Male sexual arousal involves a complex and coordinated effort among the brain, nerves, muscles, hormones, and ultimately, the blood vessels of the penis. If any physical part of the system doesn’t work properly, it can lead to erectile dysfunction (ED), the inability to achieve and maintain an erection for intercourse. In addition, psychological stressors and mental health issues can cause or worsen ED.
As an example, a physical problem that interferes with your arousal or impairs the ability to achieve an erection may cause you anxiety about your sexual abilities. The anxiety then causes a feedback loop, making you hesitant, slowing your response further, and ultimately worsening your ED.
Urologist and men’s sexual health physician Dr. William Brant understands that talking about erectile dysfunction may make you feel uncomfortable, but he and his staff want to assure you that you aren’t alone — the 1994 Massachusetts Male Aging Study found that about 52% of men experience some form of ED — and it’s nothing to be ashamed about. We offer a number of treatments that can help you regain your sexual function, including cutting-edge shockwave therapy. Here’s what you need to know.
How does an erection occur?
An erection results from increased blood flow into your penis, which can be stimulated either by sexual thoughts or direct contact with the tissue.
When aroused, a man’s penis muscles relax, allowing for increased blood flow through the penile arteries. The blood fills two chambers, one on each side of the penis, stiffening the tissue into an erection. The erection ends when the muscles contract, squeezing the blood out through the penile veins.
What are some standard treatments for ED?
There are a number of options that are commonly used to treat ED.
Medications are typically the first line of treatment for erectile dysfunction. These include Viagra® (sildenafil), Levitra® (vardenafil), and Cialis® (tadalafil). All three are phosphodiesterase (PDE5) inhibitors, which means they block the action of phosphodiesterase, a chemical that prevents you from achieving an erection. The medications increase blood flow to your penis, helping you achieve and maintain an erection suitable for sexual activity.
If psychological or mental health issues are contributing to your ED, talk therapy may prove helpful. During your sessions, you and the therapist can discuss:
- Your stress and anxiety factors
- How you feel about sex
- How you feel about your sexual performance
- Subconscious issues that affect your sexual wellbeing
- ED can take a toll on you and your partner’s relationship, so you might also want to speak with a couples’ counselor to help you reconnect emotionally. With greater openness and trust, you may feel more confident about your performance.
Some medications are injected directly into the penis. These drugs, including alprostadil (edex® and CAVERJECT®), as well as papaverine and phentolamine (TriMix or Bi-Mix), all widen and relax blood vessels, boosting blood flow to the penis.
So, how can shockwave therapy help my erectile dysfunction?
Low-intensity shockwave therapy (LiSWT) is already established as a treatment for healing wounds, bone fractures, and damaged or inflamed connective tissues. But now many doctors, such as Dr. Brant, are incorporating it as a non-invasive treatment for ED.
The treatment goes by several names — LiSWT, Gainswave, Acoustic wave, and True Pulse Protocol — and it can reduce your dependence on oral or injected medications. Dr. Brant and his team use the Li-ESWT (Low-intensity extracorporeal shockwave therapy) system for men who have mild-to-moderate blood flow-related ED and who’ve had success with PDE5 inhibitors.
Dr. Brant uses a wand-like device to deliver low-intensity sound waves into the deep tissues of your penis. The waves clear away any plaque buildup in the blood vessels that prevents flow into the two chambers, without affecting the skin around the treatment area. The waves also stimulate growth factors so that your body can build new, healthy blood vessels, improving the quality of your erections. The treatment requires no anesthesia or medication, is non-invasive, has no side effects, and takes only about 15 minutes per session. The number of sessions you need is customized to your body and your goals, but it’s fair to say that many men need one to two sessions per week for about six weeks for optimal results.