Erectile Dysfunction – Clearwater, FL

Achieving an erection can be reverse engineered and segmented into structures and processes that add up to an erection. By working through the problem of Erectile dysfunction in this way, you can diagnose the cause or causes of your Erectile dysfunction and seek the best treatment focused on that root-cause analysis.

The activation of protein kinases by cGMP relaxes vascular smooth muscle cells, which affects various downstream effectors. While the specific processes underlying the interaction of NO, cGMP, and corporal smooth muscle relaxation are unknown, it is known that a healthy vascular endothelium can regulate vascular smooth muscle constriction and relaxation to maintain excellent erectile function.

The mechanism that causes a penis to become, and stay, erect includes several key components. The cause of an erection is arousal, which stimulates the release of nitric oxide from nerve terminals and blood vessels. That increases the amount of blood that flows into the erectile tissue. As the erectile tissue fills with blood, the veins that drain the blood out of the penis collapse. That prevents blood from leaving the erectile tissue and keeps the penis erect (WebMD). It’s usually difficult for a man to get another erection right away. The length of the interval between erections varies, depending on a man’s age, his health, and whether he is sexually active on a regular basis. A young, sexually active man in good health may be able to get an erection after just a few minutes, whereas a man in his 50s or older may have to wait 24 hours. One reason may be that nerve function slows with age.

What causes a weak erection?

There are many contributing factors that can cause ED. For most males, it is an obstruction of the blood vessels.  Anyone who is experiencing ED for long periods of time, one should seek medical advice as ED can be a symptom of a bigger problem and life-threatening disease.

Treatments For ED

Diseases –

These are some of the most common diseases that can cause ED

Type 2 Diabetes – Men who have diabetes are two to three times more likely to develop ED than men who do not have diabetes (NIDDK)

Heart and Blood Vessel Disease – Several studies have shown that if a man has ED, he has a greater risk of having heart disease. Having ED is as much a risk factor for heart disease as a history of smoking or a family history of coronary artery disease (Cleveland Clinic)

Atherosclerosis – Erectile dysfunction is frequently a sign of atherosclerosis, a clogging or narrowing of the blood vessels that causes heart attacks. Erectile dysfunction usually comes 3 to 5 years before a heart attack (AHA Journals)

High Blood Pressure – high blood pressure damages the lining of the blood vessels and causes arteries to harden and narrow (atherosclerosis), limiting blood flow. This means that less blood flows to the penis (Mayo Clinic)

Chronic Kidney Disease – Erectile dysfunction (ED) is a common condition among male chronic kidney disease (CKD) patients. Its prevalence is estimated to be approximately 80% among these patients. It has been well established that the production of nitric oxide from the cavernous nerve and vascular endothelium and the subsequent production of cyclic GMP are critically important in initiating and maintaining an erection (NCBI)

Multiple Sclerosis –

A survey of MS patients (n=5868) found that 67.2% of participants endorsed sexual dysfunction symptoms that were present always or almost always in the previous six months (Cleveland Clinic)

Peyronie’s Disease –

Is a noncancerous condition resulting from fibrous scar tissue that develops on the penis and causes curved, painful erections (Mayo Clinic)

Low testosterone – 

Testosterone levels tend to decrease with age. They peak by early adulthood and then can drop by up to 1% per year beginning around age 40. Sometimes an abrupt fall occurs because of an injury or illness (such as an infection), chemotherapy or radiation treatment, or certain medications (Harvard Health).

The hormone testosterone plays a big part in men’s health, but perhaps its most meaningful role is to fuel sex drive. If testosterone levels drop too low, men can experience erectile dysfunction as well as lackluster libido.

Lifestyle choices

ED can be caused for a variety of lifestyle choices. Anyone who participates in heavy drinking/drugs, heaving smoking, overeating (that leads to obesity), lives a sedentary life should consider living a healthier lifestyle by exercising more and giving up unhealthy habits.

Mental Issues

Once a medical professional has determined there is no physical condition causing ED, it will be helpful to look at the level of anxiety and stress a person has in their life, to determine if ED is being caused by psychological reasons.

Age

ED is increasingly prevalent with age: approximately 40% of men are affected at age 40 and nearly 70% of men are affected at age 70. The prevalence of complete ED increased from 5% at age 40 to 15% at age 70.2 Age was the variable most strongly associated with ED (Cleveland Clinic).

What are some ED treatment options?

There are a variety of options available for people experiencing ED. It is important to note that not all treatments will be perfect for everyone. Talk to a medical professional to see what is best for your lifestyle and potential underlying conditions.

Prescription Pills

There are several prescription medications that can treat ED. Specifically, Viagra, avanafil (Stendra), tadalafil (Cialis) and vardenafil (Levitra). The cost to patients for ED drug therapy varies considerably, depending on the pharmacy price, co-pays, and your level of health plan coverage (if any).

Pumps

A penis pump consists of a plastic tube that fits over the penis, a hand or battery-powered pump attached to the tube, and a band that fits around the base of the penis once it is erect (constriction ring). Although short term (and only when used) the majority of men can get an erection sufficient for sex if they use a pump correctly.

Shockwave

Low-intensity shockwave therapy (LISWT) treatment is now being offered for men with erectile dysfunction (ED) caused by inadequate blood flow to the penis, called vasculogenic ED. Because most ED patients experience some blockage of their blood vessel, Shockwave therapy can be very effective for most people.

ED Shockwave Procedure

During the procedure, a medical professional will move a wand-like device around different areas of your penis, which emit gentle pulses that trigger increased blood flow. The entire treatment lasts approximately 15 minutes and each patient will need to have Shockwave Therapy, once a week for six weeks Most patients experience little to no pain and don’t need to do anything before the procedure to prepare. Once the treatment is complete, the patient will be able to safely drive themselves home. Medical professionals suggest that if your patients feel any pain, take over-the-counter (OTC) medications, such as acetaminophen or ibuprofen for pain relief. Most people can return to normal activity the following day after shockwave therapy, but your urologist will discuss whether you should restrict your activity for longer to recover.

Benefits of Shockwave Therapy in Clearwater

ED can be treated using Shockwave Therapy. Because this therapy is non-invasive patients experience little to no pain and don’t experience side effects that usually are associated with prescription pills and surgery treatments. It is recommended that all Shockwave Therapy should be performed in a facility with a trained medical professional. This provides the highest amount of effectiveness and eliminates the risk that is normally associated with someone who uses an at-home device.

Is shockwave therapy effective?

Shockwave therapy significantly reduced the pain that accompanies tendinopathies and improves functionality and quality of life. It might be the first choice because of its effectiveness and safety.

Who is a good candidate for Shockwave Therapy in Clearwater?

Men with mild to moderate vasculogenic ED who have had some response to PDE5 inhibitors are ideal candidates for LISWT. Also, anyone who doesn’t respond well to other therapies like surgery and medications are perfect candidates for Shockwave Therapy.

Radial Wave Therapy vs. Shockwave Therapy

Radial Wave Therapy

There is no data to support claims that it can help with erectile dysfunction. It is not regulated by the FDA because it is a Class I medical device (the “energy” levels are lower than medical-grade devices). No medical license or professional training is required to administer this treatment, so it’s usually safe to use at home.

Shockwave Therapy

Data shows it can stimulate blood flow and potentially help grow new blood vessels. A licensed medical professional with professional training is required to administer this treatment. It is not yet approved by the Food and Drug Administration (FDA) for use in treating erectile dysfunction but it is being researched by medical professionals.

Research

In a recent meta-analysis of 10 randomized controlled trials involving a total of nearly 900 men with vasculogenic ED, researchers reported that, compared with sham treatment, LISWT (Shockwave Therapy) resulted in significant improvements in measures of erectile function and penile blood flow (Nature 2019)

Restorative therapies are a promising technology that represents a new frontier of treatment geared towards reversing disease pathology rather than just treating symptoms (Science Direct, 2021)

This study showed that penile electromagnetic shockwave therapy may improve erectile function, to a modest extent, on certain patients that do not respond to PDE5I; making it an alternative for vascular ED patients that reject more invasive therapies (Science Direct, 2021)

LI-ESWT applied to the corpora cavernosa showed a statistically significant improvement in the quality of erections in ED patients with or without oral or intracavernous treatment, without side effects (Hindawi, 2017)

Statistics

Shockwave Therapy can cost for each treatment is between $400 and $500 out-of-pocket)

45% of 45-year-old men experience ED; 60% of 60-year-old men experience it.