Beyond the little blue pill: the alternative solutions to erectile dysfunction

Daniel Lischinsky, CEO, at Ohh-Med explores the alternative treatments available for treating ED, including radiofrequency (RF) and shockwave technologies.

Catherine Longworth July 29 2024

Half (50-55%) of all UK men aged between 40 and 70 have experienced some degree of erectile dysfunction (ED), making it one of the most common problems in men’s health. And, with its link to other health issues such as high blood pressure, cholesterol, diabetes, and depression, it is a problem that will only continue to grow.

This – combined with the impact ED is having on men’s mental health and wellbeing – makes finding suitable and effective treatment options more important than ever.    

Typically, most current first-line therapies for ED are based on treatments, such as PDE5 drugs (like ‘the little blue pill’) or vacuum devices. Both these therapies require pro-activity immediately before engaging in sexual activity, leading to loss of spontaneity and occasionally to less satisfying relationships. Our latest research also reveals concerns about ED medications, with half of UK men refusing to get help because they are worried about the potential side effects associated with these treatments.

There are also those who, for other medical reasons, are unable to take ED medication, including those with a serious heart or liver problem, those with low blood pressure, sickle cell anaemia, or those suffering from Peyronie’s disease (about 10% of UK men).

Over the past decade, experts in the field of ED have been pioneering a new concept of therapy involving a series of treatments whereby external energy is applied to penile tissues. These treatments aim to restore spontaneous erectile function without the need for any pro-activity immediately before sexual intercourse, whilst providing a safe alternative to current medicines, that can be used by anyone.

Here we discuss everything you need to know about two key technologies, as well as the main differences between them.

Radio Frequency (RF) Technology

About the technology – Conductive Radio Frequency (RF) waves are in fact the release of low-frequency energy (1 MHz). Upon its release, this energy produces controlled heat which is harnessed to stimulate the “remodeling” or “renewal” of a protein called collagen in the deep layers of various body tissues, including the penile erectile tissues. This is a collagen rejuvenation process induced by the RF energy and executed by our body. Collagen fibres provide the necessary firmness, tone, and structure to these tissues, and reinforces the tissue of the Tunica Albuginea which is responsible for reducing the “blood leakage” from the penis during the erectile state. RF therapy is non-invasive and painless.

The aim of the treatment – The aim of the treatment is to restore the biological penile erectile mechanism by using radio frequency to stimulate the collagen remodeling fibres process. The tunica albuginea in the penis holds a crucial role in the biological erectile mechanism. It is comprised of 95% collagen fibres and 5% of elastin fibres (giving it elasticity and rigidity) and is crossed with veins responsible for draining the blood from the erectile bodies. During sexual stimulation, the elastic collagen fibres enable the tunica albuginea to stretch and compress the veins crossing it, so that blood cannot drain out through them from erectile bodies. In this manner, the tunica albuginea traps the blood in the erectile bodies during sexual activity and the erection is produced and maintained.

However, around the age of 22-24, the body loses 2% to 4% of the quantity and quality of collagen fibres per year meaning that this phenomenon also occurs in the quantity and quality of collagen fibres in the tunica albuginea. The tissue loses its elasticity and rigidity, and it cannot stretch and widen during sexual stimulation as before. Consequently, the tunica albuginea is unable to efficiently block blood leakage from the erectile bodies, and for this reason men usually start experiencing erectile dysfunction. 

How is the treatment performed – A medical device is available that creates radio waves (RF energy) to produce controlled heat which stimulates the collagen fibre remodeling process in the deep layers of penile tissues, including the tunica albuginea. The “renewed” collagen fibres enable the tunica albuginea to effectively stretch to trap blood within the erectile bodies during sexual activity, decreasing the unwanted leakage from the penis.

This device is designed to induce collagen remodeling in the internal part of the penis by heating the relevant tissue. This treatment should be performed three times a week during the first month, two times a week during the second month, and following that, once a week as desired for routine maintenance. (the duration of each treatment is approx.15-30 minutes).

The added value - Penile RF treatment is a completely novel therapeutic concept and is unrelated to the timing of the sexual activity, which contrasts with pills which must be ingested before sexual activity to improve short-term erectile function. Rather, the patient can use the device at any time, in the comfort of their home. It is also the only treatment that works on restoring the natural erectile mechanism (i.e., locking the blood in the erectile bodies), offering a long-term solution, and allowing the patient to enjoy spontaneous erections once again.

Shockwave Technology

About the technology –This ED treatment is based on a shock wave device that emits gentle pulses. The pulses trigger micro-injuries to cell membranes which in turn induce the ingrowth of new blood vessels (angiogenesis) and improve blood supply to penile tissues.

The aim of the treatment – similar to oral medications, and most of the other ED treatments, shockwave therapy works on increasing blood flow to the penis. However, it will not help in cases where ED is caused due to degenerative changes in collagen fibres that result in leakage of blood from the erectile bodies during erection. Shockwave therapy may also not be suitable for every ED patient and a qualified physician should first assess suitability and the projected success rates.

How is the treatment performed – this intimate treatment is performedin clinics by medical staff members, usually in a series of 6-12 treatments. Treatment is performed solely on the external part of the penis by placing the shockwave device directly on the organ. There are different types of devices with varying levels of effectiveness. In most cases, men receive a series of 12 treatments consisting of two treatments a week during the first three weeks, with a three-week break followed by two treatments per week during the next three weeks. The duration of each session is 15-20 minutes. Every couple of months a new series of treatments must be performed in order to maintain the desired effect.

The added value – shockwave treatment allows the patient to get spontaneous erections, without timing the treatment before sexual activity. However, treatment takes place in specialised clinics, which requires scheduling appointments – a far less discrete option. Whilst the success rate of this treatment is approximately 65-75%, a number of clinical studies and meta-analyses have demonstrated inconclusive results regarding treatment effectiveness. Additionally, patients normally report a preliminary effect only after 3 months of treatment (if at all).

The only way is up

Treatment options for erectile dysfunction have certainly come a long way in recent years, with advancements in radiofrequency technology, in particular, empowering men to treat not only the root causes of ED, but in the comfort of their own homes. But the journey doesn’t end there, medtech professionals must continue to work together to innovate and pioneer in this area, to ensure men no longer suffer in silence, and are aware of the solutions available to them. Tackling ED isn’t just about facilitating a happy and healthy sex life, it is about improving men’s physical, emotional, and social well-being.

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