Erectile Dysfunction Treatment
Erectile dysfunction is the consistent inability to achieve or maintain an erection sufficient for sexual activity, affecting an estimated 30 million men in the United States, with prevalence increasing significantly with age — from approximately 5% at age 40 to 15-25% at age 65.
ED is not a single condition — it is a symptom produced by vascular dysfunction, endothelial impairment, testosterone deficiency, neurological changes, penile tissue fibrosis, or psychological factors, often in combination. The prevalence of vascular and hormonal contributors increases with age, obesity, metabolic syndrome, and cardiovascular disease risk factors.
At Rebuild Regen Medical Clinic, every male patient presenting with ED has testosterone evaluated as part of the intake — because low testosterone is both a direct cause of ED and a comorbidity that limits the effectiveness of any vascular-only treatment. The three-modality ED protocol then addresses the vascular, tissue, and desire components.
The 3 Modalities
Acoustic wave therapy (Li-ESWT): Low-intensity shockwave via the Chattanooga Intelect RPW 2, delivered to the penile shaft and perineal vasculature to stimulate angiogenesis and endothelial repair. This is the structural vascular intervention — creating new capillaries and improving arterial inflow.
P-Shot (PRP injection): Platelet-rich plasma from the patient's own blood injected into the corpus cavernosum to deliver growth factors (VEGF, PDGF, EGF) that promote smooth muscle cell health, angiogenesis, and nerve regeneration in penile tissue. Addresses the tissue-level fibrosis and cellular degeneration component.
PT-141 (Bremelanotide): Melanocortin receptor agonist administered subcutaneously before sexual activity to activate the central nervous system arousal pathway. Addresses the desire/initiation component that PDE5 inhibitors and vascular treatment do not reach.
Testosterone (if deficient): TRT is initiated if lab confirmation shows hypogonadism. Testosterone is essential for both libido and the vascular health that supports erections; treating vascular ED while leaving testosterone deficiency unaddressed produces partial results.
The full ED Treatments page describes each modality in detail.
Frequently Asked Questions
Can acoustic wave therapy help if Viagra doesn't work?
PDE5 inhibitors work by increasing blood flow acutely; they don't repair the damaged endothelium or create new vasculature. Some men whose erectile dysfunction is primarily vascular at a structural level find inadequate response to PDE5 inhibitors because the arterial supply to the penis is too compromised to respond to a vasodilatory signal alone. Acoustic wave therapy addresses the underlying vascular structure — angiogenesis and endothelial repair — producing a more durable foundation than temporary vasodilation.
How many acoustic wave sessions are needed?
A standard protocol involves 6 to 12 sessions over 3 to 6 weeks. Some men notice improvement within the first few sessions; full vascular remodeling effects continue for 2 to 3 months after protocol completion. Elizabeth assesses response at the end of the initial protocol.
When ED Requires Different or Additional Management
Severe arteriogenic ED from significant large vessel occlusion may require vascular surgery evaluation. Primarily psychogenic ED benefits from psychological support alongside or instead of physical treatment. Peyronie's disease with significant plaque and curvature requires targeted treatment for the plaque before the general ED protocol produces optimal results. Elizabeth evaluates all of these factors during the initial consultation.
Rebuild Regen Medical Clinic 3320 N Federal Hwy #101, Lighthouse Point, FL 33064 (954) 953-4208 | rebuildregenmedical.com
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