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Erectile Dysfunction: Navigating Your Treatment Options

ED and Poor Sexual PerformanceUnfortunately, many men are reluctant to report erectile dysfunction (ED) to their doctor due to social stigmas associated with sexual performance. ED is much more common than the general population may realize. A John Hopkins study revealed that over 18 million men in the U.S. over the age of 20 experience difficulties having and maintaining an erection. In response, a number of options to improve sexual performance have been developed, with varying efficacy and side effects.

Common ED Treatments

The causes of erectile dysfunction range from unhealthy lifestyles such as smoking and obesity to age-related decline and more complicated psychological and physiological problems. Because of this, consulting with a physician before embarking on a treatment plan for ED is essential. With that in mind, knowing what the potential options when you go into a visit can help you identify the best plan for your needs.

  • Comparing Interventions for ED and Poor Sexual PerformanceMedications: Pharmacological treatments for ED include pills, penile injections, or urethral suppositories.
    • Drugs such as Viagra, Levitra, and Cialis are popular and boast an 80% success rate. These medications are classified as phosphodiesterase-5 inhibitors – they increase blood flow to the penis, enabling an erection. Pills are usually taken anywhere from 15 minutes to 36 hours before sexual activity. This route typically isn’t recommended for men taking nitrate drugs or alpha-blockers, and all medications, including over-the-counter herbs and supplements, should be shared with your doctor to prevent negative interactions. The commonly reported potential side effects of phosphodiesterase-5 inhibitors include “a headache, flushing, runny nose, stomach pain, back pain (Cialis), and indigestion.”
    • Alprostadil is a drug often prescribed when oral medications are ineffective or not an option. Similar to the pill remedies, alprostadil increases blood flow to the penis, although the effects manifest much more rapidly, usually within minutes. Alprostadil can be given as an injection or through a procedure known as MUSE (medicated urethral system for erections) – a urethral suppository. Both methods are associated with side effects in some men, such as priapism (an erection lasting longer than 4 hours), burning, and minor bleeding.
    • A drawback of all these interventions is that they do not treat the root cause of erectile dysfunction; namely, the reason why blood flow is inhibited in the first place. They merely increase blood to the penis without addressing the underlying reason flow is inhibited.
  • Pumps: Some men either don’t want to take medications or aren’t able to; in these cases, a vacuum pump treatment may be recommended. Vacuum pumps are made of a plastic cylinder that’s placed over the penis – the air is then pumped out of the device, forcing blood into the penis. It is held in place by a ring at its base, thereby creating and maintaining an erection. Possible drawbacks include weak ejaculation, numbness, bruising, and the ring can only be worn for up to 30 minutes. Pumps aren’t necessarily intended as a long-term solution, but rather a method of re-enabling natural erections over time.
  • Erectile Dysfunction treatment optionsSurgery: Surgical treatments for ED fall into two categories: implants and vascular reconstruction. Vascular reconstruction surgery involves repairing blocked blood vessels in the penis and is mostly reserved for men with small blockages.
    • Implants are typically recommended for patients who have neurological or spinal injuries, and those for whom other remedies were ineffective. The two types of implants are malleable and inflatable. Malleable involves two bendable rods placed inside the penis that allow patients to manually position the penis into an erect position. The inflatable option uses balloon-like tubes that can be filled with a squeeze pump. Problems with implants include accidental inflation, infections, and a tendency to hinder prostate, bladder, and other urological surgeries. Of course, the major drawback to these interventions is that they involve extremely invasive surgery.

Addressing the Root Cause of Poor Sexual Performance

Shockwave treatment, officially known as Low-Intensity Extracorporeal Shockwave Therapy (LI-ESWT), addresses the causes of sexual dysfunction in many cases, rather than simply masking the symptoms. Shock waves have long been known to be effective at regenerating cardiac blood vessels through a process called revascularization. This type of therapy has been in use for many years in Europe as an intervention for ED and poor sexual performance.

Erectile dysfunction TreatmentGAINSWave has been spearheading shockwave therapy in the United States – and thus far, the results have been exceptional. A 2013 study presented by Therapeutic Advances in Urology concluded that the Low-Intensity Extracorporeal Shockwave Therapy (LI-ESWT) created “a significant clinical improvement of erectile function ... without any adverse effects.”

GAINSWave treatments are quick and non-invasive. Therapy typically includes between 6-12 in-office visits lasting 20 to 30 minutes each. Patients may immediately resume daily activities and 75% of men experience positive results post-treatment, though the results vary based on an individual’s medical condition and age, and may take a few months to accrue.

Of course, a medical evaluation is always recommended before determining the best intervention for any individual. Request an appointment to see how LI-ESWT can improve your sexual performance.

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