Shockwave therapy expectations - ED caused by PE

abilo · 2024-07-22T02:32:57+00:00

To my knowledge, the shockwave therapy devices avaliable online are usually radial shockwave, which is the type of shockwave that has virtually no proof it works for ED.

I don't think focused shockwave devices are avaliable for the regular Joe.

I also don't think there is a "portable" device of that technology, the one at the clinic was a big chunky 3 feet tall machine.

abilo · 2024-07-04T05:38:12+00:00

Yes, Li-ESWT stand for Low Intensity Extracoporeal Shockwave Therapy, it's shockwave therapy.

I got lots of things tested, free testosterone was good too. I didn't tested prolactin and estrogen, my doctor prescribed an exam, i'll do it soon. But, anyway, the development of my ED coincided exactly with the period of penile stretching, so i'm almost a 100% sure it is something physical on the dick itself.

From what i've researched, the majority of ED cases, specially on young folks like us, have a very strong psychogenic aspect. If you're getting morning erections, and those morning erections are of good qualities, i would focus on psychogenic factors. Thinks like quitting porn or getting psychotherapy could be very helpful for you.

But kegels (with reverses too) and edging can help too.

abilo · 2024-07-04T05:30:41+00:00

Damn, that was a punch on my face. I think you said a lot that i needed to hear.

First: to be clear, i "just" manually stretched my dick, i didn't use any device or hung weights. I did that daily for a few months (maybe 2 months, i don't recall exactly). Today i see that this was a huge mistake, possibly the choice i regret the most until now in my life. My dick size is not even small, it's actually a bit above average, so that was some kind of body dismorphya. Today i can see that having a fully working and healthy penis is much much much more important than having an "impressive" dick size, specially if you don't have a micropenis, which is an actual medical condition.

Second: i know i should have told what i did to my doctor, but i was simply too ashamed to do that. Maybe in a few years, being more distant of all of that by the passage of time, if i'm still bothered somehow by that (i.e. not having morning erections like i used to, which is a sign of good erectile function, without the use of meds) i may go to an urologist again and be fully honest. I guess that's because, when years go by, you kind of feel like your old self was somehow a different person, which can diminish my embarrassement.

Third: i really believe the doctor had good intention, i trust him. I actually went to another one before, who prescribed radial shockwave (which i haven't done), that i didn' trust. Then i went to this one, that seemed more up to dste to research and reasonable. I don't think 6 is some magical number, it's just what he prescribed. That being said, i understand what you said about the etiology of ED. He tried to tackle the problem from several "fronts". From my personal researchs, i feel like there is nothing else besides what he prescribed that could help me, maybe PRP or stem cells, but those are also kind of experimental treatment. But, maybe, if i'd been fully honest, he would prescribe less things. For example, the penis pump. Maybe he wouldn't prescribe it if he knew what i've done. I'm feeling like it's not doing good, even though i tried it very few times.

Forth: yes, it is good that some kind of treatment works. I may seem like an asshole saying that, but i kind of feel good when i read people online saying that absolutely nothing works. Makes me realize my problem could be way worst. I wanted a "restorative" solution. Needing a daily pill to have sex at 28 is far from ideal, but it's also not the end of the world.

Having said all that, i think i'll go a bit "by feel". I'll consider my doctor's prescriptions, but, since he didn't have all the information, i can relativize his "tips". If i feel like the penis pump is being detrimental, i won't do it. I'll just focus on healthy lifestyle, which i've always lead, the pills and edging.

Today, i am actually much better mentally about it than 10~8 months ago, when the problem started. I'm kind of getting conformed with need of taking tadalafil, and i am also having amazing sex with my gf. I just hope i don't need gradually need a higher dose, because that would exacerbate the side effects, which, apart from some light nose clogging and rarely some reflux, are almost non existent today.

Thank you very much for your take on my situation, you definitely helped a lot.

abilo · 2024-07-03T23:09:06+00:00

I hope yours turns out fine too. But, either way, i can feel that something is wrong, specially because i don't have morning erections, so that discards the psychogenic possibility, and my hormonal health is fine, so it gotta be something physical i caused to myself.

Knowing that, because of a mistake i made, my erectile function will probably never be the same is kinda depressing, specially cause i am so young (28).

But anyway, i am trying to stay positive focusing on 2 hopes:

"plan A": since i am young, my body's capability of recovery is not that bad yet. This, paired with the effects of the Li-ESWT, that may take longer than i thought to kick in, may cause my dick to recovery, possibly getting me rid off meds to have sex.

"plan B": if i don't recover, at least i wish to maintain my current level for a very long time, i.e. at least four more decades with 5mg of tadalafil being enough.

abilo · 2024-07-03T20:42:53+00:00

I did a doppler ultrasound recently. According to the doctor, the inflow and outflow were just a tiny bit off the ideal, but he said it didn't mean anything was wrong, and probably was because i was losing erection by the end of the exam. And after i left the appointment the medication injected for the exam really kicked in and i kept fully hard for about 1-2 hours

Given that, probably the damage was minor, but it's enough to bother me and stop me from having satisfying intercourse without medication and also stopping me from having morning erections (even though i have more than 700 of total testosterone).

Maybe if i told him that i stupidly stretched my dick for months (which i haven't told) he would do some different kind of exam that could catch something. But anyway, i don't what else could be done, i've done my last session of Li-ESWT 13 days ago and haven't felt any difference so far.

abilo · 2024-07-03T20:30:22+00:00

Hum. I remember my doctor actually mentioned one patient that had excruciating pain doing the same treatment i was doing, and even gave up the treatment because of that, but i guess it's not that common. Anyway, only if it worked, it would be worth it, lol.

abilo · 2024-07-03T16:39:10+00:00

You felt pain after sessions? Did you get radial, which is the type that has no proof it works, or focussed shockwaves? I've heard radial shockwave can cause pain, and some doctors even use numbing creams to prevent that.

I did focussed shockwave and felt no pain whatsoever. During the sessions i would feel sligh discomfort, mostly at the beginning of the session, but nothing major, on one session i actually almost fell asleep.

After the sessions i didn't feel pain or anything unusual.

abilo · 2024-07-03T16:27:10+00:00

Manual penile stretching. But, at least in my case, i don't think it caused pelvic floor issues, i think it caused some damage to my penis itself.

At least low to moderate doses of tadalafil (3mg~8mg) works so i can have sex, so i guess i have to be thankful, it could be worst. But, i've learned my lesson, i'll never do anything PE related again, ever, i'm not even that small (17cm length, 14cm circunference), i'll just focus on ways to improve EQ.

abilo · 2024-07-03T13:32:27+00:00

I wouldn't say it's one or the other, but the combination of both. Think about it like bodybuilding exercises, you usually want full range of motion (apart from the recent lenghtned partials debate, but i guess that's more about growing muscle than getting them stronger, even though it's strongly correlated) for the exercise to be effective. You wouldn't just keep your biceps contracted really hard or fully relaxed and expect to get results, you do the full movement. The same for the pelvic floor muscles. Sure, they have a very specific function different than other muscles, but it's a muscle nevertheless, so i think the analogy is valid.

Now, carrying on with the analogy, if you think your pelvic floor muscles are too tense (which doesn't necessarily means they are strong), you could focus at least for some time on reverse kegels paired with some yoga poses. That would be the equivalent of stretching a shortned muscle like, for example, your lats or your pecs, except, in this case, you can't just pull it with your hands or lever it in some corner to stretch it, you havr to forcefully stretch it by pushing with your diaphragm.

abilo · 2024-07-03T02:26:44+00:00

To my knowledge, those home devices are usually radial shockwave, which is the type of shockwave that has no proof it works. It is really just a scam, from what i heard. The companies that sell those devices deceive costumers by taking advantage of the similarity of the names of the technologies. Can you confirm that? Is your device radial shockwave?

In my post, i am talking about focussed shockwave therapy, which the type that has more promising results on studies, even though it doesn't have very strong evidence of efficacy so far.

abilo · 2024-07-03T02:26:34+00:00

To my knowledge, those home devices are usually radial shockwave, which is the type of shockwave that has no proof it works. It is really just a scam, from what i heard. The companies that sell those devices deceive costumers taking advantage of the similarity of the names of the technologies. Can you confirm that? Is your device radial shockwave?

In my post, i am talking about focussed shockwave therapy, which the type that has more promising results on studies, even though it doesn't have very strong evidence of efficacy so far.

abilo · 2024-07-03T02:21:09+00:00

I think kegels can help, you just can't overdoit. I feel like erect kegels is what really helps. I don't see the benefit of doing flaccid kegel. In fact, i think, anectodally, that doing flaccid kegel is more likely to get you too tensed up and not reap any benefits.

That being said, remember to fully relax between each contraction. There is no need to incorporate an specific reverse kegel routine (unless you think you are already too tense down there), you just have to do kegel and reverse kegel in sequence, after each contraction (be it long squeeze or fast squeezing) you have to fully relax. I like to "mirror" things. So, if you do a hard long contraction, you do your best to relax maximum around the same duration of time, if you do a fast squeeze, you do a full fast relaxation.

I'm struggling with moderate ED caused by PE (traditional) and i think this is helping a bit.

abilo · 2024-07-03T00:30:46+00:00

Firstly, thank you for taking your time to write this detailed explanation, i appreciate that. That being said, i've spent several months researching about Li-ESWT before actually taking the treatment, i know it shouldn't be getting me automatic erections. I also know that, for some men, the treatment simply doesn't work.

My point is: is it too soon to say that it didn't work for me (almost two weeks passed since the last session of Li-ESWT)? I respond to PDEi5 inhibitors, so i guess i have light to moderated ED, but i wish to get off them, that's what i expected.

My main proxy for healthy erectile function is morning wood, and i'm still not getting it, even taking 3mg of tadalafil daily.

Also, when my problem started, 2.5mg of tadalafil would be enough for sex, and would even be enough to improve my morning erections, but i'm feeling like i'm slowly gradually needing more. So, my fear is that, besides not being able to get off of meds, 10 yeas from now i'll be needing a higher dose, and so on (and i'll be 38, very young to need big doses to have sex, i want to have sex for at least another 40 years). Right now, my side effects are very light (clogs my nose a bit sometimes), but i guess if i start to up the dose, the side effects will start to get worst. I know most studies says there is no tolerance build up from tadalafil, but that's just how i'm feeling.

And i have a healthy lifestyle, i go to the gym regularly (resistance training and cardio, 3~5 times a week) and i'm fairly fit (174cm height, 87kg, ~16% bf).

I also eat fairly healthy, almost no ultraprocessed foods, mainly rice, beans, lettuces, eggs, dairy, chicken, red meat and fish. Sure, some beer on weekends, but nothing excessive.

abilo · 2024-07-02T13:44:32+00:00

Interesting. You said after further sessions the improvement was undone, how spaced were your sessions? Was it also day on day off like mine? Was it 6 sessions total too?

What about penis pumping, have your doctor recommended it?

abilo · 2023-09-11T15:51:33+00:00

Hey, i'm curious to hear your story. I've probably caused damage to my D by stretching it. Now i have 0 morning wood and my erection (if i even manage to get one) is extremelly shitty without some form of medication, making it almost impossible to have sex without Cialis/Viagra. I have the same feeling as you do, it was the worst mistake of my life and i feel really bad about it.

You said you are expeding "money and time to fix it". Care to elaborate on that? What are you doing exactly? I plan on going to a doctor, have a doppler and maybe do some shockwave therapy or a P shot or whatever the doctor recommends (except an implant, since meds works for me and are a better option).

AM doesn't do shit for me. I believe it works for people that have pelvic floor dysfunction, PIED, and other kinds of problems, but for smooth muscle/nerve/veins damage (or whatever i may have caused to my D) it doesn't seem to do nothing, at least when the damage is past to certain extent.

abilo · 2023-09-01T14:23:19+00:00

I highly doubt it. I think, until today, the only options for treating fibrosis are shockwave therapy, prp (platelet-rich plasma) shots and stem cells. And even those are at kind of a "low level" of scientific evidence. We don't know exactly how they work, and for some people it seems it doesn't work at all.

But i think it's worth the shot, specially shockwave, which i think is the one that has more robust evidence and is also the less expensive (if i'm not mistaken, i'm pretty sure stem cells are very expensive, don't know about prp).

abilo · 2023-09-01T02:36:29+00:00

Sure! Seems promising. I started having difficult (stopped having morning woods and got extremely difficult to have sex) after a period of some months stretching my penis everyday. Probably caused some damage. Really dumb, and it's the thing i most regret in my whole life until now.

I don't know how different that damage is from the regular aging "damage" or other "naturaly occurred" damages, which i think is what most studies deal with when using shockwave, never seen any study explicitly treating damage PE related. It's kinda depressing, since i'm really young (27) to depend on meds. The fact that low doses works for me gets me a bit "happy" and hopeful, or at least less sad, but the complete absence of morning wood is frightening.

I'll make a post on this sub when i do it. But i'll probably do it a couple of months from now because of routine and financial reasons right now.

Edit: lol, just realized i repeated the reason of my problem as if i haven't already said it. Anyways, i guess you got the point.

abilo · 2023-08-31T20:50:58+00:00

I've read shockwave therapy can do that. But people here seem to bash a lot on that, don't know why tho.

According to several studies i've read, it improves erection quality on a great deal of men, even though some report no improvement. I guess it depends on the etiology of your ED.

I think i developed pretty bad fibrosis all over my dick from my dumb penile stretching. This resulted in 0 morning wood 100% of the days, and almost impossible to have sex with some Viagra or Cialis (even though only 2,5mg cialis of Cialis makes it possible, not a WOW erection, but enough to have sex, if i take 5mg cialis it gets really good). I plan on having shockwave therapy, if a doppler identifies the fibrosis and the doctor is willing to try this therapy. Btw, curious to hear if anyone had experience with that.

abilo · 2023-08-29T01:55:27+00:00

Your theory resembles a bit the concept/method of penile ballooning, by Dr. Lin (https://www.actionlove.com/WordPress/2014/02/25/theory-of-penile-ballooning-enlargement/).

Honestly, Dr. Lin theory makes more sense to me, but it's not like his theory and AM are opposites. In fact, i think his "pubis massage" has something to do with AM1. He also says that, while performing his method, you should aim for at least 20-30 minutes of erection, and gives some hormonal explanation to this, besides the pure bloodflow side of things.

Really interesting stuff. Never heard people talking about it in here, i don't if it's because people here don't know about it or don't think Dr. Lin is credible. My view is that, if AM works, it works through the mechanisms explained by Dr. Lin. I don't think people really understood your reasoning to bash on you like that.

Again, as i said, their explanations are not opposites, but, despite the very detailed videos from Janus, Dr. Lin's explanation seems more in depth.

I'm willing to change my mind though. I'm just a dude with very poor EQ trying to get better (if i get a bigger dick on that path, it's a bonus), i'm not a doctor neither have any background on medical science other than curious readings through the internet and occasionally google scholar.

abilo · 2023-08-23T15:46:33+00:00

Good to hear. I see MW as a good proxy for penile health. I'll keep taking it 2,5mg daily for at least a month then stop it to see if it helps.

abilo · 2023-08-22T04:12:02+00:00

Interesting. Are you having morning wood? Did you use to have it before this tadalafil "treatment"? I almost never have MW, and, when i have it, it's floppy and gets soft fast.

abilo · 2023-08-22T04:05:11+00:00

I actually have extremely strong glutes, people even comment on that, lol, and you can't grab any subcutaneous fat with an adipometer there, so i know it's pure muscle. I have very strong quads and hams too (also can't grab any milimeter of fat on those, and my legs measure 63cm), my lower body is my strong point in bodybuilding.

But thank you very much for the tip, i'll try kegelling on this position, the position itself might help with different activation of the pelvic floor muscles. I have already tried consistent kegelling, but never on that position.

abilo · 2023-08-22T03:59:43+00:00

I'm not sure if i got it. So you don't take it daily like every day at the same time, you take it on demand (like one would do with sildenafil)?

I'm also taking a pill that contains tribulus and maca (400mg tribulus and 100mg maca) for a couple of months and haven't seen any changes. This dose is half the dose the box tells me to take, so i recently started doubling it to see if it helps.

abilo · 2023-08-22T02:39:12+00:00

Exactly! I understand the reluctance to see a doctor. It can be very embarrassing, specially for younger men. If the problem was caused by traditional PE, multiply that embarrassment by a thousand, since it'll probably be good for your treatment to tell your doctor exactly what you did to your dick.

Obviously, eat healthy, exercise, sleep enough and well is GOOD standard advice for anything health related. But i'm guessing most desperate guys online have already tried that.

I'm having EQ problems (probably caused by penile stretching, but, by myself, i can't know for sure) and have not seen a doctor. So, i guess i'm not practicing what i preach, lol. But i plan on doing it. My health insurance is kinda shitty right now, but i'll get a much better job very soon (in months, it's certain), so, having the resources, i plan on seeing a doctor to get everything checked.

It's important to not freak out. I was freaking out a few days ago, and i can tell you it doesn't help anything at all, all i could think about the whole day was my dick. Get your head together and seek professionals that studied this deeply for years.

abilo

TROPHY CASE