Health.

Less than satisfied?

In our conservative Asian society, sex is a topic that is rarely discussed. However, the findings of a recent study on sexual health in the Asia Pacific region bring to light an issue that doctors say can be treated. The Asia Pacific Sexual Health and Overall Wellness (APSHOW) survey conducted by Pfizer revealed that 46% of Singaporean men suffer from suboptimal erections, with 29% suffering from frequent suboptimal erections. This is slightly higher than the average figures for the Asia Pacific region: 44% of the men surveyed reported less than optimal erections, with 24% feeling their erections are frequently suboptimal. Moreover, 88% of the women surveyed were less than completely satisfied with their partner's erection hardness. However, doctors say that suboptimal erections can be treated. Professor Li Man Kay, a urologist in private practice, explains the causes and treatments for suboptimal erections. What are the leading causes of suboptimal erections? They are the same as the causes of erectile dysfunction causes, i.e. high blood pressure, stress, diabetes, obesity, systemic heart disease and prostrate problems. What are the secondary effects of suboptimal erections? Patients feel more dissatisfaction because they find that although their erection is hard enough for penetration, it's not completely hard. As a result, it becomes a struggle for them when they want to have sex. From the partner's point of view, the sexual experience is also less satisfying. What forms of treatment are available? We treat patients with Viagra which improves the erection hardness. This will take them from grade 3, where the penis is hard enough for penetration but not completely hard, to grade 4, where the penis is completely hard and fully rigid. We also advise maintaining a healthy lifestyle. That means that patients should try to exercise, keep themselves fit, and not overeat or drink too much. When you lead a healthy lifestyle, you have better sex and you have a better sex life. We also advise them to find time to discuss the problem with their partners. Is there any age group which suffers more from suboptimal erections than others? I tend to deal with men in their 30s and 40s. This is the age group when men tend to feel additional stress: they have one or two children, they are busy with their work and they feel a lot of pressure. Sometimes, as a result, they become less intimate in relationships and are possibly less attracted to their partners. These men also tend to be less active in terms of physical exercise due to work and family commitments. Those who often consume unhealthy food inevitably gain weight. These factors - stress, sedentary lifestyle and weight gain - collectively lead to suboptimal erections which in turn, may lead to sexual dissatisfaction. What can couples do to address this problem? Couples should definitely communicate with each other about this. Most partners keep quiet because they are embarrassed. Sometimes men don't want to bring it up because it may not have been a problem in the past, and they feel it might go away. Also, they may be too busy or too stressed or they are more sensitive about their predicament so they just keep quiet. However, men should not feel shy or embarrassed about it. Instead, they should be more open-minded. I think the best approach is for the husband to ask the wife exactly how she is feeling about their sexual relationship. They should ask questions such as 'How do you feel about my erection?', 'How do you feel about our sexual experience over the past year?'. This creates an open session where the partner can comment. How can women discuss this issue with their partners? I think they should bring it up subtly. Don't just tell the husband: "Hey, you're no good". That of course is bad. But she can say "I can see that you have been quite stressed and you are not getting enough exercise, and I feel that our sex life can improve." This would be a supportive suggestion, instead of an accusatory question which would make the man feel defensive. Professor Li Man Kay is a Senior Consultant Urologist and Transplant Surgeon at Li Man Kay Urology Associates, Gleneagles Medical Centre.