Sexual health is an important part of men’s overall health and well-being at every age. Erectile dysfunction and low sex drive are common, very often treatable, and sometimes an early signal of other health issues. At Transcend Clinic in Bangkok, our doctor looks for the underlying cause, whether hormonal, circulatory, psychological, or a mix, so treatment addresses more than the symptom.
The two pillars of male sexual health
- Sexual desire (libido): your interest in sex
- Erectile function: the ability to get and keep an erection firm enough for satisfying sex
Problems can affect one or both, and they often influence each other.
What is erectile dysfunction?
Erectile dysfunction (ED) is a persistent difficulty getting or keeping an erection firm enough for sex, despite feeling aroused. It is very common: in one large study, about half of men aged 40 to 70 had some degree of ED. But it is not an inevitable part of aging, and most men can be helped.
What causes ED?
ED usually has more than one cause:
- Blood vessel health: diabetes, high blood pressure, high cholesterol and smoking all reduce blood flow to the penis
- Hormones: low testosterone, high prolactin or thyroid problems
- Medications: some antidepressants, blood pressure medicines and others
- Psychological factors: stress, performance anxiety, depression or relationship difficulties
- Lifestyle: heavy drinking, excess weight, poor sleep and lack of exercise
- Nerve problems: for example after pelvic surgery or with diabetes
ED and your heart
The blood vessels in the penis are smaller than those supplying the heart, so they often show damage first. ED can appear several years before heart disease causes any symptoms. That is why we always check blood pressure, blood sugar and cholesterol as part of an ED assessment.
How we assess sexual health problems
Your consultation is private and unhurried. Our doctor will:
- talk through your symptoms, health history, medications and lifestyle
- carry out a physical examination
- arrange blood tests where needed, such as morning testosterone, blood sugar (HbA1c), cholesterol and, in some cases, prolactin and thyroid function
Testosterone should be measured in the morning for accuracy (when to have your testosterone test). Many of these tests are included in our men’s health and hormone check-ups.
Erectile dysfunction treatment options
Treatment depends on the cause and is tailored to you:
- Oral medication (PDE5 inhibitors) such as sildenafil or tadalafil, taken when needed or as a low daily dose
- Testosterone optimization, if blood tests confirm low testosterone. Depending on your situation and goals, this may mean testosterone therapy or treatment that helps your body make more of its own testosterone. Learn more about testosterone treatment
- PT-141 for low sexual desire. It works on the brain’s arousal pathways rather than blood flow. Read about PT-141
- Lifestyle changes and treating underlying conditions such as diabetes, high blood pressure or medication side effects
Lifestyle changes that help
- Stop smoking
- Exercise regularly, including aerobic exercise that improves circulation
- Keep alcohol moderate
- Reach and maintain a healthy weight
- Sleep well. Poor sleep lowers testosterone (sleep and testosterone)
- Manage stress, and seek support for anxiety or low mood
Frequently asked questions
Is ED just part of getting older?
It becomes more common with age, but it is not inevitable, and it is often a sign of a treatable problem.
Are ED tablets safe?
For most men, yes, when prescribed after a medical check. They must not be taken with nitrate medicines for chest pain (or riociguat), because blood pressure can drop dangerously.
Can low testosterone cause ED?
It can contribute, mainly by lowering sex drive. Raising testosterone helps when levels are genuinely low, but it is not a treatment for ED on its own when testosterone is normal.
Is my consultation confidential?
Yes. Everything you discuss stays between you and our medical team.
Book: call 063-976-4950 or message LINE @transcendclinic. Contact us