Posted on: 16 Dec 2022
Erectile dysfunction, or ED, is the most common sex problem that men report to their doctor. It affects as many as 30 million men. ED is defined as trouble getting or keeping an erection that's firm enough for sex. It's not rare for a man to have some problems with erections from time to time. But ED that gets worse or happens routinely with sex is not normal, and it should be treated.
There are a number of treatments available. Non-invasive treatments are often tried first. These include quitting smoking, changing certain food habits, exercising more or stopping using alcohol or drug use. Your doctor may also suggest treating emotional problems.
The next step may be oral drugs or pills and testosterone therapy. More invasive treatments include:
- penile injections
- intraurethral medications
- vacuum erection devices
- penile implants
- surgery to bypass penile artery damage
One of the newer treatments for ED is called shock wave therapy (SWT). With SWT, pressure from waves that move faster than the speed of sound cause small, controlled injuries to the penis.
SWT is likely safe when used to treat ED, but it is not clear if it really works. Most large studies have shown SWT results in zero or only small improvements in ED. Among the studies that did show help, they were mostly below the lowest level needed to be proven to work.
Men should be cautious when hearing that SWT helps ED. Often, out-of-pocket costs may be high. Also, there is a lot of misinformation and advertising on SWT.
Here are some resources that doctors use to learn more about SWT:
- The American Urological Association (AUA) guidelines for ED suggest patients should only have SWT in an approved clinical trial.
- The Sexual Medicine Society of North America (SMSNA) suggests SWT should be done only for research and patients should not be charged more than the basic costs for research.
- The European Society for Sexual Medicine (ESSM) says SWT is safe but may not prove to work in treating ED and needs more research.
For more information on erectile dysfunction, check out these sexual health resources.
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