Erectile dysfunction (or ED) is a common problem among a considerable percentage of older men, and one that can be quite difficult for those suffering from the condition, as well as their intimate partners. The inability to maintain a firm erection can lead to embarrassment, shame and a loss of interest in sex, which can then have reverberations into other facets of an interpersonal relationship.
A man may experience ED at any age, yet it is more likely to be found in men over 40. The University of Washington Health Men’s Health Program reports the following:
Mild and moderate erectile dysfunction affects approximately 10 percent of men per decade of life (i.e., 50 percent of men in their 50s, or 60 percent of men in their 60s, etc.). Erectile dysfunction can occur at any age, but it is more common in men that are older. Older men are more likely to have health conditions that require medication, which can interfere with erectile function. Additionally, as men age, they may need more stimulation to get an erection and more time between erections.
There can be psychological causes of ED, including depression, anxiety and stress. Physiological causes may include:
Treatment for ED most commonly consists of …
oral medications such as Cialis or Viagra, as well as penis vacuum pumps, testosterone replacement and penile implants. Seeking treatment for mental health symptoms is recommended, and there is some evidence that moderate exercise can decrease the risk of ED. Shock therapy for ED, additionally, is a controversial treatment that is worthy of more discussion.
The use of low-intensity extracorporeal shock wave therapy (LI-ESWT) is being studied by scientists in clinical trials (the most likely place where the treatment can be obtained since it is not fully FDA-approved).
Practitioners of this treatment utilize a hand-held device to apply shock waves to the penis, using a gel to conduct the pulses. The treatment is reported to not be painful, although some tingling in the penis can be felt. Side effects may include penile bruising, bloody urine, infection, pain during intercourse related to bruising and painful erection.
The energy from the shock waves is said to stimulate the growth of new blood vessels, which can then improve erection firmness. A varying number of shocks are administered per minute, and the entire session of 15-to-20 minutes may need to be repeated regularly over time.
The online literature regarding LI-ESWT can appear somewhat confusing and contradictory. Some proprietary websites claim that shockwave therapy is FDA-approved for ED. A 2017 study of 710 patients concluded that the treatment “showed a statistically significant improvement in the quality of erections in ED patients,” but then added cryptically, “the improvement effect diminished slightly in the final assessment.”
A 2019 article in the journal, Urology Times stated the following:
“Low-intensity extracorporeal shock wave therapy is a safe treatment for men with erectile dysfunction, and might work to improve, or even cure, ED in some patients. But, there remain important…
unanswered questions, including which patients are ideal candidates and which protocol and devices are best. Without answers, offering the ED treatment outside research settings is questionable medicine, some urologists say.”
Even so, the article continues, the treatment is widely used in Europe. It is further noted that there are some machines which deliver a very shallow shock wave, which are classified as Class 1 devices and don’t require FDA approval, but are seen by many as largely ineffective. Class 2 devices, which have a great deal more promise, are only FED-approved for clinical trials.
Overall, there are issues of cost, poorly designed studies, confusion over Class 1 and 2 devices and dubiousness regarding the actual safety and efficacy of the treatment, although promising data does indeed exist. A word to the wise: Speak with your healthcare provider or urologist first, especially before purchasing a device online. In other words: Caveat emptor—buyer beware.
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