgery to allow contact with clothes. It reduces glans sensitivity and discomfort after surgery
• Avoid sexual activity or masturbation for one month after surgery. To control sexual arousal, it is suggested to have intercourse or masturbation one day before surgery

 

What should I do to heal the wound after circumcision?

Things to know after surgery:

• The wound will be covered with surgical-grade skin adhesive, which is antiseptic and waterproof
• Off stitches are not needed. The stitches will be absorbed automatically within two to three weeks
• Minimal bleeding, swelling, and secretions will occur. They will disappear in a week

Important to note for wound healing after surgery:

• Press the wound mildly if minimal bleeding occurs
• Resume shower 24 hours after surgery. Avoid application of soap to the wound and soaking in the bathtub
• Clean the yellow secretions that leak out from the wound with antiseptic solution or normal saline daily
• Sit down to urinate and change the gauze daily to maintain the wound dry and clean
• Wear tight underwear or swimming pant to lock the wound in position to avoid collision. Keep the glans up to avoid edema
• Glans may be sensitive after surgery. Sensitivity varies between patients. Walking around frequently allows glans to adapt and ease the sensitivity

 

How long should I rest after circumcision?

Patient needs to rest in our clinic for only awhile before they leave. For the new version of laser circumcision, recovery is faster. Patient can resume work or school one or two days after surgery. Minimal bleeding will occur occasionally. For the traditional circumcision, longer recovery is needed. Patient can only resume work or school four or five days after surgery. Higher risk of bleeding and moderate to severe pain may occur in the first week after surgery.

 

Can I take shower or go swimming after circumcision?

For traditional circumcision, we recommend patients not to take showers during the first week; patients are instructed to clean the sutured wound daily, after the first few days after surgery. For laser circumcision, we will cover the wound with surgical-grade skin adhesive. Since it is antiseptic and waterproof, patients may take showers as usual 24 hours following surgery. The topical skin adhesive will go away gradually after about 1 week.

Since bacteria may exist in swimming pool and seawater, patients are recommended to resume swimming at least 2 weeks after circumcision.

 

How soon can I have sexual activities after circumcision?

In most cases, patients can resume sexual activities about one month after surgery. To control sexual arousal, it is suggested to have intercourse or masturbation one day before surgery.

How important is a regular health check-up?

A regular health check-up helps detect abnormal health conditions and early diseases. According to Department of Health Annual Report 2008/ 2009, Malignant Neoplasms (Cancers), Heart Diseases, Pneumonia, Cerebrovascular Diseases and Chronic Lower Respiratory Diseases were the top five leading causes of death in Hong Kong in 2008*. Regular health check-up can help detect the symptoms of such fatal or serious diseases, allowing patients to receive suitable treatments in the early stage, so as to increase the chance of cure. Thus, for diseases prevention and health protection, annual regular health check-up is recommended.

*Source: Department of Health Annual Report 2008/2009

 

What are the components of a health check-up?

A health check-up usually consists of (1) physical examination such as measurement of height, weight, blood pressure and pulse; (2) questionnaire on medical, social, domestic and lifestyle histories; (3) laboratory tests or screenings on organs’ functions or diseases such as haematological, diabetes, gout, hepatitis A & B screenings; renal, liver, thyroid, cardiac lung function tests and etc; (4) consultation and counseling.

Some health check-ups also include tumor marker tests to detect the presence of specific kinds of cancers.

 

Who should receive health check-up?

• If you are at the age of 30 or over, regular check-up on an annual basis is recommended;
• If there are closed family members suffering from genetic diseases (such as cancers or heart diseases);
• If you have doubts about your physical or psychological condition;
• If you have symptoms or confirmed having health problems;
• If there are close family members who died in their early years of life;
• If you are planning to get married.

 

What should I prepare for the health check-up?

• If you have had any medical treatments or examinations recently, please bring the reports for doctor’s reference;
• Avoid exciting activities; take enough rest before the day of check-up;
• Dress casually to let you feel more comfortable during check-up;
• Stay calm prior to the check-up for more accurate result;
• Maintain healthy diet 3 days prior to check-up. Avoid consuming too much stimulating food and drinks, such as wine, coffee;
• Ladies should avoid taking a physical check-up during menstrual period;
• Pregnant women should avoid X-ray test;
• For glucose test: you should fast for at least 8 hours prior to your check-up. (Drinking water is allowed.)
• For occult blood test: Avoid red meats such as beef, lamb, or liver 3 days prior to check-up. Ladies should avoid taking occult blood test during menstrual period.

 

What should I prepare for the pre-marital check?

Urine test, blood tests and semen tests (for males only) will be conducted in pre-marital check. We recommend ladies to perform urine test 7 days after menstrual period.

 

What should I be aware of when having semen test?

• Use a sterile bottle to collect semen through masturbation. (Get the bottle in our clinic first). Collect semen in our clinic or at a place where you feel comfortable.
• No ejaculation 7 days before the test. Abstinence for too long or too short will affect the quality of semen.
• Semen sample should not be exposed to too hot or too cold environments. The sample must be returned to our clinic within 1 hour.

 

Why should I perform tumour marker check?

According to Department of Health Annual Report 2008/ 2009, Malignant Neoplasms (Cancers) were the top killer in Hong Kong, accounting for 30% of all leading causes of death in 2008. Among all kinds of Cancers, Trachea, bronchus and lung Cancers; Colon, rectum and anus Cancer as well as Liver and intrahepatic bile ducts Cancers were the three most common Cancers in Hong Kong in 2008*. To protect you from the life-threatening Cancers, it is important to have a regular tumour marker test.

A tumour marker is a substance found in blood, urine, or body tissues that can be used in the detection, diagnosis, treatment and monitoring of cancers. There are different tumor markers and most of them are proteins. Therefore, tumor markers can be identified through tests such as blood tests to evaluate specific proteins that are associated with cancer.

A regular blood test can help identify tumour markers in the body to detect the presence of some specific kinds of cancers.

Tumour markers	Detection
AFP	liver cancer
CA15-3	breast cancer
CA19-9	pancreatic cancer; gallbladder cancer; bile duct cancer; gastric cancer
CA72-4	ovarian cancer; pancreatic cancer; gastric cancer
CA125	ovarian cancer
CEA	colorectal cancer, breast cancer, lung cancer; pancreatic cancer; gastric cancer
EBV	nasopharyngeal carcinoma
PSA	prostate cancer

*Source: Department of Health Annual Report 2008/2009, U.S. National Cancer Institute

 

How long does it take to receive the report result?

General Health Check-Up reports will be delivered to clients via email in 4 working days. Bilingual reports are provided for the ease of reading and understanding.