Mr T is a successful 50-year-old man. Married with two children and holding a high-flying job, he seems to have everything going for him.
However, he has a secret - he cannot perform in the bedroom.
He initially attributed it to work-related stress and performance anxiety.
His 42-year-old wife was understanding at first but became less so over time.
His problem led him to avoid intimacy altogether, for fear of disappointing her. This made her suspicious and distant.
Mounting frustration felt by both parties put further strain on their relationship.
Out of sheer embarrassment, Mr T resisted seeking help for his problem. Like many men in Singapore, he is suffering in silence from erectile dysfunction (ED).
ED, commonly known as impotence, is the inability to maintain an erection rigid enough for sexual intercourse.
It can range from difficulty in initiating an erection to sustaining it until completion of the sexual act. Other common complaints include erections that are not hard enough for satisfactory sex.
Contrary to popular belief, the effects of ED are not only physical. They can have a severe emotional impact on relationships and a person's self-esteem.
Up to 40 per cent of men would have experienced an episode of ED by age 40.
This increases to 75 per cent for men aged above 70.
ED can have psychological or physical causes which include blood flow, testosterone deficiency or nerve problems.
It can result from the side effects of medical treatments like surgery or radiotherapy.
Medical conditions like hypertension, diabetes mellitus and high cholesterol, and smoking are significant risk factors.
Men with diabetes are three times more likely to develop ED, compared to those who are not diabetic. They also tend to develop ED 10 to 15 years earlier, with the symptoms being more severe.
The newest form of treatment for ED is low-intensity shockwave therapy. It causes the growth of new blood vessels, which help to channel more blood into the penis, thereby giving the patient a stronger erection.
This treatment is a potential cure for the condition.
Other treatments include oral medications, injectable therapy and surgical placement of a penile prosthesis.
Adjuncts like vacuum erectile devices can also be used.
Patients should discuss treatment options with their healthcare provider before deciding on any procedures or medications.
Treatments should be administered only by trained healthcare professionals, together with frequent monitoring of blood tests and progress.
Mr T eventually sought help from his doctor and was referred to a specialist.
The treatment helped to improve his performance and relationship with his wife.
Men should not suffer in silence when their performance in the bedroom is suboptimal.
An early visit to the doctor would go a long way to ensure that the relationship with their partner does not lose its spark.
ED is treatable and no man should suffer from it.
- Dr Ronny Tan is a consultant and director of andrology at the department of urology at Tan Tock Seng Hospital, a member of the National Healthcare Group.