“There’s no single ED treatment that’s right for everyone, so getting to know the patient’s needs is important,” explains Dr. Liroff. “Sometimes ED is linked to a hormonal imbalance or a condition like diabetes, heart disease or depression. Finding the cause of ED is the first step in choosing the best treatment.” Once any health conditions have been addressed, you can move on to treatments to help you get or keep an erection.
- PDE5i plus testosterone
- Lifestyle changes plus pills
- Vacuum pump plus pills
- Psychological counseling plus meds
- Multimodal treatment plans
- Personalized medicine approach
- Combining treatments for better results
- Managing multiple conditions
- Drug interaction checks
- Holistic health strategies
- Adjusting combination therapy
ED medications improve blood flow to the penis, which helps people achieve an erection. These pills are safe and effective for many people, which is why they remain a first-line treatment.
WE ARE SPECIALIZED IN ED
A more powerful or high intensity shockwave therapy has been used to help patients with kidney stones, but the newer, low intensity form, has a role in rehabilitation including use on patients with joint and or extremity inflammation. Recently, researchers have investigated the use of LI-SWT as therapy for erectile dysfunction (ED). The ability to have erections is dependent on adequate blood flow. When a man is sexually stimulated, cavernous arteries dilate and allow blood to flow into and fill the erectile bodies of the penis. Adequate blood inflow is necessary for the penis to achieve the rigidity necessary for sex.
Executive Summary
If blood flow is inadequate, a man may experience weaker erections or may be unable to have erections at all. Shockwave therapy is a potentially revolutionary type of treatment as it actually plays a role in repairing vascular damage the penis may have sustained, damage that has contributed to erectile dysfunction. Potentially, this could possibly give men who are dependent on PDE5’s the ability to once again have spontaneous erections, or make patients who are beyond oral medications, once again responsive to PDE5’s. LI-SWT is administered in an office setting with the patient awake. Trials have most commonly employed five or six weekly treatments which last about fifteen to twenty minutes. Not everyone should take these medications, however. “Oral medications for ED can cause dangerous interactions if you take them with nitrates, which are medications that treat angina or chest pain,” says Dr. Liroff. “ED medicines can also interact with certain heart medications and alcohol. Finally, depending on the drug, you have to take them 15 minutes to two hours before sexual activity, which requires advanced planning.” If oral medications aren’t right for you, injectable ED treatments are a good next step. “With ED injection medicines, you use a thin needle to place medicine directly in your penis,” says Dr. Liroff. “Up to 85% of men get good results with this treatment, but the main drawback is having to give yourself an 100 sex tablet injection before sex.” A vacuum erection device, sometimes called a penis pump, creates a gentle vacuum around the penis to create an erection. “Pumps for ED help draw blood into the penis, and then you use a stretchy band to keep the blood in place,” says Dr. Liroff.
| Product | Dosage | Quantity + Bonus | Price | |
|---|---|---|---|---|
| Viagra Professional | 100mg | 120 + 4 Pills | 262.83€ 250.31€ | |
| Cialis Generic | 60mg | 10 Pills | 41.22€ 39.26€ | |
| Viagra Generic | 25mg | 270 + 8 Pills | 184.26€ 175.49€ | |
| Viagra Generic | 150mg | 90 + 6 Pills | 147.18€ 140.17€ | |
| Viagra Generic | 200mg | 90 + 6 Pills | 170.79€ 162.66€ | |
| Levitra Generic | 40mg | 20 Pills | 67.56€ 64.34€ | |
| Kamagra Soft Tabs | 100 mg | 12 Pills | 57.55€ 54.81€ | |
| Cialis Professional | 20mg | 270 + 6 Pills | 623.07€ 593.40€ | |
| Cialis Generic | 5mg | 180 + 10 Pills | 159.65€ 152.05€ | |
| Cialis Generic | 40mg | 60 + 6 Pills | 130.98€ 124.74€ | |
| Cialis Professional | 20mg | 120 + 4 Pills | 291.68€ 277.79€ | |
| Kamagra Soft Tabs | 100 mg | 84 + 4 Pills | 233.05€ 221.95€ | |
| Kamagra Gold | 100 mg | 12 Pills | 55.64€ 52.99€ |
“The FDA-approved devices work well for about 75% of patients.” One of the newest therapies for ED is known as low-intensity shockwave treatment (LISWT) or shockwave therapy.
ED vs Premature Ejaculation. What’s the Difference?
ED can negatively affect your self-esteem and sex life, but you don’t have to suffer alone. Our team regularly helps men experiencing this condition and can develop a personalized treatment plan to improve their sexual health and confidence. To schedule an appointment, call the nearest office in Cary, Clayton, Dunn, Raleigh, or Wake Forest, North Carolina, or use our online booking tool. The past two decades have been witness to almost miraculous advances in technology, from the internet, to the tablet, to communication by texting and wearable extensions of our smart phones. Advances in our options to improve men’s ability to achieve erections have been no less profound.
Focused shockwave therapy
The inflatable penile prosthesis is decades old but has stood the test of time. It offers men who cannot achieve an erection an ability to have an erection, whenever and for as long as they want, even if other options are not adequate. Subsequent to the development and refinement of the implant came penile injections medicine for erectile dysfunction with pharmaco-active medicines. The most common medicine given is prostaglandin E2. This therapy has allowed many men to forgo implants and has continued to be an option for the past three decades. “Shockwave therapy emits pulses of energy into the tissues of the penis, which generates a natural healing process,” explains Dr.
How to Identify Safe Supplements
Non-invasive methods include vacuum erection devices; these devices use negative pressure or suction to bring blood into the penis and cause and erection, and then trap the blood using and elastic band and are still used today as a conservative form of therapy. They have also been available for about three decades. A revolution in treatment for erectile function came with the development of pharmaceutical agents that inhibited an enzyme called phosphodiesterase type 5. These PDE5 inhibitors enable a spontaneous erection to happen more easily. They include viagra, levitra, cialis, staxyn and stendra.
Extracorporeal Shockwave Therapy (ESWT)
PDE5 inhibitors have been available for over fifteen years. Since that time, few developments have had significant impact, until perhaps now. There is a new therapy for erectile dysfunction which essentially improves blood flow into the penis through the use of pulses of energy or shockwaves into the erectile tissue and may restore ability to have erections. LI-SWT or low intensity shockwave therapy uses acoustic waves that generate a pressure impulse which carries energy through a medium or tissue to encourage better blood flow by a process called neo-vascularization. Neo-vascularization literally means new blood vessels form and improve circulation in the target organ. Liroff. “The tissues respond by increasing blood flow, which helps you get an erection.” You’ll likely need about six shockwave treatments, spaced over a few weeks. It may take up to three months to see maximum results.
| Test Name | Purpose | How It's Done |
|---|---|---|
| Blood Tests | Check hormone levels, cardiovascular health | Blood sample analysis |
| Nocturnal Penile Tumescence Test | Determine if ED has psychological causes | Monitors erections during sleep |
| Duplex Doppler Ultrasound | Evaluate blood flow in penis | Ultrasound with injection of vasodilator |
| Penile Biothesiometry | Measure sensitivity in penis | Electrical stimulation test |
“LISWT causes mild tingling, but most patients don’t find it painful,” says Dr. Liroff.
| Therapy | Description | Status |
|---|---|---|
| Low-Intensity Shockwave Therapy | Promotes blood vessel regeneration | Experimental/clinics |
| Stem Cell Therapy | Regenerates damaged tissues in penis | Experimental |
| Platelet-Rich Plasma (PRP) | Uses patient's blood to improve tissue healing | Experimental |
| Gene Therapy | Targets genetic causes of ED | Under research |
“When a licensed provider gives you shockwave therapy, it’s safe and has a minimal risk of side effects.” It’s important to know the difference between true shockwave therapy and counterfeit versions.
| Treatment Type | Description | Typical Use |
|---|---|---|
| Oral Medications | PDE5 inhibitors like sildenafil, tadalafil | First-line treatment for many men |
| Vacuum Erection Devices | Mechanical pumps creating vacuum to draw blood | Non-invasive, for short-term use |
| Injections | Alprostadil or other agents injected into penis | For men unresponsive to pills |
| Psychotherapy | Treats underlying psychological issues | Complementary to physical treatments |
A similar-sounding treatment known as radial wave therapy (rWT) is available at healthcare clinics and even non-medical facilities. Though it promises results, it has no science to back up its claims.
- Diabetes management
- High blood pressure control
- Cholesterol lowering
- Avoiding drug abuse
- Limiting sedentary lifestyle
- Regular health screenings
- Treating hormonal disorders
- Managing autoimmune conditions
- Reducing obesity risks
- Avoiding smoking and alcohol
- Prostate health maintenance
“Shockwave therapy has data to show that it stimulates blood flow and generates new blood vessels,” explains Dr. Liroff.
Erectile Dysfunction: Causes and Treatment
When you think of erectile dysfunction (ED) treatments, pills likely come to mind. Though they were the first ED treatment to be FDA-approved, oral medications are no longer your only option. Henry Ford Health urologist Stephen Liroff, M.D., explains the different ED treatments and how to find a solution that works. Before you start treatment for ED, your provider will need to learn more about you. They may perform a physical exam and ask about your symptoms, medical history and lifestyle. “Radial wave therapy doesn’t have these results, and studies have shown that it’s equal to no treatment.” Penile prosthesis surgery, sometimes called a penile implant, might be an option if less invasive treatments haven’t worked for you. “There are different types of implants, depending on your needs and preferences,” says Dr.
- Online support communities
- Local ED support groups
- Patient advocacy organizations
- Urologist referral networks
- Educational websites
- Patient forums and discussions
- Confidential counseling services
- Reading materials and books
- Telemedicine consultations
- Insurance coverage assistance
- Finding the right healthcare provider
Liroff. “See a urologist who has experience in penile implant surgery to discuss your options.” Steer clear of herbal medications and “natural supplements” for ED. No studies have proven that they work, and they could be dangerous. “The FDA doesn’t regulate ED supplements, so you don’t know what you’re getting,” says Dr.
P-Shot® PRP Therapy for Sexual Performance
The probe that administers the energy is hand held and applied directly to different areas of the penis and its root (or crus). Results of clinical trials have been encouraging. Almost no complications have been reported and the treatment is well tolerated. There are few restrictions; however, patients who are receiving anticoagulation are not currently candidates for this treatment. This new shockwave therapy has created a lot of “buzz” and excitement and will likely be premature ejaculation medicine coming soon to New Jersey. Liroff. “At best, you’re paying for something that won’t give you results. And at worst, you could experience dangerous interactions and side effects.” One of the newest therapies for ED is a gel you apply directly to the penis.
What Are Alternative Treatments for Erectile Dysfunction?
Psychological factors, such as stress and relationship issues, are believed to contribute to 10-20% of all ED cases. It can be tempting to push feelings like anxiety and depression to the side, hoping things improve on their own, but that’s rarely the case. Working with a qualified mental health professional, such as a psychologist or licensed therapist, can help you identify the root cause of the problem. They can also provide strategies to manage stress and improve communication with your significant other, making it easier to talk about ED and strengthen your relationship. Some men with ED aren’t able to take oral medication due to certain health conditions, medications, or other risk factors.
2. Testosterone replacement
If you fall into this category, a mechanical solution, like a penis pump, could be a viable alternative. These devices use suction to draw blood to the penis and are often used with a constriction ring to help maintain the erection long enough to have intercourse. Even though penis pumps are effective, some men don’t like the time and effort required to use these devices before sex. If you’d prefer sexual encounters to maintain some level of spontaneity but aren’t able to take oral medication, consider, for example, an Alprostadil injection or a urethral suppository. Both are fast-acting and stimulate an erection within minutes, making it easier to have sex without the extra steps when the moment feels right. This treatment is not yet sold in the U.S. “We need more clinical trials to show that an ED topical gel is as effective as other options,” says Dr.
- Sex education for men
- Understanding erectile physiology
- Normalizing sexual function
- Masturbation and ED
- Sexual satisfaction goals
- Foreplay and arousal techniques
- Communication skills training
- Reducing performance pressure
- Exploring intimacy beyond sex
- Libido and ED connection
- Sexual health education resources