Erectile dysfunction (ED) is a very sensitive issue that many men experience. Some men may lose confidence in their relationships with their partners, but give up, thinking, "I'm getting old..." or suffer alone without being able to talk to anyone about it.
Age-related ED is thought to be caused by damage to blood vessels and nerves.
In this article, we will unravel the causes of ED and explain new options that differ from conventional treatment methods and aim to naturally improve the lost function itself.
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The causes of ED are "vascular aging" and "tissue damage"
The root cause of ED is not simply age. Age-related ED is thought to be caused by damage to blood vessels and nerves due to aging.
The mechanism of erection
An erection begins when the sexual center of the brain is excited by thinking about or seeing sexual things, or by stimulating the genitals. When sexual excitement reaches the penis through the nerves, a substance called NO (nitric oxide) is released from the nerve endings in the spongy tissue inside the penis (corpus cavernosum).
NO is a switch that dilates the blood vessels in the corpus cavernosum of the penis. When the switch is turned on, the amount of a substance called c-GMP, which dilates blood vessels, increases, the muscles relax, and blood rushes in. When the sponge is filled with blood, an erection occurs.
ED medications improve ED by preventing c-GMP, which dilates blood vessels, from being broken down by enzymes and supporting blood flow.
source:Anatomy of the Corpus Cavernosum and the Mechanism of Erection
The main causes of ED
The following are some of the reasons why the erectile mechanism may not work properly:
- aging
- Diabetes
- Obesity and lack of exercise
- Cardiovascular disease and hypertension
- smoking
- Low testosterone
- Chronic kidney disease and lower urinary tract symptoms
- Neurological disorders
- Psychological and psychiatric components
- Drugs
- sleep apnea syndrome
If the erectile mechanism is not fully developed due to the above reasons, it will result in ED. As you can see from the causes, it is not just "due to age" but also lifestyle-related diseases that are a major cause of ED.
Age-related ED is thought to occur because blood vessels and nerves are damaged by aging.
source:Japanese Society of Sexual Function/Japanese Urological Association | ED Treatment Guidelines
source:Japanese Urological Association | Decreased erectile function
Conventional ED treatments and their limitations
Current treatments for ED include oral administration of phosphodiesterase type 5 inhibitors (PDE5 inhibitors), the use of vacuum erection aids, and intracavernosal injections. While these treatments solve the problems of many men, they also have limitations.
Conventional ED Treatment
In traditional ED treatment, phosphodiesterase type 5 inhibitors are the first choice.
Phosphodiesterase 5 inhibitors
Oral medications such as Viagra® and Cialis® are called phosphodiesterase type 5 inhibitors and are the first choice for treating ED.
It prevents the rapid breakdown of the substance (c-GMP) that dilates blood vessels, as explained in the previous section, and strongly supports blood flow by making it easier for the blood vessels in the penis to dilate. It is an effective treatment that helps achieve an erection in a natural way when sexual stimulation occurs.
Vacuum erection aids and cavernous injections
The second option is considered when oral medication cannot be used or when drug therapy is ineffective (approximately 30%).
There are methods such as vacuum erection aids, which use a special pump to physically collect blood and create an erection, and intracavernosal injections, in which a drug that dilates blood vessels is injected directly into the penis. Both are effective methods, but there are issues such as vacuum erection aids not being covered by insurance and having to be purchased at the patient's own expense, and intracavernosal injections requiring treatment at the patient's own expense, making how to treat them a major clinical issue.
People for whom conventional ED treatment is ineffective and its limitations
Although conventional treatments are effective, they all share a major limitation: they are not radical treatments that address the underlying cause, but rather symptomatic treatments that are effective when needed.
If you stop taking the medication or injections, the condition will return to its original state. What's more, if the damage to the blood vessels or nerves that caused the condition is severe, conventional treatments often do not provide sufficient results.
Source: Japanese Society of Sexual Function/Japanese Urological Association | ED Treatment Guidelines
[The challenge of regenerative medicine] Stem cells repair blood vessels and tissues, restoring natural erectile function
While conventional treatments are symptomatic, regenerative medicine aims for a more fundamental improvement. Regenerative medicine aims to restore lost natural erectile function by utilizing the power of stem cells that are naturally present in our bodies.
Comparison of conventional treatment and stem cell treatment
Stem cell therapy has a completely different purpose and approach from conventional ED treatments, and the differences are clear when compared to oral medications.
| Comparison of ED treatments | Stem cell therapy | Phosphodiesterase 5 inhibitors |
|---|---|---|
| Possibility of a cure | Yes (aiming for functional recovery) | None (temporary effect) |
| Effect manifestation | various | Immediate effect |
| constraints | none | Some people cannot take this medicine (e.g., those with heart disease). |
| side effects | No serious cases have been confirmed | Confirmed side effects (headache, hot flashes, etc.) |
The effectiveness of the treatment varies from person to person. The greatest feature of stem cell therapy is that it can be a fundamental treatment that aims to restore function itself.
Source: J-GLOBAL | Research progress on stem cell therapy for erectile dysfunction [JST/Kyoto University machine translation]
The effects of stem cell therapy on ED
When stem cells are administered into the body, they release various growth factors (cytokines) that repair damaged tissue and create new blood vessels, directly addressing the cause of ED.
- Angiogenic effect:It promotes the creation of new, healthy capillaries and fundamentally improves blood flow to the penis.
- Tissue repair effect:Helps repair damaged muscles and nerves in the corpus cavernosum of the penis.
Stem cell therapy aims to restore the body's ability to naturally achieve erections in response to sexual stimulation without relying on medication. In fact, when six men who were experiencing erectile dysfunction despite taking phosphodiesterase-5 inhibitors underwent stem cell therapy, five of them achieved morning erections within 95 days, and these results were maintained even six months after treatment. Furthermore, all but one patient reported experiencing improvements in the frequency and hardness of erections after stem cell therapy.
Clinical research underway worldwide: How to receive stem cell therapy
Stem cell therapy for ED is still a new treatment, but many people are interested in its potential, and clinical research is underway. Currently, approaches are diversifying, including not only the stem cells themselves, but also the injection of active ingredients (culture supernatant) obtained when stem cells are cultured.
Regenerative medicine treatment begins with counseling by a specialist. Whether your symptoms are suitable, what effects you can expect, and whether there are any risks are all private concerns, so the first step is to discuss your concerns and questions at a trusted clinic.
Source: Adrenomedullin Mediates Adipose Tissue-Derived Stem Cell-induced Restoration of Erectile Function in Diabetic Rats
Source: Intracavernous administration of adipose stem cells: a new technique of treating erectile dysfunction in diabetic patient, preliminary report of 6 cases
summary
ED is not a problem to be dismissed as "just because of old age." Unlike the symptomatic treatments of the past, we are now in an era where we can directly address the cause and aim for fundamental improvement. Regenerative medicine (stem cell therapy), which aims to restore natural functions by utilizing the body's innate powers, could be a new and powerful option for regaining lost confidence and a rich partnership.
Because these are private concerns, don't keep them to yourself, but feel free to consult with a clinic with extensive expertise and experience. Taking that courageous step may make a big difference to your future.