Many men put off asking about urinary or sexual health — sometimes out of embarrassment, sometimes because they assume it’s just part of getting older. The cost of that silence shows up in the data: in Singapore, prostate cancer is now among the most common cancers in men, accounting for roughly one in six male cancer cases — yet only about 15% of cases between 2018 and 2021 were diagnosed at Stage I, while around 31% were picked up at Stage IV, according to figures from the Singapore Cancer Registry.
The pattern repeats across men’s health: conditions that are common, manageable, and far easier to treat early, discovered late because nobody asked the question.
So we asked Dr Joe Lee, a urology specialist at Asian Healthcare Specialists, to answer the questions men ask most often in his clinic — and the ones they wish they had asked sooner.
In this article
- How many times is too many to pee at night?
- Does cycling really affect erections?
- When should men start prostate checks?
- Is a morning erection a sign of good health?
- Why does the urine stream get weaker with age?
- Can holding urine for hours damage the bladder?
- Blood in urine — when should I worry?
- Does a vasectomy lower testosterone or affect performance?
- How do men check for testicular cancer?
- Does ejaculating more often lower prostate cancer risk?
1. How many times is too many to pee at night?
Quick answer: Once a night can be normal. Two or more, every night, isn’t “just age” — it’s a signal worth checking.
Waking once at night to pass urine can be normal, especially if you drank a lot before bed. But if you’re waking two, three, or four times every night and it’s affecting your sleep, don’t just blame age.
You wouldn’t be alone — clinical reviews report that more than half of adults over 60 experience nocturia (waking at night to urinate), and roughly half of men in their 70s wake at least twice a night. But here’s the part many men miss: the same reviews are clear that nocturia is not a normal or inevitable part of ageing, and it can almost always be improved once the cause is found.
That cause varies. Frequent night urination can be related to prostate enlargement, bladder conditions, diabetes, sleep disorders such as sleep apnoea, or simply drinking habits. Each has a different answer — which is exactly why guessing doesn’t work.
💬 Dr Lee’s take: “If night urination is becoming a pattern, get it checked. Better sleep starts with knowing the cause.”
2. Does cycling really affect erections?
Quick answer: Not automatically. But long hours on a narrow saddle, yes — sometimes. Adjust the saddle first.
This question comes up more as cycling has boomed across Singapore’s park connectors. The short answer: cycling does not automatically damage erections, and the cardiovascular benefits of regular exercise are good for erectile health overall.
But long hours on a narrow saddle can put pressure on the nerves and blood vessels in the perineum — the area between the scrotum and the anus. If you notice numbness, discomfort, or erection changes after long rides, that’s your body flagging a pressure problem, not a reason to stop exercising.
💬 Dr Lee’s take: “Adjust the saddle, take breaks, and use proper cycling shorts. If the problem persists, see a doctor. Exercise is good for men’s health — but pain, numbness, or weaker erections are not things to push through.”
3. When should men start prostate checks?
Quick answer: From 50 for most men. From 40 if there’s a family history of prostate cancer diagnosed before 60.
For many men, the prostate conversation becomes more relevant from around age 50. That aligns with local guidance: Singapore’s Ministry of Health considers men above 50 — and men with a family history of prostate cancer diagnosed before 60 — to be at higher risk, and recommends these groups discuss screening with their doctor. There is currently no national screening programme for prostate cancer in Singapore, which means the conversation has to start with you.
If you have urinary symptoms, a strong family history, or other risk factors, it may be worth discussing screening earlier — from around 40.
And the part men dread? The finger examination can still be useful, but prostate assessment today may also involve a PSA blood test, urine test, scan, and sometimes an MRI. Much of modern prostate assessment starts with a simple blood draw.
💬 Dr Lee’s take: “Don’t wait until symptoms are severe before asking.”
4. Is a morning erection a sign of good health?
Quick answer: Not quite — but a change in erection quality can be one of the earliest warning lights for heart disease.
A morning erection is often a sign that the nerves and blood flow to the penis are working well — but it isn’t a perfect health test.
What matters more is change. If a man used to have normal erections and now notices a clear drop in erection quality, that can sometimes be an early clue to blood vessel or metabolic problems. The research here is striking: published reviews in cardiovascular and urology journals have repeatedly found that erectile dysfunction often precedes the symptoms of coronary artery disease by around two to five years. The leading explanation is simple plumbing — the penile arteries are narrower than the coronary arteries, so the same underlying vessel disease shows up there first.
That makes a change in erections one of the body’s earliest available warning lights — and a genuine window of opportunity to address heart health before anything more serious develops.
💬 Dr Lee’s take: “Erection health is not just about sex. It reflects general health too. So don’t be embarrassed to bring it up.”
5. Why does the urine stream get weaker with age?
Quick answer: Often the prostate enlarging. But “common” doesn’t mean “just live with it” — there are several other causes to rule out.
As men get older, the prostate often enlarges — a benign condition called benign prostatic hyperplasia (BPH). It is remarkably common: studies estimate that about half of men aged 51 to 60 have some degree of BPH. Because the urine tube passes through the prostate, an enlarged prostate can make the stream slower, weaker, or more interrupted.
But “common” is not the same as “just live with it” — and not every weak stream is BPH. It can also be due to infection, urethral narrowing, or bladder weakness, each needing a different approach.
💬 Dr Lee’s take: “If your stream is getting weaker, you’re straining, or you feel you cannot empty properly, it is worth checking. Most men feel better once we identify the actual cause.”
6. Can holding urine for hours damage the bladder?
Quick answer: Once in a while, no. Every day? Yes.
Occasionally holding your urine — through a long meeting, a long drive up north — is unlikely to ruin your bladder. But making it a daily habit isn’t ideal.
Your bladder is a muscle. Keep overstretching it and you may develop discomfort, difficulty controlling or emptying it properly, and even infections. This matters most for people who already have bladder or prostate issues, where an already-stressed system has less room for abuse.
💬 Dr Lee’s take: “Don’t panic if it happens once in a while. But don’t train your bladder to suffer every day.”
7. Blood in urine — when should I worry?
Quick answer: Always. Even if it happens just once. Even if there’s no pain.
Blood in the urine should always be taken seriously. Sometimes the cause is straightforward — an infection or a stone. But studies of people investigated for visible blood in the urine have found underlying urinary tract cancers in a meaningful share of cases, with bladder cancer the most common finding. Visible blood in the urine is, in fact, the most common first symptom of bladder cancer.
Two things trip men up here. First, the bleeding in serious conditions is often intermittent — it appears once, disappears, and the relief of it stopping becomes a reason to do nothing. Second, it’s frequently painless, which feels reassuring but isn’t.
💬 Dr Lee’s take: “Even if the blood appears only once, even if there is no pain, you should still get it checked. Blood in urine is one of those symptoms where early evaluation really matters.”
8. Does a vasectomy lower testosterone or affect performance?
Quick answer: No. Testosterone is produced and released directly into the bloodstream — a pathway a vasectomy doesn’t touch.
A vasectomy does not lower testosterone, and we don’t expect it to reduce erection strength, sex drive, or performance.
The anatomy explains why: a vasectomy blocks the tubes that carry sperm into the semen. Testosterone, however, is produced by the testes and released directly into the bloodstream — a pathway a vasectomy doesn’t touch. The testes continue producing testosterone exactly as before.
Many men worry that a vasectomy affects masculinity; it does not. It is, however, intended as a permanent form of contraception, so the decision should be made carefully, ideally together with your partner.
9. How do men check for testicular cancer?
Quick answer: Self-exam after a warm shower, monthly. New lump or hardness? Get it checked. Survival when caught early: over 95%.
Testicular cancer is uncommon — affecting roughly 1 in 250 men over a lifetime — but it has an unusual profile: it is the most common cancer in men aged roughly 15 to 35, with an average age at diagnosis of about 33, according to the American Cancer Society. In other words, this is the one cancer check that matters most for the youngest men, who are often the least likely to be thinking about cancer at all.
The encouraging part: when detected and treated early, five-year survival exceeds 95%, making it one of the most treatable cancers there is. Early detection usually starts with the man himself.
How to check: The best time is usually after a warm shower, when the scrotal skin is relaxed. Gently hold and feel each testis between your fingers, looking for a new lump, hardness, swelling, or a clear difference from before.
💬 Dr Lee’s take: “Not every lump is cancer. But any new lump should be checked. The goal is not to panic. The goal is to know your own body and act early.”
10. Does ejaculating more often lower prostate cancer risk?
Quick answer: There’s a real study behind the claim — but it’s not a substitute for proper screening.
This one has travelled far on social media — and unusually, there is real research behind it. A large prospective study published in European Urology (2016), following around 32,000 men over nearly two decades as part of the Health Professionals Follow-up Study, found that men reporting 21 or more ejaculations per month had roughly a 20% lower risk of being diagnosed with prostate cancer than men reporting four to seven times per month.
But the fine print matters. The association was strongest for low-risk prostate cancer, was not significant for aggressive disease, and as an observational study it can show a link but not prove cause and effect.
💬 Dr Lee’s take: “It does not mean ejaculation is a guaranteed way to prevent prostate cancer. For prostate health, the basics still matter: healthy weight, exercise, not smoking, managing diabetes and cholesterol, and appropriate prostate screening when indicated. It is an interesting topic — but don’t treat it as a substitute for proper health checks.”
The bigger picture: ask earlier
Run through the ten questions above and a single thread emerges: almost every condition on this list — an enlarging prostate, a changing stream, blood that appears once, a lump found in the shower — is significantly more manageable when raised early. The barrier is rarely medical. It’s the asking.
That’s also why continuity matters. A doctor who knows your baseline — your usual pattern, your last PSA reading, your family history — is far better placed to spot the change that matters than one meeting you for the first time at the emergency stage.
If one of these questions has been sitting in the back of your mind, consider this your prompt to ask it out loud.
Even strong men stop. It’s stronger to know for sure.
→ Book a urology consultation with Doctor Anywhere
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This article shares general health information and is not a substitute for medical advice. If you’re experiencing any of the symptoms above, speak with a doctor about your specific situation. You can book a consultation with a urology specialist through Doctor Anywhere.
References
- Singapore Cancer Registry Annual Report 2021, National Registry of Diseases Office — prostate cancer incidence and staging data.
- Ministry of Health Singapore — prostate cancer screening guidance for higher-risk men.
- Nocturia. StatPearls, NCBI Bookshelf — prevalence of nocturia by age.
- Benign Prostatic Hyperplasia. StatPearls, NCBI Bookshelf; Yale Medicine BPH fact sheet — BPH prevalence by decade.
- Reviews on erectile dysfunction as an early marker of cardiovascular disease (Arab Journal of Urology and PubMed-indexed reviews) — ED preceding CAD by ~2–5 years.
- Systematic reviews of haematuria investigation outcomes (European Urology and AUA Microhematuria Guideline) — urological cancer detection rates in visible haematuria.
- American Cancer Society — Key Statistics for Testicular Cancer.
- Rider JR, et al. Ejaculation Frequency and Risk of Prostate Cancer: Updated Results with an Additional Decade of Follow-up. European Urology. 2016;70(3):574–582.
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