In Saturday's Times Magazine is a long article on the above. Below is a link to the article which is likely behind a paywall, and below that what seem to be the main extracts:
'It used to be a taboo subject. Now more and more men are taking radical steps to combat sexual problems. Stefanie Marsh meets Dr Amy Killen, the expert on a mission to improve our sex lives.'
Link behind paywall probably:
https://www.thetimes.co.uk/past-six-days/2019-10-05/the-times-magazine/the-doctor-pioneering-new-ways-to-tackle-erectile-dysfunction-3nmdkshks
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One of the major areas mentioned is Shockwave Therapy. A contact for the trial is given:
f you are interested in joining the study at Guy’s and St Thomas’s in London into the effectiveness of shockwave therapy following treatment for prostate cancer, email paula.allchorne@gstt.nhs.uk
'In Britain, beyond the little blue pill, there are few treatment options. As Tet Yap, a consultant urologist at Guy’s and St Thomas’s in London, who is carrying out the world’s largest study into the effectiveness of shockwave therapy for erectile dysfunction (ED) in survivors of prostate cancer, tells me, 40 per cent of men in their forties and 70 per cent of men in their seventies experience erectile dysfunction. For some of them, a pill doesn’t work; when it does, it can be a quick fix, subject to the law of diminishing returns – the more you take, the less effective it becomes over time.
It’s astonishing, given the number of men suffering from erectile dysfunction – and that includes the great numbers of men whose erections have been affected by prostrate cancer or diabetes – there’s been so little work into finding a cure. It’s a measure, Yap tells me, of how reluctant men have been to admit to sexual problems. “It sounds like a cliché, but I think we’re entering into a new generation of men’s sexual health where men are more vocal about these issues.” The results of his study will be published at the end of 2020. If they are positive, it’s possible that the shockwave therapy Killen and some private clinics in the UK offer for £300 a go, will be available on the NHS within 5 years. In the meantime, the “devastation” of sexual dysfunction, warns Yap, makes men vulnerable to big claims based on little evidence.'
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'Shockwave therapy is one my favourites,” she says. “We’ve only been doing that three years. It’s pretty new. The tech has been around for 30 years; the devices were originally approved to treat muscular-skeletal pain, fasciitis and tendonitis. What it does is increase blood flow and healing, and that happens whether you put it on your penis or your shoulder. It’s amazing technology because it’s completely safe. It’s just soundwaves. Which is crazy to me. I love it.”'
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How Erections Work Extract From the Article:
'The way erections work is, “You have arousal in your brain. The nerves get sent down to your pelvis, where nitric oxide gets released from the nerves and tells the blood vessels to open up so the blood rushes in – that’s how you get an erection.
The nitric oxide is made by the cells in the blood vessels and as you get older, those cells become dysfunctional – you see things like sclerosis, plaque building up. So even by the time you’re 40, you’re making about half as much nitric oxide as when you were 20. By the time you’re in your eighties, you’re making about 15 per cent. Even with Viagra, sometimes you can’t have an erection because you don’t have enough of it around for it to be effective.”'
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“The other thing that’s really important is that even if you’re eating a lot of these foods and even if you have a lot of nitrates in them, there’s a two-step process your body uses to convert the nitrates into nitric oxide. The first step is via the bacteria living in your mouth and some people who use a lot of antiseptic mouthwash are killing that bacteria. The second thing you need is a very acidic stomach. It’s common for people to take acid blockers to help with their heart burn and things like that, and the problem is that all of a sudden you don’t have enough acid to complete that second step, to make nitric oxide. Which can mean less blood flow and higher blood pressure.”
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'Here’s Killen’s take on the penis as an early warning system “of what is to come”. “Because the vessels in the penis are so small, the blood flow is curtailed much faster than it is in your heart, so basically the penis shows signs of sclerosis – plaque – before your heart and brain do. And we think of erectile dysfunction sometimes as a sign that you’re at risk of having a heart attack or a stroke.” If the eyes are the window of the soul, the penis is the window of the cardiovascular system, the subconscious and your life expectancy.'
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'In the past few years she’s also been using stem cells, harvested either via a mini-liposuction treatment from the patient’s belly fat or from their bone marrow, “which is a little more intense”. Stem cell penis injections are a bad idea, according to Tet Yap at Guy’s. He tells me there is poor evidence to support their use. Killen says, “Getting stem cells from fat has come under fire from the FDA [Food and Drug Administration, America’s standards agency]. '
Edited by member 06 Oct 2019 at 22:44
| Reason: marked mention of Prostate Cancer in bold