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Research finds that low-intensity shockwave therapy is useful as an alternative to oral medications for the treatment of vascular-related erectile dysfunction. Some men may be able to get the desired results by using both forms of treatment in combination.
Introduction
The introduction of Viagra in 1998 was the answer to the prayers of millions of men with vasculogenic erectile dysfunction, the most common form of male impotence. Pfizer’s little blue pill and the other oral ED drugs that followed in its path proved to be safe and effective in the vast majority of men who took them.
The so-called PDE5 inhibitors revolutionized the treatment of ED, allowing men whose erectile function had been compromised by insufficient blood flow to the penis to once again participate in sexual activity. Sadly, however, these drugs don’t work sufficiently for all men with vascular-related ED, forcing some to resort to second- and third-line treatment options that are uncomfortable, cumbersome, and often expensive and invasive.
Over the last decade, low-intensity extracorporeal shockwave therapy (Li-ESWT) has emerged as an increasingly viable alternative to, or combination therapy with, PDE5 inhibitors. Recent studies and reviews of scientific data have shown that shockwave therapy significantly improves erectile function in men suffering from ED.
What Is Vasculogenic ED?
By far the most common form of erectile dysfunction, vasculogenic impotence is caused by a lack of robust blood flow to the penis. The actual erection mechanism is dependent primarily on simple hydraulic principles — a maximum inflow of blood into the penis and a minimal outflow until sexual activity is complete.
In men whose vascular function has been compromised, blood flow into the penis may be insufficient to achieve and/or sustain an erection long enough for the completion of sexual activity.
Just as the heart and brain require robust blood flow to operate at optimal levels, so does the penis. The buildup of fatty plaques on artery walls known as atherosclerosis can hamper blood flow and eventually reach the point where normal erection function is no longer possible.
Because the arteries that supply the penis are much smaller in diameter than those that feed the heart and brain, vasculogenic ED serves as an early warning sign of cardiovascular disease. If the underlying causes of the problem are not addressed through medication, lifestyle modification, or a combination of the two, more serious health problems such as heart attack or stroke could lie ahead.

How Do PDE5 Inhibitors Work?
Viagra and the other oral ED medications known collectively as PDE5 inhibitors temporarily improve blood flow so that men with vasculogenic ED can get and keep an erection suitable for intercourse. They do nothing to repair the underlying damage that is causing the blood flow problem, but they do open up a window of time during which sexual activity is possible.
As their family name indicates, PDE5 inhibitors sideline an enzyme known as phosphodiesterase-5 or PDE5. The enzyme in question breaks down a substance known as cyclic guanosine monophosphate, or cGMP, which plays a key role in the erection process. It triggers the relaxation of smooth muscle tissue lining artery walls, thus allowing the arteries to expand and carry more blood.
In men with normal vascular function, the PDE5 enzyme can break down cGMP with no significant impact on erectile function. As soon as some cGMP is broken down by the enzyme, their bodies produce more cGMP to replace it. However, in men who are vascularly challenged, the PDE5 enzyme kills off cGMP faster than their bodies can replace it, thus leading to impotence.
Taking Viagra or another PDE5 inhibitor suppresses PDE5 activity for anywhere from four to 36 hours, thus allowing for relatively normal sexual performance during that period.
Shockwave Therapy Explained
It was not until about 2010 that shockwave therapy was first studied as a potential treatment for vasculogenic ED. However, this type of therapy isn’t new and has been used in the past to speed the healing of wounds, fractures, and injured ligaments and tendons.
As previously noted, shockwave therapy is noninvasive. The low-intensity shockwaves are delivered via a wand-like device that is applied to the external surface of the penis. The shockwaves promote the development and growth of new blood vessels within the penis, which helps to improve blood flow throughout the organ.
Of shockwave therapy’s effectiveness, Cleveland Clinic urologist Daniel Shoskes, M.D., had this to say: “It has been shown in studies that pretty much everyone gets an improvement in blood flow. He noted that those studies have shown that shockwave therapy produces an overall improvement in erectile function whether used by itself or in combination with a PDE5 inhibitor.

Recent Research Findings
In a review and analysis of data from relevant studies, two researchers at the Julius Maximilian University of Wurzburg found that shockwave therapy “significantly improves erectile function in patients with vasculogenic ED.”
The researchers evaluated data from 10 randomized controlled trials covering 823 patients. Shockwave therapy appeared to improved erectile function from both subjective and objective points of view. Their findings were published in an early 2019 issue of the International Journal of Impotence Research.
Published in the March-April 2019 issue of the American Journal of Men’s Health, yet another review found similarly encouraging results from a review of seven randomized controlled trials covering a total of 522 study participants.
This second review, conducted by a team of Chinese researchers, found that men who underwent shockwave therapy showed significant improvement in both the International Index of Erectile Function and Erection Hardness Score tests.
Which Therapy Is Right for You?
If Viagra or another of the PDE5 inhibiting drugs allows you to get and keep an erection suitable for intercourse, there is no need to seek further treatment. Stick with the PDE5 inhibitor that works best for you.
However, for men who get some help from PDE5 inhibitors but not enough to function normally, shockwave therapy offers a complementary form of treatment that could help to restore relatively normal erectile function.
Shockwave therapy is also an option for men who get no improvement at all when using PDE5 inhibitors. They might find that shockwave therapy will gradually improve erectile function through neovascularization, the development of new blood vessels.
Ordering ED Drugs Online
For men whose ED symptoms are treated adequately with PDE5 inhibitors, ordering those drugs online can often save both time and money. Consider taking your business to eDrugstore.com, a longtime online prescription drug service based in Tempe, Arizona.
Ordering online can spare you the hassle of trips to and from the local pharmacy plus any time you might spend waiting for your script to be filled. Shipping is free, and eDrugstore can also help you get a prescription if you don’t already have one. Just take advantage of its complimentary online consultation service, and you’ll be matched up with a physician licensed to practice in your state. If the doctor finds that you’re an appropriate candidate for an ED drug, a prescription will be authorized. Visit eDrugstore’s Erectile Dysfunction page to learn more.

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