Birth Control

Best Birth Control Pill In Singapore And Where To Buy

Birth control pills are a safe, simple & convenient way to prevent unwanted pregnancy while you remain sexually active. It also has other benefits like reducing acne, making your periods lighter and more regular, and easing menstrual cramps.

Today, birth control pills are prescribed under many different brand names. Wondering which birth control pill is best for you? Keep reading our comprehensive guide to learn about the different contraceptive pill options and their advantages and disadvantages.

How Do Birth Control Pills Work?

Birth control pills contain a small amount of hormones similar to the ones your body uses as part of the menstrual cycle.

The hormones work to prevent pregnancy in 3 main ways: 

  • Inhibiting ovulation, which is the release of an egg from the ovary;
  • Thickening the cervical mucus (the fluid in the vaginal tract), hindering the sperm from reaching the egg to fertilise it and 
  • Thinning the endometrium (uterine) lining, preventing the attachment of a fertilized egg.

What Are Birth Control Pills Made Of?

Birth control pills contain a small amount of synthetic hormones (estrogen and progestin, or only progestin) that were designed to be better absorbed, more potent and longer lasting than their natural counterparts.


This is the most common form of synthetic estrogen found in combination birth control pills. Most combination birth control pills contain 10 to 35 mcg of ethinylestradiol. Women who are sensitive to the side effects may benefit from taking a pill with lower estrogen content. However, low-dose pills may result in more breakthrough bleeding — spotting or bleeding between periods — than higher-dose pills.


There are a few types of progestins commonly found in birth control pills. Classification of progestins is based on their time of invention.

Fourth-generationDrospirenone, Cryproterone acetate 
Classification of Progestins Based on Their Time of Invention

Each generation of progestin confers a different set of pros and cons. As such, different brands of birth control pills are suited to unique individual preferences. Generally speaking, brands containing earlier-generation progestins may increase the risk of side effects such as acne and water retention but are usually more affordable options compared to brands with later-generation progestins.

Types Of Birth Control Pills In Singapore

Combination Birth Control Pills

As the name suggests, combination birth control pills contain both ethinylestradiol and progestin. Combination birth control pills come in different mixtures of active and inactive pills:

Monophasic Pills. Each active pill contains the same amount of hormones in it. The 2 common regimens are

  • 21/7. Each pack contains 21 active pills only. One active pill is taken daily for 21 days consecutively, followed by a no-pill period of 7 days. Some common brands include: Mercilon, Microgynon 30, Yasmin, Liza, Diane-35 and Estelle-35.
  • 24/4. Each pack contains 24 active pills and 4 inactive pills. One active pill is taken daily for 24 days consecutively, followed by 4 days of inactive pills. Some common brands include: Yaz and Drospera.

While the general consensus is that both regimens are highly effective in preventing pregnancy, there are studies showing that the 24/4 regimen is more effective and provides a shorter withdrawal bleed duration than the 21/7 regimen.

Multiphasic Pills. The amount of hormones in each active pill varies, and pills have to be taken in a specified order otherwise contraceptive efficacy will be affected. It is not commonly found in Singapore and is generally not preferred due to its complicated dosage regimen.

Benefits Of Combination Birth Control Pills

On top of contraception, combination birth control pills may provide additional benefits such as

The type and extent of benefits differ among the brands available. Have a discussion with your doctors about what kinds of benefits you are looking for specifically to personalise your treatment plan.

Progestin-Only Birth Control Pills (Mini-Pills)

Also known as mini-pills, progestin-only pills contain only progestin and no estrogen. FDA-approved since the 1970s, progestin-only pills have been wildly popular in the overseas market. The first of its kind, Slinda®, has recently got approved by Health Sciences Authority (HSA) for usage in Singapore. Such exciting news indeed!

Benefits Of Progestin-Only Birth Control Pills (Mini-Pills)

Progestin-only pills are highly beneficial for women unable to tolerate or take estrogen for example:

  • Age ≥ 35 years old,
  • Smokers,
  • Have a history of migraine with aura,
  • Have a history of stroke, heart issues, high blood pressure and blood clot issues,
  • Just given birth or are breastfeeding.

Unlike combination birth control pills, progestin-only pills are safe for breastfeeding women as estrogenic components reduce milk production and have been linked to early cessation of breastfeeding. In fact, the World Health Organisation guidelines state that combination birth control pills should not be taken for at least 6 months after giving birth. 

Beyond the benefits of contraception, progestin-only pills are also helpful for women who have heavy or painful periods. Some women may have less bleeding or stop having periods altogether while taking these pills.

Branded vs Generic Birth Control 

Branded birth control is basically the pioneer and innovator of the product. Generic birth control refers to “copies of brand name drugs that have exactly the same:

  • dose,
  • intended use,
  • side effects,
  • route of administration,
  • risks,
  • safety, and
  • strength

as the original drug, but usually at a fraction of branded drug’s price.

Find out more about the differences between branded and generic birth control

Common Birth Control Pill Brands in Singapore

The table below compares some of the most common types of birth control pills in Singapore:

Medication Name (Branded)TypeGenericsActive ingredients
YazCombinationDrospera, JastindaEthinylestradiol 20mcg
Drospirenone 3mg
YasminCombinationLiza, GvezaEthinylestradiol 30mcg
Drospirenone 3mg
Diane 35CombinationEstelle 35Ethinylestradiol 35mcg
Cyproterone acetate 2mg
MercilonCombinationEthinylestradiol 20mcg
Desogrestrel 0.15mg
Microgynon 30CombinationEthinylestradiol 30mcg
Levonorgestrel 0.15mg
SlindaProgestin-OnlyDrospirenone 4mg
Common Birth Control Pill Brands in Singapore

How Effective Are Birth Control Pills?

Birth control pills are more than 99% effective in preventing pregnancy when used perfectly. However, missed pills and improper storage may occur day-to-day. Hence, in typical use, birth control pills are around 91% effective. 

Generally, birth control pills are more effective than male condoms in preventing pregnancy — male condoms are shown to be 98% effective when used perfectly, and 82% effective with typical use. However, unlike male condoms, sexually transmitted infections (STIs) cannot be prevented by using birth control pills.

How To Choose A Birth Control Pill 

Some factors to consider when picking a birth control pill include:

  • Your age
  • Your personal and family medical history
  • Your lifestyle (e.g. if you are a smoker)
  • Your financials
  • Non-contraceptive benefits of contraceptive pills

A person may try several different birth control methods before finding one that works best for them.

Where To Buy Birth Control Pills In Singapore? 

Birth control pills is prescription-only medication and can only be bought with a prescription from a general practitioner or gynaecologist in Singapore.

MOH-Approved Telemedicine Service for Birth Control in SIngapore

We get it. Going to a brick-and-mortar clinic for your sexual issues can be awkward and troublesome.

Siena is recognised by the Ministry of Health (MOH) as a telemedicine/teleconsult health provider. Speak to a licensed doctor online and get your birth control delivered discreetly, all from the comfort of your home.


Combined hormonal birth control: Pill, patch, and ring. (2018). American College of Obstetricians and Gynecologists (ACOG). 

Use of hormonal contraception in women with coexisting medical conditions. (2019). American College of Obstetricians and Gynecologists (ACOG). 

Progestin-Only Hormonal Birth Control: Pill and Injection. (2020). American College of Obstetricians and Gynecologists (ACOG).

S. Christin-Maitre, et al, Comparison of a 24-day and a 21-day pill regimen for the novel combined oral contraceptive, nomegestrol acetate and 17β-estradiol (NOMAC/E2): a double-blind, randomized study. (2011). Human Reproduction.

Willis SA, et al, Greater inhibition of the pituitary–ovarian axis in oral contraceptive regimens with a shortened hormone-free interval. (2006). Contraception.

Medical Eligibility Criteria For Contraceptive Use: Fifth Ed. (2015). World Health Organization. 

Skin Uncategorized

Guide To Acne Treatments Prescribed By Dermatologists In Singapore

While there are tons of home remedies or over-the-counter (drug store) acne products out there that promise help, not all of them are backed by research and they may not work for stubborn/more severe acne.

In this article, we share the common acne treatments prescribed by dermatologists, their costs and how/where to get them in Singapore.

What Causes Acne? 

Acne vulgaris (medical term for acne) forms when a combination of sebum and dead skin cells build up in your pores and hair follicles, creating a blockage.

Your sebaceous glands create sebum to lubricate your skin and hair. Under normal circumstances, this is a good thing because this sebum also forms a barrier on your skin, protecting it from things like bacteria and other harmful environmental factors.

However, certain things can cause your body to kick its sebum production into high gear, which can lead to blocked pores, pimples, blemishes, and acne. 

Why Use Prescription Acne Medication?

While over-the-counter acne medications are effective at managing minor outbreaks of facial acne, many people experience persistent/more severe acne that just doesn’t go away with regular, store-bought treatments.

Prescription Strength Acne MedicationPrescription Strength Acne Medication
PotencyLow concentrationMore powerful with higher concentrations of active ingredients
AvailabilityCan be bought off the shelfAvailable by prescription only, after a doctor’s evaluation
UsageFor general public useIntended to be used by one person (patient himself/herself)
Over-the-counter Acne Products vs Prescription Strength Acne Medication

Common Acne Treatments Prescribed By Dermatologists

Acne can occur for a variety of reasons, ranging from skin bacteria to excessive levels of sebum production. Because of this, there are several different types of prescription drugs used to treat acne. And for each of those specific drug types, there are specific drugs that fall under them.

Prescription Topical Treatments (Gel/Cream)

Ingredient(s)How it works
AdapaleneAdapalene is a retinoid, a form of vitamin A. It works by exfoliating the skin (removing dead skin cells) to prevent blocked pores and soothes inflammation.

Known brands: Differin
Adapalene + Benzoyl peroxideAdapalene is a type of retinoid. It works by exfoliating the skin (removing dead skin cells) to prevent blocked pores and soothes inflammation. Benzoyl peroxide is an antimicrobial agent that works to soften and peel the skin’s outer layer as well as tackle the microbes which can trigger acne.

Known brands: Epiduo gel 0.1%/2.5% pump
ClindamycinClindamycin is an antibiotic that kills acne-causing bacteria. 

Known brands: Dalacin T gel
Clindamycin + Benzoyl peroxideClindamycin is an antibiotic that kills acne-causing bacteria. Benzoyl peroxide is an antimicrobial agent that works to soften and peel the skin’s outer layer as well as tackle the microbes which can trigger acne.

Known brands: Clindoxyl
Tretinoin Tretinoin is a retinoid, a form of vitamin A. It works by exfoliating the skin (removing dead skin cells) to prevent blocked pores and soothes inflammation. 

The main difference between Tretinoin and Adapalene is that Adapalene is used for acne, while Tretinoin can be used for acne and hyperpigmentation.

Known brands:
Stieva-A 0.025%, Stieva-A 0.05%, Retacnyl 0.025%, Retacnyl 0.025%
Common Topical Acne Medications Prescribed by Derms

Prescription Oral Medications

For mild to moderate acne, topical treatments alone can generally calm a breakout. However, in moderate to severe cases, oral medications may be prescribed to treat stubborn acne. 

Ingredient(s)How it works
DoxycyclineDoxycycline is an antibiotic that suppresses the growth of acne bacteria and decreases inflammation.

Known brands: Medomycin
Combination birth control pillsWomen with hormonal acne may be treated with combination birth control pills. These medications regulate hormones that can cause acne through a decrease in oil production.

Known brands: Yaz, Drospera (Generic Yaz), Yasmin, Liza (Generic Yasmin), Diane-35
SpironolactoneFor women with hormonal acne, Spironolactone slows down the body’s production of androgen hormones, such as testosterone. These hormones can make the skin produce too much oil, which clogs pores and causes acne. 

Known brands: Uractonum
IsotretinoinIsotretinoin is a potent oral medication that reduces the amount of sebum (oil) produced by the glands in the skin and clears inflammation. The use of Isotretinoin requires careful monitoring due to potential side effects.

Known brands: Acnotin, Accutane, Roaccutane, Oratane
Common Oral Acne Medications Prescribed by Derms

Which Acne Medication is Best For You?

The best acne medication for an individual can vary depending on various factors, including the type and severity of acne, skin type, medical history, and individual response to different treatments.

Because of this, there’s no “best” acne medication for everyone. The best approach is to consult with a dermatologist or healthcare professional who can evaluate your specific situation and provide tailored treatment options to help you manage your acne effectively.

Your provider may prescribe topical medication(s), oral medication(s) or a combination of both to address different aspects of acne formation, such as bacteria, inflammation, and excessive oil production.

Cost Of Acne Medications In Singapore

For most cases of mild to moderate acne conditions, the costs are relatively cheaper. Treating cystic acne may take a longer time as the chances of recurrence are higher.

At Siena, we offer a customised acne treatment plan based on your needs and budget:

  • Tele-consultation: $20
  • Topical medication: from $38
  • Oral antibiotics: from $24/month
  • Oral hormonal medication: from $12/month
  • Oral retinoids: from $68.50/month
  • Delivery: $0

Depending on the severity of the acne condition, the price will vary.

How To Get Prescribed Acne Medication

Traditionally for prescription products, you’d have to visit a medical provider in person to get a prescription. 

But now, thanks to the internet and technology, you can access prescription acne medication via virtual medical visits at Siena, a MOH-approved telemedicine provider

Telemedicine For Acne In Singapore

Whether you are struggling with hormonal acne, adult acne, cystic acne, persistent acne etc, simply answer an online medication evaluation to book a tele-consultation session ($20) with a licensed doctor at your convenience. If prescribed, your medication will be delivered discreetly, at no additional cost.


Acne (2012). Retrieved from

Physiology, Sebaceous Glands, (2021). Stat Pearls. Retrieved from

Makrantonaki, E, Ganceviciene, Zouboulis, C (2011, Jan-March). An update on the role of the sebaceous gland in the pathogenesis of acne. Dermato Endocrinology. 3(1), 41-49. Retrieved from

Zeichner, J. A., Baldwin, H. E., Cook-Bolden, F. E., Eichenfield, L. F., Fallon-Friedlander, S., & Rodriguez, D. A. (2017). Emerging Issues in Adult Female Acne. The Journal of clinical and aesthetic dermatology, 10(1), 37–46.retrieved from

Koster, M.I. (2009, July). Making an epidermis. Annals of the New York Academy of Sciences. 1170, 7-10. Retrieved from

Acne: Tips for Managing. (n.d.). Retrieved from

Clindamycin Topical. (2016, October 15). Retrieved from

Tretinoin Topical. (2019, March 15). Retrieved from

Baldwin, H. (2020). Oral Antibiotic Treatment Options for Acne Vulgaris. The Journal of Clinical and Aesthetic Dermatology. 13 (9), 26–32. Retrieved from

Hair Loss

Guide to Male Pattern Hair Loss (Androgenic Alopecia): Causes, Symptoms and Treatments in Singapore

Male pattern hair loss, also known as androgenetic alopecia, is the most common type of hair loss in men. In fact, about 69% of men will experience some form of male pattern baldness by the time they hit their 36th birthday. 

Even with today’s advancements in science, there’s still no known cure. The good news? There are proven treatments that can combat the symptoms! Read on to learn more about the causes of hair loss
and treatment options available in Singapore.

What Male Pattern Baldness Looks Like

Male pattern hair loss typically follows a distinct pattern, often referred to as the Norwood scale.

  • It usually starts with thinning of the hair on your scalp.
  • It then evolves into a bald spot on the crown of your head and a receding hairline that resembles an “M” shape. 
  • If left untreated, it may eventually progress into partial or complete baldness.

Norwood Scale

The severity of male pattern baldness is often assessed using the Norwood Scale as shown below. 

Image credit: Medical News Today

How Much is Too Much Hair Loss?

If you’ve noticed some strands of hair lying around your floor or clogging up your bathroom drain, don’t panic or jump to conclusions immediately! It’s completely normal for you to shed some hair every day. In fact, a normal person may shed 50 to 100 strands of hair per day, and this number varies from person to person. However, if you are losing more than 100 strands of hair per day or 700 strands per week, you may want to get it checked out. 

Causes of Male Pattern Baldness

The primary cause of male pattern hair loss is believed to be a combination of genetic and hormonal factors. 


Male pattern hair loss can be hereditary, and it can be inherited from either of your parents. Besides deciding your likelihood of having male pattern baldness, your family history also decides how severe your hair loss is. 


Dihydrotestosterone (DHT) is a male sex hormone that is usually responsible for male sex characteristics, such as the development of the male genitals, deepening of your voice, and growth of body hair. Simply put, DHT contributes to every male’s development during puberty. 

However, too much of anything isn’t going to do you any good. Excessive DHT can shrink your hair follicles, making them less conducive for supporting healthy hair growth. Furthermore, DHT messes with your hair growth cycle. Not only does this cause your hair to fall out faster, but it also causes new growing hair to be thinner and more brittle. 

Treatments for Androgenetic Alopecia

Androgenetic alopecia is treatable and most treatment options work best when the hair loss is in its earliest stages.

There are two safe and effective formulas — minoxidil and finasteride — that are FDA-approved for preventing hair loss. Depending on whether you have a receding hairline, balding at the crown, or overall hair loss, your provider may recommend one or both of these treatments. If you’re susceptible to dandruff, your doctor may also recommend a shampoo which can also help as a hair loss treatment.

Minoxidil (generic Rogaine®)

Minoxidil is a FDA-approved topical solution that slows hair loss and promotes regrowth at the top of your head and crown. Increases hair growth by up to 35% according to clinical studies.

Finasteride (generic Propecia®)

Finasteride is a daily prescription-only pill FDA-approved to prevent hair loss and boost regrowth across the entirety of your head, including receding hairlines. It works by reducing the level of DHT hormones, which is the main cause of male pattern baldness. 90% effective at treating hair loss according to clinical studies.

Ketoconazole 2% Shampoo

Ketoconazole is a FDA-approved prescription shampoo that is used to treat dandruff, itchiness, and flaking. It supports healthy hair growth by reducing scalp inflammation

A combination of minoxidil and finasteride

A 2015 research revealed that using a combination of both minoxidil and finasteride is more effective than using either one alone. If you are unsure about your treatment options, don’t hesitate to connect with our doctors.  

Where To Get Hair Loss Medication (Finasteride, Minoxidil) In Singapore?

The only (safest and legal) way to get prescribed medication for hair loss in Singapore is by consulting a Singapore-licensed doctor at a local GP clinic, a private clinic or an aesthetic clinic.

Singapore Telemedicine Service for Male Pattern Hair Loss

Sometimes hair loss can be a symptom of a more serious illness or nutritional deficiency. That’s one of the reasons why it’s so important to talk to a licensed physician about any significant shedding.

With Siena, a MOH-approved digital health clinic in Singapore, you’ll be able to get the hair loss medication you need from the comfort and privacy of your home.

Getting started with Siena couldn’t be simpler – all you have to do is answer an online medication evaluation to book a tele-consultation session with a licensed doctor at your convenience. If prescribed, your medication will be delivered discreetly, at no additional cost.


  • Ho, C. H. (2021, May 5). Androgenetic Alopecia. StatPearls [Internet].
  • Tang, P. H., Chia, H. P., Cheong, L. L., & Koh, D. (2000). A Community Study of Male Androgenetic Alopecia in Bishan, Singapore. Singapore Medical Journal 2000, 41(5), 202–205.
  • British Association of Dermatologists. (2019). Male Pattern Hair Loss (Androgenetic Alopecia).
  • Chandrashekar, B. S., Nandhini, T., Vasanth, V., Sriram, R., & Navale, S. (2015). Topical minoxidil fortified with finasteride: An account of maintenance of hair density after replacing oral finasteride. Indian Dermatology Online Journal, 6(1), 17–20.
Sexual Health

Viagra, Cialis, Spedra, Caliberi or Levitra: The Best Medication for Erectile Dysfunction in Singapore

For most men who have trouble keeping an erection firm enough for sex (erectile dysfunction), oral medications are often the first line of treatment as these medications work well and cause few side effects (if any). 

With so many erectile dysfunction (ED) medications on the market, does it make any difference which one you take? In this article, we compared the pros and cons of Viagra, Cialis, Spedra, Caliberi, Levitra and their generics to help you decide which one is right for you.

Oral Erection Medications In Singapore

Viagra, Cialis, Spedra, Caliberi and Levitra are oral medications commonly prescribed by doctors in Singapore for the treatment of erectile dysfunction (ED). You may also know them by their generic names:

ED medications are designed to be taken as needed or on a daily basis to help promote an erection during sexual stimulation. Not all of these medications work the same for everyone, so a doctor may suggest that you start with one and try another type if you’re not getting the results you want.

How Does Erectile Dysfunction (ED) Medication Work?

According to the Singapore Urological Association, the recommended oral treatment for ED is phosphodiesterase type 5 (PDE-5) inhibitors. 

Viagra, Cialis, Spedra, Caliberi and Levitra are all PDE5 inhibitors that work by relaxing the blood vessels. This increases the rate of blood flow to the penis when you get aroused to create and sustain an erection.

They also enhance the effects of nitric oxide, a natural chemical your body produces that relaxes muscles in the penis. Relaxed muscles increase blood flow and allow you to get an erection in response to sexual stimulation.

How Fast Does Erectile Dysfunction (ED) Medication Work?

The onset time (how soon the drugs start working) determines how soon you can engage in intercourse.

There are 2 types of ED medications

  • As-needed. As-needed ED medications as the name suggest are taken prior to any sexual activity. It is best suited for men who are able to predict when they’ll have sex or if they don’t want to take a pill every day.
  • Daily. These ED treatments are taken daily. Best suited for men who don’t like to plan ahead and want to be ready 24/7, or carry pills on them.

The onset time for as-needed ED treatments ranges from 15-60 minutes while the onset time for daily ED medication is continuous.

MedicationHow To Take ItOnset
Viagra® (Sildenafil)
Take 1 pill on empty stomach 30 minutes before sex 30-60 minutes
Cialis® (Tadalafil) 20mg
Tadalafil 20mg
Caliberi® (Tadalafil) Orodispersible Films 20mg
Take 1 pill/film with or without food 30 minutes before sex30-45 minutes
Cialis® (Tadalafil) 5mg
Caliberi® (Tadalafil) Orodispersible Films 5mg
Take 1 pill/film daily with or without foodContinuous
Spedra® (Avanafil) Take 1 pill with or without food 15 minutes before sex15-30 minutes
Levitra® (Vardenafil)Take 1 pill with or without food 30 minutes before sex. A high-fat meal might keep it from absorbing as quickly.30-60 minutes
Oral Erection Medications in Singapore, How To Take & How Fast They Start Working

How Long Does Erectile Dysfunction (ED) Medication Last?

ED medications break down at different rates in the body. The duration of action (how long the effect lasts) ranges from 4-36 hours. Each dose should be sufficient to provide a full cycle of intercourse, from erection to climax. 

It is not guaranteed for the effect to last through another cycle. For men who have sex more than once a day, Cialis 5mg and Caliberi 5mg will be preferred.

MedicationDuration of Action
Viagra® (Sildenafil)
4-5 hours
Cialis® (Tadalafil) 20mg
Tadalafil 20mg
Caliberi® (Tadalafil) Orodispersible Films 20mg
24-36 hours
Cialis® (Tadalafil) 5mg
Caliberi® (Tadalafil) Orodispersible Films 5mg
Spedra® (Avanafil) 6-12 hours
Levitra® (Vardenafil)4-5 hours
Oral Erection Medications in Singapore & How Long They Last

How Much Does Erectile Dysfunction (ED) Medication Cost?

The cost of ED medications will depend on factors such as brand name, retailer and dose. Generic medications typically cost about 80% to 85% less than the same brand-name drug.

One of the best ways to save money on ED pills is to use services like Siena, which offers bundled purchases for a discounted price and provides both brand name and generic.

Do Generic Medications Work The Same As The Brand-Name Equivalent?

As the FDA explains, generic medications are required by law to be the same as their brand name equivalent in dosage, safety, effectiveness, strength, stability and quality, as well as in the way it is taken. Drug companies that produce generic medications are also required to do so in an environment that’s held to the same strict standards as that of the brand name medication.

In other words, the generic sildenafil that’s legally sold in Singapore provides exactly the same effects as the brand name Viagra and is equally safe to use.

Where To Buy Viagra, Cialis, Spedra, Caliberi and Levitra in Singapore?

The only (safest and legal) way to get Viagra, Cialis, Spedra, Caliberi, Levitra or other ED pills in Singapore is with a valid prescription from a Singapore-licensed doctor.

Singapore Telemedicine Service for Erectile Dysfunction

We get it. Going to a brick-and-mortar clinic for your sexual issues can be awkward and mundane. With Siena, you can now speak to a doctor online and get your ED treatment delivered discreetly, all from the comfort of your home.


Sexual Health

Priligy (Dapoxetine) for Premature Ejaculation: How It Works, Potential Side Effects & Where To Buy In Singapore

Premature ejaculation (PE) is a very common sexual problem in men – and, it doesn’t just occur among the younger, more inexperienced ones. In Singapore, PE affects 34% of men at some point in their lives. The good news is, PE is a treatable condition.

In this article, we will be digging deeper into Priligy (Dapoxetine), the first and only prescription medication developed specifically for the treatment of PE:

  • What is premature ejaculation;
  • How does Priligy work for PE;
  • Effectiveness of Priligy;
  • How to take it;
  • Potential side effects;
  • Where to buy Priligy in Singapore.

What Is Premature Ejaculation?

Premature ejaculation (rapid ejaculation, premature climax or uncontrolled early ejaculation) is a condition wherein a man ejaculates with little sexual stimulation or sooner than him/his partner would like.

Though there is no fixed time frame which constitutes PE, it is often defined as “premature” as long as ejaculation occurs sooner than desired. Most sources cite a duration of 30 seconds – 4 minutes.

Ejaculating early can be extremely frustrating for men and so taking Priligy (Dapoxetine) to counteract it can have a very positive effect on mental health and self-confidence. Taking Priligy pills can also improve the user’s sexual or romantic relationships, as PE can often cause problems in this area.

What Is Priligy and How Does It Work?

Priligy (Dapoxetine) contains the active ingredient dapoxetine and is taken on demand for the treatment of premature ejaculation in adult men aged 18-64 years old.

Dapoxetine belongs to the group of medicines called Selective Serotonin Reuptake Inhibitor (SSRI). It works by increasing the serotonin level in the nervous system which in turn help to:

  1. Increase the time it takes to ejaculate; and
  2. Improve control over ejaculation.

How Effective is Priligy?

Priligy (Dapoxetine) has been proven to work in around 80% of men (approximately 8 out of 10), effectively lengthening the time it takes them to ejaculate by 2-3 times.

How To Take Priligy

Priligy (Dapoxetine) may be taken when needed, anywhere from 1 – 3 hours before sexual activity. 

Priligy is not affected by whether or not it’s taken with food, so you do not need to worry about having something to eat. However, you should avoid taking Priligy with alcohol as this may cause, or worsen, unwanted side effects such as dizziness and sleepiness.

The most effective period after taking Priligy is around 1 – 3 hours after first taking the medication. However, the effects of Priligy can last for up to 12 hours. Despite this, it is recommended that you utilise its effects within the first 1 – 3 hours. 

Do not take Priligy more than once a day or the dose prescribed for you.

What Are The Potential Side Effects of Priligy (Dapoxetine)?

Priligy (Dapoxetine) is rapidly absorbed and has a short half-life which minimizes the adverse effects that are common to the SSRI’s.

The most common side effects – similar to many drugs – include dizziness or light-headedness, headache and nausea.

More serious side effects are rare. If you experience symptoms of a drug allergy (which can include swollen face, breathing difficulties or hives), seek immediate medical attention. 

Where To Buy Priligy (Dapoxetine) In Singapore

In order to purchase Priligy (Dapoxetine) in Singapore, you will first need to see a doctor for a prescription as it is a prescription-only medication.

Singapore Telemedicine Service for Premature Ejaculation

We get it. Going to a brick-and-mortar clinic for your sexual issues can be awkward and mundane. That’s why more than 9 in 10 men in Singapore who reported having experienced PE have not sought treatment, creating a heavy impact on their partners.

With Siena, you can now speak to a doctor online and get your PE treatment delivered discreetly, all from the comfort of your home.


Health Sleep

Circadin® (Melatonin) for Insomnia: How It Works, Potential Side Effects & Where To Buy In Singapore

If you are one of the millions worldwide suffering from insomnia, you’ve probably struggled to find a safe and effective method to get that restful sleep clocked in. Non-medical lifestyle changes don’t always work. Yet taking the plunge into prescription sleep medications (Sedative-Hypnotics) carries the risk of dependence.

Turning to supplements such as melatonin seems to be the next best option because supplements are all-natural, right? But is melatonin safe to take? And what does prescription-grade melatonin even mean?

Here’s all you need to know about Circadin® and melatonin:

  • What is Circadin®?;
  • How does melatonin work?;
  • Circadin® (prescription-grade) vs. over-the-counter melatonin supplements;
  • Circadin® vs. prescription sleeping pills;
  • How to take Circadin®;
  • Potential side effects; and
  • Where to buy Circadin® in Singapore.

What Is Circadin®?

Circadin® is a prolonged-release formulation of the highest grade of pure melatonin. It has a unique secretion profile that mimics the body’s melatonin secretion pattern by releasing melatonin gradually over 8-10 hours from the time it is being swallowed.

Circadin® is the first in a new class of drugs: melatonin receptor agonists that have been approved for the treatment of primary insomnia in many countries globally.

It is clinically proven and can decrease the time to fall asleep, improve sleep quality and daytime functioning, and does not have rebound insomnia, dependence or withdrawal effects.

How Does Melatonin Work?

Melatonin is a naturally occurring hormone produced by our body. Also known as the darkness hormone, melatonin production increases soon after the onset of darkness. The day-night cycle influences the timing of our biological clock so that we produce very little melatonin in the day and high amounts at night. 

Melatonin itself does not make you fall asleep. Instead, it signals the body that it is time to sleep, reducing your alertness and increasing your propensity for sleep. Increased exposure to light at night thus delays and reduces the production of melatonin. This is why experts suggest you avoid computers and smartphones before bedtime.

Circadin® (Prescription-Grade Melatonin) Vs. Over-The-Counter (OTC) Melatonin Supplements;

Circadin® is the only brand of melatonin that is approved and regulated by the Health Sciences Authority (HSA) as a therapeutic product. Like all other medications registered with the HSA, Circadin is subjected to the same detailed regulations, extensive checks and quality controls.

Over-the-counter (OTC) melatonin supplements do not require approval and are not evaluated by HSA before they can be sold locally. Previous research has found that melatonin content in these unregulated, commercially available melatonin supplements ranged from -83% to +478% of the advertised labelled content. Previous studies also found 26% of the melatonin supplements contained serotonin, a hormone that can have harmful effects even at relatively low levels.

Circadin® has also been studied in multiple clinical trials, showing statistically significant and clinically meaningful efficacy in the treatment of insomnia. Circadin® was clinically proven to improve sleep quality:

  1. Circadin® significantly shortened the time to onset of sleep by 9 minutes compared to placebo.
  2. Circadin® significantly improved both quality of sleep and morning alertness by 47% as compared to 27% in the placebo group.

Long term safety profile of Circadin® is also proven: No tolerance, rebound or withdrawal effects were reported post 3 weeks, 26 weeks and 12 months of Circadin® usage.

Moreover, Circadin® is specially formulated to release melatonin slowly throughout the night to keep you asleep (also known as a prolonged-release tablet). OTC melatonin is formulated as immediate-release tablets, and usually, only stays in the body for much shorter durations.

Circadin® Vs. Sleeping Pills

Most prescription sleeping pills fall into the category of Sedative-Hypnotics. Some examples include:

  • Antidepressants – such as Fluoxetine (Prozac®) and Escitalopram (Lexapro®).
  • Benzodiazepines – such as Alprazolam (Xanax®) and Lorazepam (Ativan®).
  • Z-drugs – such as Zolpidem (Ambien®) and Zopiclone (Imovane®).

These sleeping pills carry the risk of tolerance and dependence (or, addiction), and are thus recommended only for short-term treatment (generally less than 2-4 weeks) at low doses.

Circadin®, however, has proven long-term safety data with no tolerance, rebound or withdrawal effects reported in clinical studies after 3 weeks, 26 weeks and 12 months of Circadin® usage.

How To Take Circadin® Melatonin Pills?

Circadin® contains 21 pills, each containing 2 mg of melatonin. You should take 1 pill after food as and when required, 1 to 2 hours before bedtime. 

As the tablet is prolonged-release, it must be swallowed whole with water or other liquids; do not crush, chew or cut into half.

What Are The Potential Side Effects Of Circadin®?

Circadin® is generally well tolerated and it has been shown that side effects associated with Circadin® are mild. If you are taking Circadin® for the first time, you may experience some of the following side effects:

  • Nausea or vomiting. Take Circadin® with or after food to reduce this. 
  • Light-headedness (especially during a sudden change in posture). Get up slowly from a sitting or lying down position.
  • Feeling tired or drowsy. Avoid driving or engaging in activities requiring concentration.

Side effects vary widely among individuals and will improve with time. Speak to your doctor if they persist, get worse or are affecting your daily life.

How To Buy Circadin® In Singapore?

In Singapore, Circadin® is unavailable over the counter and can only be purchased if you have a valid prescription from a registered doctor. In other words, you will have to set aside time amidst your busy schedule to visit the doctor in person.

Siena is a digital health clinic that offers you easy and affordable access to Circadin®. Simply complete an online questionnaire, and speak with a doctor online from the comfort of your home. If prescribed, we deliver your medications to you at no additional charge.


  • Adam, R., Kanakarajan, S., Onyeakazi, U., Columb, M., & Galley, H. (2020). Phase II double-blind randomised controlled trial of exogenous administration of melatonin in chronic pain (DREAM-CP): a study protocol. BMJ open, 10(3), e034443.
  • Erland, L. A., & Saxena, P. K. (2017). Melatonin Natural Health Products and Supplements: Presence of Serotonin and Significant Variability of Melatonin Content. Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine, 13(2), 275–281.
  • Lemoine, P., & Zisapel, N. (2012). Prolonged-release formulation of melatonin (Circadin) for the treatment of insomnia. Expert opinion on pharmacotherapy, 13(6), 895–905.
  • Team, C. by M. I. M. S. O. (2022). Circadin. Circadin Dosage & Drug Information | MIMS Singapore.
  • U.S. Department of Health and Human Services. (2022). Melatonin: What you need to know. National Center for Complementary and Integrative Health.
Birth Control

Diane-35® Birth Control: How It Works, Potential Side Effects & Where To Buy In Singapore

The type of birth control you use is a personal decision, and there are many options to choose from. If you’re a sexually active person who can become pregnant, you could consider birth control pills.

In this article, we share all you need to know about one of the most common birth control pill brands in Singapore — Diane-35®

  • How it works;
  • How to take it; 
  • What to do if you missed a dose;
  • Potential side effects; and
  • Where to buy Diane-35® in Singapore.

What Is Diane-35®? 

Diane-35® is a brand-name combination birth control pill that contains 2 hormones: 

  • progestogen (2mg cyproterone acetate); and
  • estrogen (0.035mg ethinylestradiol).

Estelle® is a generic version of the brand-name drug Diane-35®.

Besides preventing unwanted pregnancies, Diane-35® can also help to:

How Does Diane-35® Work? 

Diane-35® helps to prevent pregnancy by:

  • Inhibiting ovulation, which is the release of an egg from the ovary;
  • Thickening the cervical mucus (the fluid in the vaginal tract), hindering the sperm from reaching the egg to fertilise it.

How Effective Is Diane-35®?

Diane-35® has shown to be highly effective in preventing pregnancy. According to the Centers for Disease Control and Prevention, when used perfectly Diane-35® is more than 99% effective in preventing pregnancy. Even with typical use (possibly due to missed pills or improper storage), Diane-35® is still around 91% effective. 

In general, birth control pills are more effective than male condoms in preventing pregnancy — male condoms are shown to be 98% effective when used perfectly, and 82% effective with typical use. However, unlike male condoms, sexually transmitted infections (STIs) cannot be prevented by using birth control pills.

Therefore, always use dual protection of condoms and non-barrier contraceptives such as birth control pills during any sexual activity.

How To Take Diane-35® Birth Control Pills?

Diane-35® contains 21 active pills. You should take one pill at the same time every day for 21 days, followed by 7 days where you take no pills. During the pill-free days, a withdrawal bleed usually occurs that is similar to having your period. After the 7-day pill-free interval, start on a new pack of Diane-35® whether or not you have any menstrual bleeding.

You should swallow each pill whole with water. Do not chew the pill. The back of the pill strip states the days of the week (Monday – Sunday). Start your course by taking a pill marked with the correct day of the week and follow the direction of the arrows on the strip.

What To Do If I Missed My Diane-35® Birth Control Pill?

You should establish a regular routine of taking your birth control pills at the same time every day during the 21 days. This is because taking a pill late or missing pills may affect the effectiveness of the pill in preventing pregnancy. 

Diane-35® is considered “missed” if you:

  • don’t take it for 24 hours or more after you were supposed to; or
  • vomit or suffer from diarrhoea within 3 to 4 hours of pill-taking.

If you forget to take a pill, here’s what you should do: 

​​If you are late (less than 24 hours) or missed (24 to 48 hours) an active pill

You’re still protected against pregnancy if you missed 1 pill anywhere in the pack or started a new pack 1 day (24 hours) late. 

Follow these steps:

  1. Take the late or missed pill immediately
  2. Continue taking the remaining pills at the usual time (even if it means taking two pills on the same day)
  3. Take the 7-day pill-free break as prescribed or if you’re on an everyday pill, take the inactive pills 
  4. Emergency contraception is not usually needed but can be considered if hormonal pills were missed earlier in the cycle or in the last week of the previous cycle
  5. No additional contraceptive protection (e.g. condoms) needed

If you missed two or more active pills (48 hours or more)

When this happens, it greatly increases your chances of ovulation. In this case, when you missed 2 or more active pills anywhere in the pack or started a new pack only after 2 days (48 hours) or more, you may not be protected against pregnancy. 

What you should do:

  1. Take the last pill that you missed immediately even if it means taking 2 pills a day 
  2. Discard any earlier missed pills 
  3. If the missed pill is within:
    • Week 1 (pills 1 to 7) or Week 2 (pills 8 to 14) of the pack:
      • Continue to take the active pills in your current pack daily
      • Take a 7-day break
      • Begin a new pack the next day
    • Week 3 of the pack (pills 15 to 21):
      • Continue to take the active pills in your current pack daily
      • When you have finished taking all the active pills, discard the pack
      • Don’t take the 7-day break, begin a new pack the next day
  4. Consider taking emergency contraception if you missed 2 or more pills during the first week of a pack and/or had unprotected sex in the last 7 days
  5. Use extra contraception (i.e. condoms) or abstain from sex for the next 7 days

What Are The Potential Side Effects Of Diane-35®?

Women who just started taking Diane-35® may experience some of the following side effects:

  • Nausea, vomiting, bloating and stomach cramps. Take Diane-35® after food to reduce these side effects. 
  • Headache. Can be managed by taking over-the-counter painkillers such as Paracetamol.
  • Spotting between your periods during the first few months of taking oral contraceptives.
  • Breast tenderness
  • Weight changes due to fluid retention, mood swings. Take Diane-35® at the same time every day to avoid huge changes in the hormone levels in your body.

Side effects vary widely among individuals and usually ease within 2–3 months of starting to take the pill as your body adjusts to the hormones. Inform your doctor if the side effects last for a long time (more than 3 months) or bother you.

How To Buy Diane-35® In Singapore?

In Singapore, all hormonal birth controls including Diane-35® can only be purchased if you have a valid prescription from a registered doctor and are unavailable over-the-counter. In other words, you will have to set aside some time amidst your busy schedule to visit the general practitioner or gynaecologist in person.

Siena is a digital health clinic that offers you easy and affordable access to birth control. Simply complete an online questionnaire, and speak with a doctor online from the comfort of your home. If prescribed, we deliver your birth control to you in discreet packaging at no additional charge.


Sexual Health

Viagra® (Sildenafil) For Erectile Dysfunction (ED): Effectiveness & Where To Buy In Singapore

Viagra®, also sometimes known as “the little blue pill”, is the most famous name in treating erectile dysfunction (ED). It was the first oral pill to treat ED and was approved by the U.S. Food and Drug Administration (FDA) in 1998.

In this article, we share more on how Viagra® works to treat ED, potential side effects, Viagra® alternatives, and the safest way to obtain Viagra® in Singapore.

What Is Viagra®? 

Viagra® is a brand-name prescription drug that’s approved to treat ED. With ED, you are unable to get or keep an erection firm enough for sex.

Viagra® is often mentioned alongside a drug called Sildenafil / Generic Sildenafil. While these two medications might have different names, they contain the same ingredient and work exactly the same. In comparison with Viagra®, generic sildenafil is much more affordable and wouldn’t burn a hole in your wallet.

How Does Viagra® Help To Treat Erectile Dysfunction?

An erection occurs when nerves in your penis are stimulated. This results in muscles around the penis, known as the corpora cavernosa, to relax and allow blood to flow in, causing an erection. 

Sildenafil, the active ingredient in Viagra®, is a PDE-5 inhibitor that works by relaxing the blood vessels, allowing blood to flow into your penis when you get aroused to create and sustain an erection. 

Viagra® helps you get hard. If you often find yourself climaxing too fast, you may have premature ejaculation (PE), which is treated with a different medication.

How Effective Is Viagra®?

In multiple clinical studies, between 43% and 83% of men who took Viagra® had improved erections (these success rates varied depending on the cause of their ED and the dosage of Viagra® being used).

How Long Does Viagra® Last?

According to Viagra®’s FDA label, the drug can help to produce an erection up to 4 hours after pill-talking but its effects usually start to taper off after 2-3 hours. 

As you get older, your metabolism slows down. Hence, some people notice Viagra® works for a longer period as they age. 

Can you climax more than once with Viagra?

Viagra® may not work again immediately after ejaculation. Your stamina, natural refractory period, and level of arousal are just some factors that can determine how many times you’ll be able to come before the medication wears off.

How To Take Viagra®?

Viagra® may be taken anywhere from 30 – 60 minutes before sexual activity. This is the average time needed for Viagra® to start working, but in some cases, it can take up to 2 hours to work. 

Do not take Viagra® more than once a day or the dose prescribed for you.

How To Take Viagra® For Best Results?

Viagra® works best when taken in the right conditions. Below are some tips that you can use to take Viagra® more effectively and get the best possible results from each blue pill:

  1. Eat a light meal beforehand

Viagra® does not need to be taken with food to work. However, a light meal can help to prevent indigestion/stomach upset!

Avoid large meals and high-fat foods (eg. fried, greasy food) before taking Viagra®. The fat in the meal can potentially delay the absorption of Viagra® in your body, meaning it may take longer to take effect. 

Had a large meal? Wait a couple of hours to allow enough time for digestion before taking Viagra®.

  1. Try to relax

If you feel anxious, nervous, depressed, or stressed, your body may not respond well to sexual stimulation. If this is the case, try to relax, make yourself comfortable, and give yourself time for the medication to work! Viagra® usually starts to work within 30-60 minutes. You may take it up to 4 hours before sexual activity.

  1. Get in the mood

Viagra® will not work if you are not sexually aroused! Try giving each other a sensual massage or taking a warm bath together. Extend your foreplay, and you may even want to try role-playing to shake things up a little!

  1. Avoid alcoholic drinks after taking

Alcohol can decrease blood flow to your penis, making Viagra® less effective and shorter-lasting. 

Also, Viagra® can lower blood pressure. Combining it with alcohol can increase this effect. If your blood pressure drops, symptoms like dizziness, lightheadedness, and headache could also hinder your hard-on and mood.

Potential Side Effects Of Viagra®

Viagra® is generally safe when taken under the advice and supervision of a medical professional. According to the NHS, most men have no side effects or only minor ones. 

Mild side effects

Common side effects include:

  • Headaches are mostly mild and go away quickly with rest. If the headache is bothersome, take paracetamol painkillers that can be purchased over-the-counter. 
  • Facial flushing where the skin on your face feels hot. Open a window, turn on a fan or lie down and rest to cool down if flushing occurs.
  • Indigestion or stomach pain. Take with a light meal if Viagra® causes stomach upset. However, do note that food can delay the absorption of the medication, meaning it may take longer for Viagra® to work. 
  • Stuffy nose.
  • Visual disturbances (eg. blurring of vision, blue tinge in vision).

Common side effects typically go away over time as you adjust to the medication. If you experience any of the above, keep taking the medicine, but tell your doctor if these side effects bother you or do not go away.

Serious side effects

Serious side effects from Viagra® are rare, but they can occur. Stop your medication and contact your doctor immediately if you experience any of the following:

  • Chest pain. 
  • Allergic reaction. Symptoms can include swelling of the face, eyes, lips or tongue, difficulty in breathing, or itchy skin rashes over your whole body. 
  • Priapism, a prolonged and sometimes painful erection that lasts more than 4 hours.
  • Sudden vision loss in one or both eyes.
  • Sudden hearing decrease or loss. May also involve other symptoms, such as tinnitus (ringing or buzzing in ears) or dizziness.

Alternative ED Pills To Viagra®

While Viagra® is considered to be the most common medication for ED, there are quite a few on the market. They all work the same — improve blood flow to the penis so that you can have and keep an erection long enough to have sex, but can differ in the cost, how fast they start working and how long their effects last. 

ED PillsCharacteristics
Viagra® (Sildenafil)– Taken prior to sexual activity
– Onset: 30-60 minutes
– Duration: 4-5 hours
Generic Sildenafil– Taken prior to sexual activity
– Onset: 30-60 minutes
– Duration: 4-5 hours
Spedra® (Avanafil)– Taken prior to sexual activity
– Onset: 15-30 minutes
– Duration: 6-12 hours
Cialis® (Tadalafil) 20mg– Taken prior to sexual activity
– Onset: 30-45 minutes
– Duration: 24-36 hours
Generic Tadalafil 20mg– Taken prior to sexual activity
– Onset: 30-45 minutes
– Duration: 24-36 hours
Levitra® (Vardenafil)– Taken prior to sexual activity
– Onset: 30-60 minutes
– Duration: 4-5 hours
Cialis® (Tadalafil) 5mg– Taken daily
– Onset: Continuous
– Duration: Continuous
ED drugs: How soon they start working and how long they last

How And Where To Get Viagra® In Singapore?

The only (safest and legal) way to get Viagra® (Sildenafil) or other ED pills in Singapore is with a valid prescription from a Singapore licensed doctor.

ED pills may result in harmful physical reactions if they are not taken in the right dose, if you have certain medical conditions, or if you’re on certain medication. As such, it is important for a doctor to access your health condition before he/she can deem your suitability for Viagra® and at what dose.

Avoid counterfeit viagra

Oral medications for ED are among the most counterfeited medications in the world. A Straits Times article in 2014 reported that 11 men in Singapore have died after taking illicit sex drugs.

Never buy medication for ED from unauthorised sellers or if the medication is of unknown origin. These illegal products have no guarantee on the contents, efficacy, safety and quality. So you actually have no idea whether the pill will work or worse, if the pill will harm you. 

Where to get a doctor’s prescription for Viagra®?

A Viagra® prescription can be obtained from a General Practitioner (GP) or urologist (private and public sector). However, talking about our issues in bed may be a little awkward, and having to make a trip down to the clinic deters most men from seeking the help they need. 

With Siena — a MOH-approved digital health & wellness clinic for men, you can get a personalized ED treatment prescribed by a SG licensed doctor online and delivered discreetly to your home at $0. Simply start by answering some questions on your lifestyle, symptoms and medical history. 

The Bottomline

If ED is affecting your relationship, sex life or self-esteem, it is best to seek help from a medical professional. They’ll help you find the solution that’s right for you, and potentially catch other health problems before they become severe.

At Siena, we believe in empowering men with access, choice and knowledge to navigate health issues that matter. We provide affordable access to ED treatments, delivered conveniently to your door in discreet packaging to ensure your health remains confidential.


Sexual Health Uncategorized

Erectile Dysfunction (ED): Symptoms, Causes, Treatments In Singapore

Are your erections, or rather, lack thereof, causing disappointing nights for you? We’ve got you covered! Here’s a comprehensive guide on everything you need to know about erectile dysfunction.

What is erectile dysfunction?

Erectile dysfunction (ED), sometimes known as impotence, refers to the inability to get or sustain an erection that is firm enough for sex. It is one of the most common sexual problems that men encounter. In fact, a study published by the Singapore Medical Journal has revealed that among Singaporean men above the age of 30, about 1 in 2 of them have had ED at some point in their lives. 

Symptoms of erectile dysfunction

If your penis fails to perk up very occasionally, chances are it is completely normal, especially if you’re recently feeling a little stressed out. However, if you routinely have difficulty getting or maintaining your erection, you might want to get it checked out – it may be ED. Some men also find themselves losing interest in sexual activities or having lower self-esteem about their erections. These psychological factors may ultimately result in ED.

The mechanics of erectile dysfunction

Imagine someone filling up a balloon with water. The balloon expands in size and becomes more turgid. Likewise, when a man is sexually aroused, your brain sends signals which cause blood to flow into your penis. Blood fills up spongy tissues, known as corpora cavernosa, causing the penis to become more rigid.

Now, imagine if the tap that you are using to fill the balloon is faulty. Water flows out so slowly that there isn’t enough force to stretch and fill up the balloon. That’s exactly how ED works. When blood flow to your penis is blocked or slowed down, your penis remains flaccid. Other causes of ED may be a disruption in brain signals arising from depression, anxiety or stress. 

Causes of erectile dysfunction

You might have heard that ED is “all in your head”. For many years, experts believed that emotional and psychological problems were the sole causes of ED. Well, this is partially correct and partially wrong. Here’s the truth – ED can be caused by a multitude of factors, including emotional, physical, lifestyle factors and many more. 

Psychological and emotional causes of erectile dysfunction

Your brain plays a key role in a good erection. It is responsible for feelings of sexual excitement, as well as transmitting nerve signals to allow blood flow to your penis. The common psychological culprits of poor erection include: 

  • Depression
  • Anxiety
  • Stress
  • Low self-esteem
  • Guilt
  • Performance anxiety
  • Relationship conflicts

Physical causes of erectile dysfunction

Contrary to popular belief, ED is not “all in your head”. Any chronic disease that decreases blood flow can result in ED. If you have any chronic diseases, it is important to keep them under control. Common diseases include:

  • Diabetes
  • High blood pressure
  • High cholesterol

Besides those mentioned above, there are also other less common, albeit more serious diseases that can contribute to ED. These include: 

  • Hormonal imbalance
  • Parkinson’s disease
  • Alzheimer’s disease
  • Benign prostate hyperplasia (BPH)

Does old age cause erectile dysfunction?

Is age just a number in the onset and progression of ED? Well, maybe, maybe not. Although ED becomes more common with age, growing old does not always cause ED. Some men remain sexually functional, even in their 80s. On the other hand, younger men, including teenagers, can have ED due to lifestyle factors such as drinking, smoking and overall health.

Treatments for erectile dysfunction

Depending on what caused your ED, you may be recommended for different treatment options. Most ED pills belong to a class of medication known as “phosphodiesterase type 5 inhibitors (PDE5 inhibitors)”. To put their mechanism of action in simple terms, these pills cause your blood vessels to relax, increasing the blood flow to the penis. 

Different pills follow different treatment schedules. Generally, ED pills can be categorised into two groups: the as-needed pills and the daily pills. 

As-needed pills/strips

These pills/strips are taken prior to any sexual activity. They are recommended for men who are able to predict when they have sex or men who do not wish to take pills daily. 

  • Viagra® (Sildenafil), also known as the blue pill. These pills were the first FDA-approved oral treatment for ED. 
  • Generic Sildenafil. These pills contain the same ingredient and work exactly the same as its branded option, Viagra®. In comparison with Viagra®, generic sildenafil is much more affordable and wouldn’t burn a hole in your wallet. Generic sildenafil is also the most popular treatment option at Siena.
  • Spedra® (Avanafil). These pills are great for men who prefer spontaneity. They are fast-acting and are effective just 15 minutes after taking them.
  • Cialis® (Tadalafil) 20mg. These pills are long-lasting and are effective for up to 36 hours after taking them. 
  • Tadalafil 20mg. These pills contain the same ingredient and work exactly the same as its branded option, Cialis®. But cheaper!
  • Caliberi® Tadalafil Orodispersible Films 20mg. These strips contain the same ingredient and work exactly the same as Cialis® but dissolve on your tongue.
  • Levitra® (Vardenafil). These pills are the branded alternatives to Viagra®, the blue pill.

Daily pills

These ED pills are to be taken every day. They work best for men who don’t like to plan ahead and want to be ready around the clock.

Other treatment options

Other options include testosterone therapy if you have low testosterone, penile injections, vacuum erection devices, intraurethral medications, penile implants or even surgery.

Lifestyle changes for better performance

Keeping a healthy lifestyle not only boosts your overall health, but also your sexual health. Here are some tips that you can follow: 

  • Keep a heart-healthy diet: A poor diet that is full of fats and sugars can lead to clogged arteries, diabetes and heart disease, which eventually spirals into ED. Reduce fats and sugars while incorporating more vegetables and fruits into your diet. 
  • Stay within your healthy weight range: If you are overweight, it’s best that you shake off that excess weight.
  • Exercise regularly: Not only does exercise promote blood circulation, it is also amazing at alleviating stress. In short, exercise targets both root causes of ED. Having 30 minutes of exercise for at least 5 days a week is bound to boost your health and energy, both in and out of the bedroom.
  • Quit smoking and drinking: As both smoking and drinking increase your risk of ED, we recommend that you sever your ties with them. Trust us, your body and penis will thank you. 

Finding the best treatment for erectile dysfunction

There is no one-size-fits-all treatment for ED. To choose the best treatment option for yourself, take into account your lifestyle, preferences, medical history and affordability. If you’re experiencing ED, it’s a good idea to speak to a doctor at Siena. They’ll help you find the solution that’s right for you, and potentially catch other health problems before they become severe.


Birth Control Period

How To Delay or Skip My Period(s) Safely

Us women have never asked for periods. It is uncomfortable, troublesome and sometimes even painful. It doesn’t help that they are a monthly occurrence.

There’s no natural way to stop the Crimson Wave and other monthly woes from crashing onto the shore, but there are medicines that may do the trick – period-delay medication such as norethisterone and hormonal contraception such as birth control pills/patches.

In this article, we share more about:

  • Benefits of delaying or skipping your period(s);
  • How to delay or skip your period(s) safely;
  • Is it safe to delay or skip period(s); and
  • Where to buy period delay medication (Norethisterone) or birth control in Singapore.

Benefits Of Delaying Or Skipping Your Period(s)

There are many reasons why many women choose to skip their periods. As periods are a hassle for all and even excruciating for some, it is understandable why women would rather skip their periods than bear with the inconvenience, especially since it’s proven to be safe to do so.

Symptoms, conditions or reasons why people delay or skip their periods can help with include:

  • heavy periods – excessive blood loss every month can take its toll physically and emotionally, and can also lead to iron deficiency anaemia, which can leave you feeling very tired (fatigued), but skipping periods can help avoid this. 
  • painful periods – if your periods cause cramping tummy pains or lower backache, skipping a period can give you a well-needed break.
  • irregular periods – not knowing when your period is coming can be annoying, but delaying or skipping it can put you back in control. 
  • premenstrual syndrome (PMS) – PMS symptoms you can get before your period range from bloating and mood swings to acne and breast pain, but not having a ‘natural’ cycle can reduce your chances of getting them. 
  • endometriosis – this long-term (chronic) condition can cause heavy and painful periods, but hormonal treatments that stop your periods can help ease symptoms.
  • fibroids – these non-cancerous growths that can develop in or around your womb can also cause heavy or painful periods, so skipping or stopping periods can help manage symptoms. 
  • blood clotting disorders – conditions that cause bleeding, such as Von Willebrand disease, often cause heavy periods, so not having periods can make symptoms easier to manage.
  • other health conditions – several other health conditions can be aggravated or made worse by having periods, including menstrual migraines, asthma and irritable bowel syndrome (IBS).
  • non-medical reasons – such as for a holiday, staycation or big event.

How To Delay Or Skip Your Period(s) Safely?

There are no natural remedies to delay or stop your period, but there are medicines that may do the trick!


If you are currently not on any hormonal contraception and want to delay your period, your doctor can temporarily prescribe you a period-delay medication called Norethisterone.

Norethisterone contains the hormone progesterone. In a natural female cycle, the menstrual period (monthly shedding of the womb lining) is triggered by a drop in the level of progesterone hormone. By taking norethisterone and artificially keeping your natural progesterone levels up, it stops the lining of your womb from shedding and hence prevents your period from happening. 

Once you stop taking Norethisterone, your progesterone levels return to normal and your next period usually starts again within 3 days.

Norethisterone has to be taken 3 times a day (1 tablet each time), starting 3 days before your period is due to start. Norethisterone does not act as a contraceptive when taken for period delay, so you could still get pregnant. It is important to consider if you need alternative contraception such as condoms. However, Norethisterone should not be used alongside any hormonal contraceptive.

Birth Control Pills/Patches

To skip your period(s) using the combined birth control pills, simply skip the inactive pills or 7-day hormone-free break by starting on a new pack of pills immediately. 

To skip your period(s) using the combined birth control patches, simply skip the 7-day hormone-free break by starting on a new pack of patches immediately. 

When you are on continuous use of birth control pills/patch, levels of estrogen and progesterone are consistently high which prevents ovulation from taking place. When ovulation does not occur, your period does not come too.

Is It Safe To Delay Or Skip Periods?

Menstrual suppression — the use of hormones to delay or eliminate menses — is often used to manage conditions associated with the menstrual cycle and to accommodate lifestyle preferences. Studies show that reducing the frequency of menstrual bleeding does not cause any known physiologic harm and has potential short-term and long-term advantages. Different methods used for menstrual suppression, however, have associated risks and side effects that need to be weighed against the benefits of controlling menses.

Where To Buy Period Delay Medication (Norethisterone) Or Birth Control In Singapore?

Norethisterone and birth control are prescription-only medications in Singapore. You would need to consult a doctor in person before you can get started on them.

With Siena, you can have access to affordable period delay pills and birth control from the comfort of your home. Simply complete an online questionnaire, and speak with a doctor via an online video call. If prescribed, your medication will be delivered to you in discreet packaging and at no additional charge!