Erectile Dysfunction Treatments

Erectile dysfunction is a very common problem for men, especially as they age, and made worse for men who don’t engage in regular physical exercise, have poor diets and gain weight.

This page explains how erectile dysfunction can be treated. It lists natural treatments and new treatments, such as using testosterone and shockwave.

Different Approaches to the Treatment of ED

The most appropriate treatments depend on the types of erectile dysfunction that are listed here. You can see how you score on erectile dysfunction here.

There are four broad categories of dysfunction: psychosocial/relationships, cardiovascular, neurological and hormonal.

The Best Way to Treat Erectile Dysfunction is to Start with Lifestyle

There are two ways that help reverse erectile dysfunction that cost little but take discipline. The first is to include exercise and healthy foods, while avoiding detrimental habits such as smoking and disrupted sleep habits.

The second is to engage in regular sexual activity including masturbation at least several times a week. The flaccid penis does not get enough blood flow to maintain the erectile tissues without regular semi hardness.

Regular exercise helps control stress that is a frequent cause of erectile dysfunction.

Here are five ways to maintain a healthy penis.

Loving Relationships Help Prevent Erectile Dysfunction

That is right, good erectile performance helps support a loving relationship, which in turn helps the penis remain healthy. It is the same with most tissues in the human body where active use helps them retain levels of performance.

An active, high quality sex life is not only good for him, it also has health benefits for her. See why doctors should prescribe “more sex”!

Testosterone Treatment & Erectile Dysfunction

Testosterone and erectile function decrease as men age. Low testosterone levels can lead to issues with cardiovascular health, muscle wasting, decreased bone density, and lower libido.

The pills commonly used to boost erectile performance work better when testosterone levels are not depressed.

To improve erectile function, testosterone replacement therapy can be used, which can lead to better results when combined with PDE5 inhibitors. Men with ED should be put in a state of normal testosterone levels before starting PDE5 inhibitor therapy. Testosterone levels should be checked in the morning due to normal daily variations.

Natural Supplements

Natural supplements are often looked down upon by practitioners of mainstream Western medicine.  However, some men find the benefits are real. The most promising natural supplements are: Icariin (“horny goat weed”), MACA, Tribulus and perhaps Ginseng. See details about these three natural supplements that help erectile performance.

Dietary & Nutritional Supplements

The optimal approach for optimizing erectile performance is to eat a healthy diet.

Foods that are particularly healthy for erectile performance include dark chocolate, fatty fish, avocados, bananas, pomegranates, walnuts, beets, watermelon, and oatmeal. These foods are rich in vitamins, minerals, and antioxidants that can help improve blood flow, support healthy hormones, and boost energy.

Studies have shown that dietary supplementation of L-arginine and citrulline, both substrates of nitric oxide synthase, can help improve erectile performance in men with erectile dysfunction. In one study, 57 men with erectile dysfunction were given either a placebo or 5,000 mg of L-arginine and 1,000 mg of citrulline daily for 12 weeks. After 12 weeks, those taking the L-arginine and citrulline supplement experienced improved erectile function compared to the placebo group. Similarly, another study found that supplementation with 5,000 mg of L-arginine and 1,000 mg of citrulline for 12 weeks improved erectile function in men with erectile dysfunction.

Mainstream Treatments for Erectile Dysfunction in Canada

In August 2021 the Canadian Urological Association published guidelines for treating erectile dysfunction.  The guideline, written for urologists and students of urology, was to “provide the best available evidence to facilitate care delivery through a Canadian lens,” acknowledging that “ED is assessed and treated by multiple different types of health practitioners.”

The document recommends lifestyle changes that are well-accepted and conservative which are outlined above. The medical and device interventions are as follows:

The first line treatments are erection pills and PDE5s that are explained here.

The guidelines list three second line treatments for ED as follows:

  1. Intraurethral alprostadil which is a small pill that needs to be pushed into the tip of the penis. The guidelines state that while “effective for select patients” this approach “has failed to gain a significant market share due suboptimal efficacy and urethral discomfort.”
  • 2. Vacuum erection pump devices that consist of a cylindrical chamber placed over the penis coupled with a manual or mechanical pump to generate a vacuum that pulls blood flow into the penis, which is trapped by a constriction ring placed at the base of the penis and can be maintained safely for up to 30 minutes. Many find this approach cumbersome and it can cause numbness, pain, bruising, and painful ejaculation.
  • 3. Intracavernosal injection of a prostaglandin prior to intercourse into the erectile tissues of the penis. This was the principle treatment for ED prior to the introduction of PDE5s and shockwave. The guidelines list side effects including pain at the injection site, bruising, pain, penile scarring/curvature, and priapism. One of the more common prescriptions is TriMix that is three-drug medication usually containing alprostadil, papaverine, and phentolamine.

Surgical implantation of prosthetic devices

The third line solution for ED listed in the guidelines are prosthetic devices that are implanted into the penis. This surgical intervention should be undertaken as a last resort. There are two types of prosthesis, one is malleable and the other inflatable. The guidelines state that “postoperative penile length can be negatively affected by corporal fibrosis or previous prostatectomy and the glans will remain flaccid post-implant.”

Guidelines for low-intensity shockwave therapy (Li-SWT)

The CUA Guidelines state, “Based on the available evidence, the panel conditionally recommends against Li-SWT as a treatment for patients with ED at this time.” This conclusion is perplexing because the therapy has proven effective for patients with defined vasculogenic symptoms and is better tolerated and without the adverse effects of the second and third line treatments described above.

And moreover, many urologists utilize Li-SWT to treat erectile dysfunction in their practices.

SONICWAVE Therapy – Non-drug Solution for Vasculogenic ED

SONICWAVES are high intensity vibrations similar to sound waves but with far greater energies. These vibrations cause the cells in and around the penis to experience micro trauma stimulating them to regenerate. The capillaries in the erectile tissue and the nerves regrow. 

The processes are natural and similar to what occurs when a muscle is stressed through hard physical exercise or the skin slightly bruised.

SONICWAVE™ also referred to as “soundwave therapy,” “acoustic therapy”  and “low intensity extracorporeal shockwave therapy” (LI-ESWT) have been used in medicine for over 50 years. At higher energies ESWT are used to break up kidney stones. Low intensity shockwaves are regularly used in orthopaedics, aesthetic and sports medicine. 

FullMast employs Dual-action SONICWAVE to treat erectile dysfunction.

The Benefits of Dual-action SONICWAVE

There are two types of SONICWAVE: Focused and radial. Focused penetrates more deeply and works especially well for the nerves and deeper lying erectile tissue, known as the crus, that lies behind the testicles. During therapy the focused waves can hardly be felt and are never painful. 

Radial SONICWAVE works best for the more superficial erectile tissue in the penis itself. The radial waves feel different and at higher energies cause the penis to redden and swell. This goes away after a couple of hours.  

FullMast is unique in using a combination of focused and radial shockwave that we tailor according to the condition of the patient. Further details here

The combination of focused and radial shockwave provides a Dual-action for treating vasculogenic ED.

If you or your partner are experiencing erectile concerns and you live in the Greater Toronto Area call to discuss with the medical professionals at FullMast.