Category: Sexual Health

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:

• sildenafil (Viagra)
• tadalafil (Cialis, Caliberi)
• avanafil (Spedra)
• vardenafil (Levitra)

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.

Medication	How To Take It	Onset
Viagra® (Sildenafil) 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 sex	30-45 minutes
Cialis® (Tadalafil) 5mg Caliberi® (Tadalafil) Orodispersible Films 5mg	Take 1 pill/film daily with or without food	Continuous
Spedra® (Avanafil)	Take 1 pill with or without food 15 minutes before sex	15-30 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

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.

Medication	Duration of Action
Viagra® (Sildenafil) 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	Continuous
Spedra® (Avanafil)	6-12 hours
Levitra® (Vardenafil)	4-5 hours

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.

References

• Harvard Health Publishing. (2020, April). Which drug for erectile dysfunction?. https://www.health.harvard.edu/mens-health/which-drug-for-erectile-dysfunction 
• Rosen, R. C., Riley, A., Wagner, G., Osterloh, I. H., Kirkpatrick, J., & Mishra, A. (1997). The international index of erectile function (IIEF): a multidimensional scale for assessment of erectile dysfunction. Urology, 49(6), 822-830. https://www.sciencedirect.com/science/article/abs/pii/S0090429597002380 
• Yuan, J., Zhang, R., Yang, Z., Lee, J., Liu, Y., Tian, J., … & Tang, J. (2013). Comparative effectiveness and safety of oral phosphodiesterase type 5 inhibitors for erectile dysfunction: a systematic review and network meta-analysis. European urology, 63(5), 902-912. https://www.sciencedirect.com/science/article/abs/pii/S0302283813000249

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.

References

• Healthhub. (2019, September). Dapoxetine. https://www.healthhub.sg/a-z/medications/350/Dapoxetine 
• MIMS. Dapoxetine: Indication, Dosage, Side Effect, Precaution https://www.mims.com/singapore/drug/info/dapoxetine
• National Institute for Health and Care Excellence. (2014, May). Full evidence summary | Premature ejaculation: dapoxetine. https://www.nice.org.uk/advice/esnm40/chapter/full-evidence-summary
• P. Ganesan Adaikan, Peter Lim, Kok Kit Ng, and Ee-Ling Fock. Journal of Men’s Health. S84-S86. (2011, April). Asian perspective: Premature ejaculation prevalence and attitudes (PEPA) among Singaporean men. http://doi.org/10.1016/S1875-6867(11)60030-4 
• Peng, J. et al (2021, April). Safety and Effectiveness of Dapoxetine On Demand in Chinese Men With Premature Ejaculation: Results of a Multicenter, Prospective, Open-Label Phase IV Study. Sexual medicine, 9(2), 100296. https://doi.org/10.1016/j.esxm.2020.100296

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®.

2. 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.

3. 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!

4. 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 Pills	Characteristics
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

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.

References

• Jewell, T. (2018, November). Everything You Need to Know About the Refractory Period. Healthline. https://www.healthline.com/health/healthy-sex/refractory-period
• Jewell, T. (2021, September). How Long Does Viagra Last?. Healthline. https://www.healthline.com/health/erectile-dysfunction/how-long-does-viagra-last
• Lim, J. (n.d.). Erectile Dysfunction (ED): Causes and Diagnosis. HealthXchange. https://www.healthxchange.sg/men/erectile-dysfunction/erectile-dysfunction-causes-diagnosis 
• Marshall, H. (2021, August). Side Effects of Viagra: What You Need to Know. Healthline. https://www.healthline.com/health/drugs/viagra-side-effects 

• Pietrangelo, A. (2021, July). Viagra vs. Cialis vs. Levitra vs. Stendra: How Each Stacks Up. Healthline. https://www.healthline.com/health/erectile-dysfunction/cialis-levitra-viagra
• Tan, J. K., Hong, C. Y., Png, D. J., Liew, L. C., & Wong, M. L. (2003). Erectile dysfunction in Singapore: prevalence and its associated factors – a population-based study. Singapore medical journal, 44(1), 20–26. https://pubmed.ncbi.nlm.nih.gov/12762559/ 

Herpes is one of the most common sexually transmitted diseases (STDs) in Singapore. There is currently no cure for herpes, so people who are infected have it forever.

However antiviral medications are available to treat sores, speed up the healing process, limit outbreaks and lower your chances of giving the virus to other people. And the good news is, outbreaks usually become less frequent over time, and even though herpes can sometimes be uncomfortable and painful, it’s not dangerous. People with herpes can have relationships, have sex and live totally normal lives.

In this article, we will discuss the:

• Types of herpes (oral & genital herpes);
• How do you get herpes;
• Symptoms of herpes;
• How to prevent herpes;
• Available treatments for herpes in Singapore.

What Is Oral & Genital Herpes?

Herpes is a contagious viral infection caused by the herpes simplex virus (HSV). There are notably two members of this family: HSV-1 and HSV-2.

• HSV-1: This type primarily causes oral herpes, characterized by cold sores or blisters inside of/around the mouth and on the face.
• HSV-2: This type primarily causes genital herpes, which involves sores that appear on or around your genitals, anus, buttocks, and inner thighs. Sores can also develop inside the vagina.

How Do You Get Herpes?

Herpes spreads through close contact with a person who has the infection. The virus can be found in the skin and saliva. If you have herpes simplex, you are most likely to pass the virus to another person when you have sores. But you can infect someone else even if you have no symptoms (also known as asymptomatic viral shedding).

People may transmit or contract HSV-1, or oral herpes, through

• Kissing.
• Touching a person’s skin near the mouth.
• Sharing food utensils, lip balm or razors.
• If you receive oral sex from someone who has a cold sore, it may spread a herpes infection to your genitals.

People may transmit or contract HSV-2, or genital herpes, through

• Intercourse, including anal, vaginal-penile and vaginal-vaginal.
• Oral sex (giving or receiving) with someone who’s infected.
• Skin-to-skin contact without ejaculation.
• Touching open sores, including while breastfeeding.
• Childbirth by a mother or gestational parent who has an active infection.

Symptoms Of Herpes

Most people infected with HSV may experience mild to no symptoms, leaving them in the dark about their infection, or even mistaking these signs as a skin condition instead. This is when transmission usually occurs as the individuals will dismiss the symptoms and leave the infection untreated while continuing to engage in sexual intercourse.

This is why it is useful to know the hallmarks of a herpes infection so that you can seek help as soon as possible. Here are some common signs that you can look out for:

• Cold sores around lips, mouth or tongue. They may look crusty or like fluid-filled blisters;
• Sores on their genitals, anal and surrounding areas;
• Tingling, itching or burning;
• Pain on urination;
• Flu-like symptoms (headache, fever, muscle aches); and
• Swollen lymph nodes in the groin area.

What Triggers A Herpes Outbreak?

Herpes infection is lifelong, and symptoms can recur over many years. A herpes outbreak may be triggered by:

• Stress;
• Menstruation;
• Illnesses;
• Surgery; or
• A suppressed immune system (due to chemotherapy, AIDS, transplant etc.)

While some people may only have one outbreak during their lifetime, others may have several recurrences a year. Recurrent episodes are usually shorter in duration (usually 1 week) and less severe/painful than the initial episode. Though the virus will always be present in the body, the number of outbreaks often decreases over the years.

How To Prevent Giving Or Getting Herpes

The best way to avoid herpes is by practising abstinence (not engaging in sexual intercourse) but most people have sex at some point in their lives. Here are some ways that can help lower the risk of giving or getting herpes:

• Always use protection like condoms and dental dams when having sex can lower your risk of giving or getting herpes.
• Taking antiviral medication every day (preventive treatment) inhibits the activity of the virus, thereby lowering the risk of infecting partners.
• Abstain from sexual activity when you feel a herpes outbreak coming or during a herpes outbreak, even with a condom. There may be sores on places the condom doesn’t cover (e.g. scrotum, butt cheeks, upper thighs, and labia).
• Abstain from sexual activity sex until your sores are totally gone, and the scabs heal and fall off.
• Avoid touching your sores and if you do, wash your hands with soap and water immediately.
• If you have a cold sore on your mouth, don’t kiss anyone — especially babies, children, or pregnant women.
• Always tell your sexual partners that you have herpes before you have sex, so you can work together to prevent it from spreading.
• Encourage your sexual partner(s) to be evaluated and treated for any STDs as well.

Treatment For Herpes In Singapore

There is currently no cure for herpes but prescription antiviral medication (Acyclovir) can be used to stop the spread of the herpes virus in the body. This helps to lessen symptoms, speed healing of your infection, limit outbreaks and lower your chances of giving the virus to other people

Topical antivirals	Oral antivirals
– Temporarily relieve the pain and discomfort and may help the sores (if any) heal faster – Most effective when used at the start of an outbreak	– If you have frequent or severe recurrence, a daily dose will help to prevent them (suppressive therapy) – If you have occasional outbreaks, start treatment when you feel one coming on (episodic therapy)

Where Can I Buy Antiviral Medication For Herpes In Singapore?

Topical and oral antiviral medications are only available with a prescription from a licensed doctor in Singapore. 

With MOH-approved telemedicine providers like Siena, you can now get your herpes treatments discreetly, conveniently, and inexpensively, all from the comfort of your home! Connect with one of our doctors via an online video consultation and if prescribed, we deliver your treatment plan right to your door in discreet packaging at $0.

References

• Centers for Disease Control and Prevention. (2022, Janurary). STD Facts – Genital Herpes. https://www.cdc.gov/std/herpes/stdfact-herpes.htm 
• HealthHub. (2020, November). Herpes: Causes, Symptoms, and Treatment – Singapore. https://www.healthhub.sg/a-z/diseases-and-conditions/50/herpes
• Planned Parenthood. Herpes: Causes, Symptoms, and Treatment – Singapore. https://www.plannedparenthood.org/learn/stds-hiv-safer-sex/herpes

This article is contributed by our partner, Noorindah from Shy & Curious.

Constant communication is an important part of all relationships — and that includes talking about sex.

What We Talk About When We Talk About Sex

Sex talks aren’t just about pleasure. Other topics about sex can include:

• sexual health
• family planning and contraception
• what you and your partner like and how to deal with differences
• consent and boundaries

Having these conversations help lay the groundwork for a better relationship as you learn about each other and try new things together, all while being on the same page.

It’s also worth getting past the awkwardness to talk about health, especially sexually transmitted infections (STIs) and birth control. Avoiding these important conversations might be endangering your health and altering the future you’d hoped for.

How To Start The Conversation

Here are some common difficult conversations related to sex and sexual health with some ideas on conversation starters. As always, speak in a neutral setting and time (e.g. outside the bedroom/NOT during sexy times) as you want both parties to be calm and feel safe since these conversations can be emotionally charged.

1. How do I bring up STI testing with a new sexual partner? 

Desired Outcome: You want to be sexy but still stay safe when it comes to a new partner. You want to know if they’ve been recently tested and practice safe sex.

Conversation Starter: “Just to make sure we’re on the same page, I’m sexually active and my last STI test was X. How about you?”

When it comes to discussing sexual health, keep it short, simple and direct. Lead with your own information first so they’ll feel less self-conscious about volunteering theirs.

2. How do I talk about birth control with my partner?

Desired Outcome: You’re thinking of getting intimate in bed with your partner and would like to find a birth control method(s) that best suits both of you.

Conversation Starter: “I think it’s great that we’re taking the next step in our relationship and it helps me feel closer to you. I do want to talk to you about sharing the costs for birth control together since I’m not ready to have a child yet. I definitely prefer the peace of mind with birth control instead of hoping we get lucky with the pull-out method.”

Birth control is a shared (and big) responsibility for everyone involved. Whether it’s pregnancy, STIs or how you feel while on different birth control methods, you and your partner share the experience. So why not make sure the end result is what you both wanted and expected by having the birth control talk before hitting the sheets?

When it comes to birth control, you’ve got options and even better, there are no bad options! At Siena, speak to a sex-positive and judgement-free doctor via tele-consultation about your options and get a personalized prescription that will work best for you and your health needs.

3. How do I bring up emergency contraception with my partner?

Desired Outcome: You’ve had unprotected sex in the past 72 hours and suspect that there might be a probability of getting pregnant. You want to let your partner know of your situation and purchase emergency contraception together.

Conversation Starter: “I don’t mean to alarm you but I think that the condom broke during our last session together. I want to be on the safe side and get the morning-after pill. Will you accompany me to get it?”

Don’t worry, it happens to the best of us! Whether it’s an accident or the heat of the moment, emergency contraception exists exactly for that reason. While it’s perfectly reasonable to ask for your partner’s emotional support (and split the cost as well as it takes two to tango!), there’s also a much easier way of getting your emergency contraception without having to head down to the clinic. Telemedicine platforms like Siena provide a range of emergency contraception at transparent and affordable pricing, and literally couriered to your doorstep incognito! While it might be called the morning-after pill, Siena also offers an emergency contraception pill that can be taken up to 120 hours after unprotected sex. That’s a 5 days window to quell the panic – but obviously don’t use this as an excuse to treat emergency contraception as a form of birth control. 

4. How do I introduce the idea of using sex toys with my partner?

Desired Outcome:  You don’t want to replace your partner but you’re interested in exploring using sex toys together so you can both enjoy different sensations and experiences. 

Conversation Starter: “So I’ve been reading about all these cool toys for the bedroom and I’m quite intrigued. Are you open to exploring these sex toys together with me? I think it’ll be fun to try something new and I’ll love to have that experience with you… ”

For some, the idea of sex toys and pleasure accessories may seem quite foreign or seen as ‘dirty’ because as a conservative Asian society, we’ve been conditioned to view sex as purely procreational. Pleasure hasn’t been placed in the forefront of conversations around sex so talking about owning, receiving and giving pleasure is still seen as taboo or weird.

The stigma around sex toys is also exacerbated by the misconception that a partner’s worth is also determined by how much they can give pleasure to their partner through just their genitals alone. (A.k.a if you have to use a toy in the bedroom, it means that you’re not sexually satisfied by your partner.) So when it comes (pun intended) to trying out sex toys to a partner who might be new to this world, we suggest emphasizing that it’s all about the shared experience, and mutually giving and receiving different types of pleasure as a fun way to strengthen your bonds. 

5. How do I bring up my kink/fetish with my partner?

Desired Outcome:  You are ready to share with your partner a sexual kink that you would like to experience with them. 

Conversation Starter: “I really love being with you and how much sexual chemistry we have. There’s been something I’ve wanted to share with you but since I felt quite vulnerable about it, I wanted to wait till we were closer. I’m actually quite turned on by BDSM and have wanted to explore it with someone I trust. Is this something you’ll be keen to explore with me? It’s ok to let me know if you’re not comfortable with the idea either. ”

Similar to our notes on introducing sex toys, be prepared that your partner might not initially know how to react if they’re not used to speaking openly about their sexual fantasies and pleasure preferences. Keep the dialogue open-ended and emphasize that while it might be your personal kink, they’re free to say a hard ‘No’ or that they can try it first but set up boundaries that they’re comfortable with. Remember that consent isn’t set in stone. While they may be open to trying it at first, they have the right to retract consent during play or afterwards if they’re uncomfortable and you should respect that decision.

6. How do I give constructive feedback about sex with my partner?

Desired Outcome:  Everything’s great except for that one thing in the bedroom! You want to speak to them after sex about how it can be better. 

Conversation Starter: “That was amazing! I really liked it when you did X. I wasn’t a fan when Y was happening but it felt really good when you switched it to X. ”

It’s often been called the ‘shit sandwich’ when it comes to delivering constructive feedback and it works even for sex! You’ll want to start by complimenting what you did enjoy during sex, then mentioning how it didn’t feel as good when they did the other act instead. Avoid accusatory negative comments like “You were pulling too hard” and rephrase it to focus on the act and how it felt (e.g. “It can get painful and intense when there’s a strong grip. I like it best when you focus on this part instead.”)

7. How do I tell my partner that this is my boundary?

Desired Outcome:  You gave consent previously but it’s now making you feel uncomfortable to engage further. You would like to stop and set a boundary to prevent it from happening again. 

Conversation Starter: “Can I speak to you about something important? I feel uncomfortable when X happens/you do Y. I know I’d initially said that I’ll like to give it a try but now I realize it’s not right for me. This is my boundary and I hope you respect that.”

For more tips on having the Talk® with your partner, do read the full article here.

Conclusion

We hope these scripts have given you some ideas on how to navigate those difficult conversations with your sexual partner. Keep it short, simple and direct. Don’t feel guilty or the need to apologize for putting up a boundary. You also shouldn’t feel the need to explain why it makes you uncomfortable – it’s a line you’ve drawn up and the only expectation on their end is to respect it. 

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About Noorindah Iskandar
Noorindah is the founder and writer behind Shy & Curious – an online platform that explores sex and love without the fear of having to hide your Google search history! With honesty and humour, she writes articles and essays about sex, relationships and intimacy through personal stories and informed insights.

Remember the proverb, “slow and steady wins the race”? Whether or not you actually heed this advice in your daily life, I’m sure you’ll agree that this proverb holds potent truth in bed. Indeed, coming too fast in bed often ruins the mood and can be extremely distressing for both you and your partner.

With 1 in every 3 men aged between 18 and 59 years old experiencing premature ejaculation (PE) at some point, PE is more common than you think.  

What is premature ejaculation (PE)?

Premature ejaculation occurs when:

1. A man orgasms and ejaculates sooner than he or his partner would like.
2. A man orgasms with very little stimulation.

How soon is too soon?

There is no clearly defined time period of what constitutes PE. The time frame can vary across individuals, depending on what he or his partner constitutes as “too soon”. International guidelines often cite that a man has PE if he ejaculates within 1 minute of entering your partner. Once again, this isn’t a hard-line definition, and it really depends on you and your partners’ preferences and feelings. 

What if it happens only occasionally?

It’s okay to have some disappointing nights, you can’t always have it all. However, if the problem occurs almost every time for more than 6 months and causes you significant distress, then you may have PE. 

Types of premature ejaculation

Also, did you know that not every PE is the same? Here, we break down the 2 different types of PE for you.

• Lifelong PE (primary PE): These men have been experiencing PE ever since their first sexual encounter. 
• Acquired PE (secondary PE): These men have previously had normal ejaculations, but later developed PE.

Lifelong PE is often caused by psychological factors, whereas acquired PE can be caused by a mixture of both psychological and biological factors. Moving on, let’s explore the different reasons for PE. 

Causes of premature ejaculation

PE may be due to psychological factors or physical factors, or a mixture of both. It’s good to know the common causes of PE so that you can identify which ones have led to your PE. 

Psychological factors

Anxiety is one of the leading factors of PE. This usually comes in the form of performance anxiety, where a man is concerned about his sexual performance. However, anxiety and stress about other aspects of life, such as work or relationship problems, can also play a part in PE. Other psychological factors that cause PE include depression, guilt, low self-confidence and unrealistic expectations about sex. 

Think back about your teenage years. If you recall masturbating hurriedly for fear of getting caught by your parents or others, that might have caused a lasting effect and led to your PE today. Besides that, traumatic sexual experiences at a young age or strict upbringing that frowns upon sex as shameful can lead to PE. 

Biological factors

Ever heard of serotonin, the happy hormone? Not only does serotonin boost your mood, but it is also the controller of your sexual desires and erection. The higher the serotonin levels in your brain, the longer it takes for you to ejaculate, allowing more satisfactory and happier sex. However, when serotonin levels are low, the time to ejaculation is shortened, causing PE. Not so happy anymore.

Besides serotonin imbalance, other medical conditions can also lead to PE. These include erectile dysfunction (ED), diabetes, an overactive thyroid and some prostate-related conditions. Genetics or simply an overly sensitive penis may even be at blame. 

Medical treatment for premature ejaculation

Oral medication

A common way to treat PE is using selective serotonin reuptake inhibitors (SSRIs). This is a class of drugs that increases the level of serotonin, hence prolonging the time it takes to ejaculate. They may also help increase your sense of control over ejaculation. If deemed medically appropriate, Siena can prescribe you an SSRI medication known as Priligy®, which contains dapoxetine. 

In men who have both PE and erectile dysfunction (ED), ED pills can help. These include sildenafil (Viagra®), also known as the blue pill, as well as avanafil (Spedra®) and tadalafil (Cialis®). These pills improve blood flow to the penis, which is necessary for an erection. 

Not sure if you have ED? Check out our previous blog article to learn more about ED.

Sprays and creams

Some men may find that local anaesthetic sprays and creams help reduce penile sensation, increasing the time to ejaculation. These sprays or creams should be applied onto the head of the penis up to 30 minutes before sex. You should wash the spray or cream off your penis 5 to 10 minutes before sex or put on a condom to prevent absorption of the spray or cream by your partner. Otherwise, it may cause vaginal numbness in your partner during vaginal sex. The condom also helps reduce your penile sensation, ultimately prolonging your time to ejaculation. 

Other tips and tricks to combat premature ejaculation

There are several natural ways to combat premature ejaculation. These include behavioural therapy, psychological therapy, lifestyle changes and even switching up your sex positions and techniques. We’ll save those for the next blog post, so do keep a close lookout for it!

Our final tip to all men with PE is to talk to your partner and seek treatment. Keep in mind that PE does not only affect you, but it can also lead to frustration and feelings of hurt from your partner. This may, of course, be a difficult topic to approach. However, your partner can be a great pillar of emotional support, and an open discussion with your partner will help to pave the way for mutual understanding. 

Lastly, remember that PE can be easily treated. That’s fortunate, but it means nothing if you shun away from seeking treatment. We know that visiting the clinic for treatment can be embarrassing and daunting, and that’s where we step in to help you. At Siena, simply fill up a questionnaire to answer the awkward questions and connect with one of our doctors for a video consultation, all from the comfort and privacy of your own home. 

References

• What are the DSM-5 diagnostic criteria for premature ejaculation (PE)? Latest Medical News, Clinical Trials, Guidelines – Today on Medscape. (2021, June 4). https://www.medscape.com/answers/435884-30677/what-are-the-dsm-5-diagnostic-criteria-for-premature-ejaculation-pe. 
• Nazario, B. (2020, July 7). Premature Ejaculation: Symptoms, Causes, Treatment, & Prevention. WebMD. https://www.webmd.com/men/what-is-premature-ejaculation. 
• NHS. (2019, July 24). Ejaculation problems. NHS Choices. https://www.nhs.uk/conditions/ejaculation-problems/. 
• Premature Ejaculation. Premature Ejaculation: Causes & Treatment – Urology Care Foundation. (2020, July 16). https://www.urologyhealth.org/urology-a-z/p/premature-ejaculation. 
• Lowy, M. (2018). Premature Ejaculation Fact Sheet. Healthy Male (Andrology Australia). 
• Urology Care Foundation. (2020). Premature Ejaculation Patient Guide.