Highlights
- Tadalafil is highly effective for mild to moderate ED but may be limited in severe cases.
- Low-intensity shockwave therapy (LiSWT) uses gentle shockwaves to help repair tissue and increase blood flow to the penis.
- Recent research suggests that combining tadalafil and shockwave therapy can improve even severe erectile function long term.
- Combining tadalafil and LiSWT for severe ED also has the advantages of being noninvasive with minimal adverse events.
- Additional research is needed to confirm these findings.
Michael DiLeo, MD, has over 30 years of experience in clinical and academic medicine. Through medical school, residency, and private practice, he has functioned as both a specialist and a primary care practitioner. He has twice served as chief of staff of a large regional hospital. He is a published author on women's health for McGraw-Hill. Learn More
Struggling with erectile dysfunction (ED) can take a toll on your relationships and your confidence. When ED becomes severe, finding effective solutions can be challenging. Discover how innovative combination therapies are changing the game for severe ED and offering hope to those seeking lasting solutions.
Tadalafil: A First-Line Treatment for ED
Tadalafil, also sold as Cialis, is a popular ED medication. It’s available for daily use or for use as needed. The daily version allows for continuous support, while the as-needed option offers flexibility before planned sexual activity.
How Tadalafil Works
Taladafil belongs to a class of drugs called phosphodiesterase type 5 (PDE5) inhibitors. It works by relaxing the muscles and blood vessels in the penis, which improves blood flow. This helps to achieve and maintain an erection firm enough for sex.
How Effective is Tadalafil?
Tadalafil is remarkably effective in treating ED. So far, it’s been shown to be most effective in treating mild to moderate ED. However, tadalafil is limited in its ability to treat some cases of severe ED.
Severe ED caused by underlying vascular issues often requires more intensive treatment. Men with severe ED may need to explore combining tadalafil with other therapies for better results.
Low-Intensity Shockwave Therapy (LiSWT): A Promising Adjunct Treatment
For more than a decade, researchers have explored the application of shockwave therapy for ED. This cutting-edge therapy is being refined to improve sexual function without surgery or medication.
How LiSWT Works
Low-intensity shockwave therapy (LiSWT) is a modern treatment for ED that uses gentle shockwaves to help repair tissue and boost blood flow to the penis.
During the procedure, a small device delivers painless shockwaves to the penis, triggering a healing response. This process encourages the release of nitric oxide, which helps achieve and maintain erections naturally. Over time, LiSWT promotes the growth of new blood vessels and improves blood flow to the penis.
How Effective Is LiSWT?
Research suggests that LiSWT can potentially reverse age-related changes in penile tissue. Recent findings offer new hope to men suffering from severe ED caused by blood vessel problems.
For example, a study on older rats found that LiSWT increased the expression of important factors like vascular endothelial growth factor (VEGF) and endothelial nitric oxide synthase (eNOS). These factors promote blood vessel growth and function.
A clinical trial involving patients with vasculogenic ED compared outcomes for LiSWT therapies at different energy flux densities (EFD) and session frequencies. They found that all groups receiving LiSWT showed improvement in erectile function, regardless of session frequency. However, those with a higher EFD had the best outcomes.
Daily Tadalafil and LiSWT
Pairing tadalafil with LiSWT is one option for improving the odds when treating ED. Tadalafil relaxes penile muscles and boosts blood flow, while shockwave therapy promotes tissue repair and stimulates blood vessel growth. Recent trials have demonstrated that this combination therapy significantly enhances erectile function, especially in cases where tadalafil alone may not be sufficient.
The Combination Therapy Study
In a recent double-blind, randomized clinical trial, researchers looked into combining LiSWT with daily tadalafil in men with severe ED. They specifically focused on men with severe vasculogenic ED, one of the most challenging forms of ED to treat.
Key Findings
Here’s what they found:
- Better erectile function. Men who received LiSWT plus tadalafil had better scores on the International Index of Erectile Function–Erectile Function domain (IIEF-EF) compared to those who underwent sham therapy plus tadalafil.
- Long-lasting benefits. The improved erectile function lasted at least three months after treatment.
- Safe treatment. No adverse events were reported with the combination therapy. This suggests combination therapy is safe for use in men with severe ED.
What This Means for Men with Severe ED
These findings offer hope for men living with severe ED caused by blood vessel problems. Combining LiSWT with tadalafil allows for a noninvasive treatment that tackles both the immediate symptoms and underlying causes at the same time. More research is needed to confirm these findings and expand treatment options for complex cases of severe ED.
Advantages of Tadalafil Plus Shockwave Combination Therapy
The recent combination therapy study builds on previous research findings. Recent research points to several advantages to using a combined approach to treating severe ED.
Better Outcomes
Mounting evidence suggests that for severe ED, using tadalafil together with LiSWT is more effective than either treatment alone.
For example, a matched-pair comparison study tested different shockwave protocols in men with ED and type 2 diabetes. Researchers found that using 2400 shockwaves per session with tadalafil led to significantly better improvements in erectile function at 12 and 24 weeks compared to using tadalafil alone.
Noninvasive Nature
One major advantage of LiSWT is that it’s noninvasive. Unlike surgery or other invasive treatments, LiSWT uses gentle shockwaves to stimulate tissue repair and enhance blood flow, making it a safer and more comfortable option for patients. Daily tadalafil is similarly noninvasive in that it only requires taking one pill per day.
Minimal Side Effects
Another key benefit highlighted by recent research is the minimal occurrence of side effects with combination therapy. This suggests that combined treatment is well tolerated and safe for most men with severe ED.
Future Directions and Limitations
Learning more about this combined treatment approach will help to provide more effective and personalized treatment plans to men living with severe ED.
More Research is Needed
The recent study is promising, but larger and longer-term studies are necessary to confirm the safety and effectiveness of combining daily tadalafil and shockwave therapy in treating severe ED. Like most therapies, shockwave or acoustic wave therapy won’t work for everyone. Future studies can provide stronger evidence and better understanding of how well this treatment works over time and how well it works for different groups of men.
Availability and Accessibility
The availability and access to this combination therapy will be important factors for its widespread use. As more research supports its benefits, we may start seeing this treatment offered in more clinics and healthcare settings. However, the cost and insurance coverage could affect how accessible it is for different people.
Hope for Severe ED with eDrugstore
Combining daily tadalafil 5 milligrams with shockwave therapy holds promising potential for men with severe ED, especially those with underlying vascular issues.
It’s important to consult with a healthcare provider to discuss whether a combined therapy approach is right for you. They can evaluate your health history and underlying causes of ED to help you find the best treatment plan.
If you’re interested in exploring safe and effective ED treatment options, you’re in good hands with eDrugstore. We offer a wide range of ED medications, including tadalafil (Cialis). Take advantage of our free consultations with a physician and explore your options today.
Disclaimer: This article provides general information about health and related topics but is not intended as a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition.
Shelby is a public health professional with research and field experience in sexual and reproductive health. She holds a Master of Public Health (MPH) and is a Certified Health Education Specialist (CHES).