Erectile Dysfunction
December 9, 2023
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5 Mins
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Race, ED & Me: What's The Link?
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Our race affects much more than the languages we speak. It can also predict our risk for certain medical conditions. Find out which races in Singapore are more likely to develop erectile dysfunction, why this happens and what you can do about it.
Erectile dysfunction, also known as ED, is a condition that affects over 40% of Singaporean men in their 40s, almost doubling to 80% by the time they hit their 60s.¹ Many underlying causes – such as obesity, cardiovascular disease and smoking – are well-documented risk factors that increase the likelihood of developing ED. But did you know that certain races are also more likely to suffer from ED than others?
Research has shown that the prevalence of ED varies between people of different races. A study in California, USA found that the prevalence of moderate-to-severe ED differed between white men (28%), Hispanic men (31.5%), black men (33.2%) and Asian men (26.8%).²
Closer to home, Chinese researchers summarised the overall prevalence of ED in various Asian countries.³ Here is the estimated prevalence of ED for some South-East Asian countries:
• Singapore – 2 to 53%
• Thailand – 29 to 65%
• Philippines – 33 to 65%
• Malaysia – 22.4 to 59%
• Indonesia – 11%
Now here’s the interesting part.
A group of doctors set out to find the prevalence of ED right here in Singapore. Of the participants studied, 51.3% reported having ED, with almost 20% suffering from severe ED.¹
When the participants were categorised by race, they found that almost 60% of Indian men were experiencing ED, compared to 49.3% of Chinese and 55.8% of Malays. The study concluded that Indian ethnicity was a significant risk factor for developing ED, alongside other known risk factors such as increasing age, diabetes and cardiac diseases.
Similar results were found in neighbouring Malaysia, where researchers found that Indian men were three times more likely to report ED compared to Malay and Chinese men.⁴ Another study found that both Malays and Indians were more likely to develop moderate-severe ED compared to Chinese.⁵
Why are some races at higher risk of ED than others? There are a few possible explanations.
Different ethnic groups have distinct cultural and social practices which influence their diets and lifestyles. In particular, Indians, Malays and Chinese appear to vary in their levels of physical activity and in the types of food they consume.⁶ This makes Malays and Indians more likely to develop metabolic syndrome (a cluster of conditions including obesity and insulin resistance) than Chinese.
ED is strongly linked to metabolic syndrome,⁵ so it is unsurprising that the lifestyle differences which make Indians and Malays prone to metabolic syndrome also increase their chances of experiencing ED.
Another reason may lie in our genes.
Indians are known to have unusually high rates of vascular disease (blocked blood vessels) and develop conditions like heart disease 5-10 years earlier compared to other ethnic groups.⁷ This can be traced to their genes, according to Indian researchers who discovered that roughly 35% of Indians carry genetic variations that increase their risk of heart disease.⁸
ED is also a vascular disorder, causing reduced blood flow to the penis. The same genes that increase their risk of vascular disorders may be causing Indians to suffer from ED more often than their Malay or Chinese counterparts.⁴
In summary, Indian men have three times the risk of ED compared to Malay or Chinese men, while Chinese men appear to have the lowest risk of moderate-severe ED among all three groups. This could be due to different lifestyle habits among the three races and because Indians have certain genes that make them more likely to suffer from vascular disorders like ED.
Our race is not something we can change. Our lifestyle, however, is under our control.
To prevent yourself from developing ED, it is crucial to ensure you remain in good overall health. To keep your blood vessels healthy and minimise your chances of ED, you can:
• Exercise regularly
• Avoid smoking
• Maintain a healthy body weight
• Take care of your mental health
• Speak to our doctors on our platform about your concerns and we’ll help you become your best, most confident self.
• Find out about ED treatments.
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Articles featured on Noah are for informational purposes only and should not be constituted as medical advice, diagnosis or treatment. If you have any medical questions or concerns, please talk to your healthcare provider. If you're looking for a healthcare provider, click here.
¹ Tan JK, Hong CY, Png DJC, et al. Erectile Dysfunction in Singapore: Prevalence and Its Associated Factors – A Population-Based Study. Singapore Med J. 2003; 44(1): 020-026. Accessed September 12, 2021. (Link)
² Smith JF, Caan BJ, Sternfeld B, et al. Racial Disparities in Erectile Dysfunction among Participants in the California Men's Health Study. J Sex Med. 2009;6(12): 3433-3439. doi: 10.1111/j.1743-6109.2009.01519.x. Accessed September 12, 2021. (Link)
³ Cheng JYW, Ng EML, Chen RYL, et al. Prevalence of erectile dysfunction in Asian populations: a meta-analysis. Int. J. Impot. Res. 2007;19:229-244. doi:10.1038/sj.ijir.3901517. Accessed September 12, 2021. (Link)
⁴ Nordin RB, Soni T, Kaur A, et al. Prevalence and predictors of erectile dysfunction in adult male outpatient clinic attendees in Johor, Malaysia. Singapore Med J. 2019;60(1): 40-47. doi: 10.11622/smedj.2018049. Accessed September 12, 2021. (Link)
⁵ Tan WS, Ng CJ, Khoo EM, et al. The triad of erectile dysfunction, testosterone deficiency syndrome and metabolic syndrome: findings from a multi-ethnic Asian men study (The Subang Men’s Health Study). Aging Male. 2011;14(4): 231-236, doi: 10.3109/13685538.2011.597463. Accessed September 12, 2021. (Link)
⁶ Tan AKG, Dunn RA, Yen ST. Ethnic Disparities in Metabolic Syndrome in Malaysia: An Analysis by Risk Factors. Metab Syndr Relat Disord. 2011;9(6): 441–451. doi: 10.1089/met.2011.0031. Accessed September 12, 2021. (Link)
⁷ Gupta M, Singh N, Verma S. South Asians and Cardiovascular Risk What Clinicians Should Know. Circulation. 2006;113: 924-929. doi: 10.1161/CIRCULATIONAHA.105.583815. Accessed September 12, 2021. (Link)
⁸ Subramanian L, Khan AA, Allu PKR, et al. A haplotype variant of the human chromogranin A gene ( CHGA) promoter increases CHGA expression and the risk for cardiometabolic disorders. J Biol Chem. 2017;292(34): 13970-13985. doi: 10.1074/jbc.M117.778134. Accessed September 12, 2021. (Link)
