“Affirm” for Boosting Nitric Oxide for Sexual Health, Heart and Vascular Diseases, and Brain Health

For more than a year I have been using shock wave therapy (focused and radial), testosterone replacement, PDE5i medications (i.e. low dose daily Cialis [tadalafil] usually), some supplements (NO boosters), diet and exercise to improve erectile and sexual function in a male patient population generally between the ages 60 and 90. With that combined approach over 70-80% have improved enough to have successful intercourse as long as their relationships are intact to have intimacy. Less than 10% have had no improvement in their erections at all.

Do I think shock wave therapy by itself will work to improve erections to a point were no other medical therapy is needed? Generally not. Especially in my population of men usually in their late 60s to late 70s. Maybe if you get younger sexually active men between 40-60 just shock wave therapy alone may work. Do I think shock wave treatment is a critical component in the age group 60 plus year olds to be used sometimes in combination with medications (i.e. PDE5i like low dose daily Cialis) and testosterone replacement if deficient? Absolutely!

Why did I leave out in the paragraph above diet, exercise and supplementation to optimize heart and vascular function, reduce blood pressure and blood sugar and for patients to lose weight? Because I and my patients have to do better in these areas. Diet and exercise are the critical components in improving endothelial health and enhancing NO, the gas that is really responsible for blood flow into the penis (and other blood vessels like your coronary arteries) to achieve and maintain an erection. There are many supplements that claim to boost nitric oxide, a key component of any ED therapy, and for that matter heart and brain health. While shock wave therapy results in the body (genital area) creating new blood vessels and thereby enhancing blood flow, it also directly causes the release of NO in the penis. Some men noticed after the first treatment a difference in their erections. This can’t be from angiogenesis (neovascularization – building of new arteries) if erections improve immediately it is from nitric oxide being produced by the shock wave treatment, a PDE5i (i.e. daily Cialis) or a nitric oxide booster like Affirm created by urologist Dr. Judson Brandies ( Watch educational video on NO and Affirm ).

Taking an NO Booster for ED Help Get Rid of Angina?
This is a quick anecdote. A late 60 year old patient who was having regular intercourse with his wife a couple of times per week came in for treatment not because of frank ED but to improve performance. After a couple of treatments he noticed improved firmness in his erections. This patient has a history of angina when he goes from walking to jogging. So he has been walking. I recommended the Affirm (link above) at two tablets twice daily which is the dose Dr. Brandeis recommends during the initial shock wave treatments. I recently saw the patient and he noted that he decided to do more jogging than walking and his angina to his surprise didn’t come on when he was jogging? Coincidence or real effect? Point being if you improve NO production that improves endothelial function, the precious inner lining of our arteries everywhere so a true NO booster can improve ED, your heart disease and vascular diseases and brain health. So I think Affirm is worth a try for both men and women. The number one killer in women is heart disease. And infact improving female sexual function is highly depend on blood flow to the female genitals. So the same exact formula in the “pink” bottle Dr. Brandeis sells to women. We have the blue bottle in our clinic. I have recommended it to women.

Over the last year I have corresponded with (by email and writing), talked to via zoom and by phone, and watched numerous webinars and videos on enhancing sexual function in men using the above combination of modalities. While shock wave therapy (pulsed sound waves either created by a radial pressure device (radial) or a magnetic coil (focused) is many times the focus of this approach and is marketed as such (listen for radio spots on acoustic wave therapy in your community) what is more critical is the role of nitric oxide (NO) a gas release by nerve cells and by the endothelium (single layer of cells that line all blood vessels and the heart) in enhancing sexual function. In males NO production is critical in assisting in firm, consistent and lasting erections to have successful sexual relations.

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