Viagra and similar drugs work by increasing blood flow to the penis, but men who use them have to plan sex around the drugs, and side effects can include headaches, dizziness, nasal congestion and sudden hearing loss. An alternative, called extra-corporeal shock wave therapy (ESWT), could provide a longer-term solution, according to several studies discussed this month at a meeting of the European Society for Sexual Medicine in Madrid, Spain.

One study of ESWT involved 112 men with erectile dysfunction. Half received five weekly doses of low-intensity sound waves directed at six sites along their penis. The other half received a placebo. At the start of the study, none of the men were able to have penetrative sex without medication. By the end, 57 per cent of the treated men said they were having intercourse, compared with 9 per cent of the men who received the placebo (Scandinavian Journal of Urology, doi.org/bch9).

The treatment seems to increase blood flow to the penis by encouraging the growth of new blood vessels, says Ilan Gruenwald of the Rambam Medical Center in Haifa, Israel. If this proves true, it suggests the treatment could be long-lasting.

“The treatment seems to encourage the growth of new blood vessels in the penis“
Another study found that ESWT improves erectile function in men who do not respond to traditional drugs. Other small trials have also reported positive results. The treatment is unlikely to cause any harm because the sound waves are of such low energy, says Delphine Behr-Roussel of Versailles Saint-Quentin-en-Yvelines University in France, who is studying the effects of ESWT in rats.

Although ESWT is offered in some clinics around the world, Trinity Bivalacqua at Johns Hopkins University and Hospital in Baltimore, Maryland, says that he would not offer it to his patients just yet, because treatment protocols need to be standardised. However, he is hopeful for the future of the therapy. “I’ve been a sceptic, but I’m becoming a believer,” he says.

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