Health + Wellness Sponsored Wellness

Is it Time to Stop Using the ”Little Blue Pill?”

June 19, 2020

Dr. Diego Hernandez uncovers the risks of treating sexual dysfunction in men with over-the-counter medications and introduces safe, non-invasive options

Sponsored by Bloomfield Vein & Vascular, PLLC.

Over the last few years, we’ve learned more about sexual dysfunction in men and how to help men who suffer from it. An epidemic is a condition that affects or is tending to affect a disproportionately large number of individuals within a population or a community. If we look at the statistics, a condition that, as of 2018, affects 18-30 million men is of concern. This condition worsens with age, with 40% of men over the age of 40, 50% of men over the age of 50, 60% of men over the age of 60 and 70% of men over the age of 70, reporting this as a problem in their lives.

Bloomfield Vein & Vascular

Evidenced by these statistics, sexual dysfunction has become increasingly prevalent in men. At the core of sexual dysfunction is Erectile Dysfunction (ED) in men, which when complete can be defined as the inability to obtain or maintain an erection during sexual activity. ED appears to vary in its presentation, with some men reporting mild impairment to others with severe difficulties. Irrespective of its severity, the psychological impact of this condition is often devastating, which also has a profound effect on the person’s sexual partner. Anxiety and depression have been tied to ED, which then creates a negative, vicious cycle that can often lead to helplessness and hopelessness.

Erectile Dysfunction became a regular topic of discussion since the introduction of Sildenafil or Viagra, aka “the little blue pill” in 1998. Several other similar drugs followed, including Tadalafil (Cialis) and Vardenafil (Levitra). A number of other medications then made it to the market (they’re commonly known as Phosphodiesterase-5-inhibitors)  and can be effective in about 80% of patients. These medications work by dilating or “opening up” blood vessels and specific tissues within the penis and may facilitate erections. Their effects, however, are not isolated to this area alone, and are short lived.

Bloomfield Vein & Vascular

These medications can have profound side effects, are contraindicated in certain patients (particularly those with cardiac conditions), and the dropout ratio (the proportion of patients who stop taking these medications for one reason or another) can be as high as 70%. The side effect profiles of these medications caution prescribing these drugs to patients who are taking nitrates (blood pressure or angina medications that are commonly used in patients with coronary disease) or have diabetes, men over the age of 50, smokers, men who have hypertension, and those that have high cholesterol. In essence, the patient population that may have to depend on these drugs to sustain their sexual health is the same population that tends to be afflicted by these medical conditions. If you are a man who suffers from ED, you are essentially at risk of having some type of side effect if you opt to use these drugs.

treating erectile dysfunction

Attempts at finding natural solutions to this problem has led to an explosion of non-FDA approved supplements. There are approximately 7,350 different male enhancements on the market! These “natural” alternatives promote the enhancement of a number of performance issues, but no one has studied the long-term effects of these medications or supplements, and over time these alternatives can become expensive. Furthermore, the psychological effect of taking these medications needs also to be discussed: sexual performance becomes tied to a pill or a tablet, which is a very unnatural approach to something that is so inherently natural in our make-up and that often requires spontaneous intimacy.

treating erectile dysfunction

It is estimated that the erectile dysfunction drug market reached US $3.4 billion dollars in 2019, and that does not take into effect the financial impact of the “natural” remedies that are touted as solutions. We have watched commercials with different spokesmen, typically former athletes, that tout the benefits of some of these medications or natural supplements. Often, the promised performance effect is not achieved, which leads to worsening the psychological impact of ED. These medications and supplements are a “band-aid” — they do not address the root cause of the problem.

At its core, ED is often a vascular condition, although it remains a complex problem with different processes involved, such as those associated with the nervous and endocrine systems. We are going to exclude from this discussion the subset of men who underwent prostate operations previously in which no concern was made to protect the nerves that are also involved in sexual function. Unfortunately for those individuals, the treatment options are more limited.

For the vast majority of patients who experience ED, however, having and maintaining an erection is directly tied to blood flow. Aging is associated with vascular changes in the arteries and sinusoids (think of these as small pooling lakes within tissues) of a specific area of the penis known as the corpora cavernosa. Research has indicated that these are the same vascular changes that contribute to the development of coronary disease, and that is why the proportion of men who have ED and heart disease is so high. But yet, the men with heart disease are the ones that have to be the most careful when using PDE-5is to treat their ED.

Bloomfield Vein & Vascular

Bloomfield Vein & Vascular

Studies have shown that over 80% of ED issues are caused by inadequate blood flow. As we age, there is material (plaque) that forms inside of our blood vessels that restrict flow to specific organs. That is what happens with coronary artery disease (CAD) and peripheral arterial disease (PAD), conditions that develop with age. Although diet has often been blamed for the development of issues tied to inadequate arterial flow, the formation of this plaque is multi-factorial, with genetics and lifestyle choices combining to create this material inside our arteries that ultimately restrict flow. We currently have no drugs that can reverse plaque within our vessels.

Attempts in the past by vascular surgeons to improve blood flow by using angioplasty (the use of a balloon inside of a blood vessel to treat the restriction by pushing the plaque to the side) in the main arteries flowing to the penis have been unsuccessful. The main reason as to why this did not work has to deal with the small vessels that are already present in the penis and the presence of plaque inside these vessels, and not just plaque that builds in the vessels leading to the penis. Angioplasty does not work in these small vessels and is very difficult to actually get to these vessels to perform such a delicate intervention. Intuitively it would make sense that if you improve flow in the major arteries that lead to the penis, that flow would also improve within the penis. However, the reality is that the arteries within the penis would have to be “clean” and devoid of plaque for that to work. That does not appear to be the case with ED. Furthermore, angioplasty only pushes the plaque to the vessel edge and does not remove it. As a result, the plaque tends to recur, and the effectiveness of the procedure diminishes with time. Stents in the larger blood vessels that lead to the penis are not effective as long-term solutions, either.

treating erectile dysfunction

Fortunately, there is now a new option in the treatment of ED, one that is non-invasive, not associated with the use of any medications and has scientific data to prove its benefit and is safe. GAINSWave® utilizes high frequency, low-intensity shockwaves to break up the plaque that is present within the smaller blood vessels of the penis. It focuses the treatment on the root cause of the problem: impaired blood flow. By treating the plaque directly, and not just pushing it to the side as angioplasty does, it allows improved flow to the penis, which is essential for and to maintain an erection. But it also stimulates the growth of new blood vessels, a process known as neovascularization. These new arteries are part of the microvasculature that is essential for an erection and it has the added benefit of increasing overall blood flow to the penis, which improves sexual function. GAINSWave® also achieves growth of new nerve tissue, thus enhancing sensitivity in the penis, and can also activate dormant stem cells, which leads to new cell growth. All of these effects contribute to enhance performance, improve men’s sexual health, do not require any medications, and unlike drugs, actually addresses the cause of the problem.


In clinical trials, men who have undergone GAINSWave® treatment report improved sexual performance, increased sensitivity, more spontaneous erections and better orgasms. From a psychological point of view, this has tremendous benefits, and as data have shown, improved sexual health tends to be associated with overall improvements in health. The benefits of GAINSWave® are not just limited to those men who are already suffering from ED or are beginning to have issues. GAINSWave® has proven to be beneficial for men who seek to improve their performance, and in many cases can delay the onset of ED.


The procedure is performed as an outpatient office visit, lasting 15-20 minutes per session, with the ability to resume sexual activity right away. It is not painful, and a special ultrasound handpiece is used to deliver the shockwaves that break the plaque into smaller fragments that the body is able to absorb. Based on research, benefits begin to be seen after 4-5 sessions and such benefits can last up to 14-16 months, and in some cases even up to 2 years. Maintenance therapy can continue to provide benefits, without depending upon a pill for those times that require spontaneous intimacy.

GAINSWave® is associated with up to 75% success rate, with better results seen in those patients who are seeking to enhance performance and who might not be yet be suffering from incapacitating ED. Because ED is often caused by blood flow abnormalities, being a board-certified vascular surgeon with expertise in minimally invasive procedures puts me in a privileged position to be able to deliver this therapy.

Bloomfield Vein & Vascular

Why is sexual health important? Research has noted that having a healthy sexual life can lower your blood pressure, reduce your risk of heart disease, stroke and high blood pressure, enhance your immune system, reduce your risk of prostate cancer, and can lower your overall risk of death. There is less anxiety and depression and an overall boost to confidence. The benefits also extend towards your partner. Healthy sexual lives increase levels of trust, intimacy and love, and leads to stronger bonds.

treating erectile dysfunction

Men’s health is intimately tied to sexual health. GAINSWave® is a scientifically proven, non-invasive procedure that can have profound physical, functional and psychological effects, without depending upon a pill and without concern for medication side effects. The benefits of adequately treating the root cause of ED are immense, not only for their short-term effects, but because GAINSWave® can achieve a long-term solution.

As a board-certified Vascular Surgeon, with decades of experience in treating vascular conditions in a minimally invasive fashion, the ability to incorporate GAINSWave® into my practice sets me apart from all of the other practitioners who offer different, substandard solutions to ED and who do not have the background in vascular conditions to effect the most benefit.

Contact our office today at 248-481-2100, or visit us at www.bloomfieldveinandvascular.com and let us guide you through your journey to improved sexual health!

Bloomfield Vein & Vascular

43700 Woodward Ave., suite 207, Bloomfield Hills



1 Comment

  • men's sexual health
    April 21, 2022 at 2:05 PM

    Informative post! This is a great share thank you

Leave a Reply