Dr. George Shapiro
Appearances
The Dr. Hyman Show
Erectile Dysfunction: The Warning Signs You Shouldn’t Ignore
Scope of the problem is significant, and it just is not in the older population. We're seeing problems age 30. Age 30, 40, 50, men and women. 80% of erections in men is vasculogenic. It's due to blood flow. 20% is hormones. So a lot of the younger patients come in and say, listen, my testosterone must be low because I can't get an erection. But that's not the case.
The Dr. Hyman Show
Erectile Dysfunction: The Warning Signs You Shouldn’t Ignore
It's other things that are involved. Vessels, blood vessel flow. Blood flow is a big problem. Now, why do people have lack of blood flow? It turns out that, you know, atherosclerosis starts at age five. You can start having plaque in your blood vessels. Yeah. And the first sign of of erectile dysfunction is endothelial dysfunction. The endothelium is the inside lining of blood vessels.
The Dr. Hyman Show
Erectile Dysfunction: The Warning Signs You Shouldn’t Ignore
We have 60,000 miles of blood vessels in our body.
The Dr. Hyman Show
Erectile Dysfunction: The Warning Signs You Shouldn’t Ignore
Well, so it turns out that it's one organ, not multiple organs, the endothelial system. So people often ask, as a cardiologist, why are you dealing with erectile dysfunction? Because the first sign of endothelial dysfunction is erectile dysfunction. The first presentation that someone has a blockage in an artery is lack of early morning erections or erectile dysfunction.
The Dr. Hyman Show
Erectile Dysfunction: The Warning Signs You Shouldn’t Ignore
So when we see that- Can be a sign of heart disease, diabetes, right?
The Dr. Hyman Show
Erectile Dysfunction: The Warning Signs You Shouldn’t Ignore
Diabetes is a big thing. Hypertension is a big problem.
The Dr. Hyman Show
Erectile Dysfunction: The Warning Signs You Shouldn’t Ignore
alcohol is a huge problem when you have alcohol you have an acute inflammatory reaction in the blood vessel wall but the most the most that we see is sugar sugar sugar is extremely inflammatory if you have a coca-cola with basically the donut or a coke or an erection you gotta choose right within two hours right within two hours of having sugar we can actually measure in the urine an inflammatory mediator
The Dr. Hyman Show
Erectile Dysfunction: The Warning Signs You Shouldn’t Ignore
We can actually measure your blood vessel by looking at endothelial function testing to see that it's vasoconstricted after sugar. Sugar could precipitate a heart attack. There was a good video. So basically you don't have dessert if you wanna have sex, is that the idea? You gotta pick what you want.
The Dr. Hyman Show
Erectile Dysfunction: The Warning Signs You Shouldn’t Ignore
So sugar's a big problem, but what we're finding out is blood flow is huge, and like you said, to see the diseases or what we're eating, and that can affect us a lot. I want people to really get that.
The Dr. Hyman Show
Erectile Dysfunction: The Warning Signs You Shouldn’t Ignore
Well, sugar is the biggest cause of inflammation inside the blood vessel lining, which is a big factor, the reducer of blood flow. It's all about blood flow. So what are some of the things that we can do to increase blood flow? A technology that I recently started using about a year ago is called Gaines Wave.
The Dr. Hyman Show
Erectile Dysfunction: The Warning Signs You Shouldn’t Ignore
GainsWave uses low-intensity extracorporeal shockwave therapy, and it basically can optimize men's health. It can optimize performance. What it does is it creates a small injury. Injury then sends a message to the brain. The brain releases mediators, mesenchymal stem cells, to go to that site and increase blood flow by causing what's called angiogenesis.
The Dr. Hyman Show
Erectile Dysfunction: The Warning Signs You Shouldn’t Ignore
Actually, the Gaines Wave treatment, which has been very popular lately, and it's available all over the U.S. We do it in New York City and my Westchester location, but it's involved everywhere. But it's for two things. It basically helps increase blood flow. And it does that by angiogenesis.
The Dr. Hyman Show
Erectile Dysfunction: The Warning Signs You Shouldn’t Ignore
Correct. So anytime you have an injury, your body's trying to repair that injury. And our natural repair mechanism is stem cells. So you have a cut on your finger or a shave, you're shaving and you have a cut. What happens in two days? It's healed. Why does it heal so fast? We have a self-repairing mechanism.
The Dr. Hyman Show
Erectile Dysfunction: The Warning Signs You Shouldn’t Ignore
So this low intensity shockwave therapy, GAINS Wave, basically gives you this small injury And we're all familiar with shockwave therapy for lithotripsy, right? Lithotripsy is higher intensity for kidney stones. So this is low intensity. So the GAINS wave therapy basically works by angiogenesis, new blood vessel growth, and growth factors, bringing new growth factors to the area.
The Dr. Hyman Show
Erectile Dysfunction: The Warning Signs You Shouldn’t Ignore
Usually we do a treatment once a week. or twice a week, it's about six sessions. It doesn't hurt, it's not painful, it's non-surgical, it's not invasive. Patients see results, you know, significant, we're getting great responses. And usually we do six treatments or 12. Some people have Peyronie's disease, which is a plaque. of fibrous plaque and injury to the penis.
The Dr. Hyman Show
Erectile Dysfunction: The Warning Signs You Shouldn’t Ignore
This has been curing it in patients.
The Dr. Hyman Show
Erectile Dysfunction: The Warning Signs You Shouldn’t Ignore
That's incredible. And these are young patients that we're seeing, you know, 30s and 40s, some 50s and 60s. But, you know, we're seeing some great results with Gaines Wave therapy.
The Dr. Hyman Show
Erectile Dysfunction: The Warning Signs You Shouldn’t Ignore
Well, yeah, not exactly. I mean, that's the mechanism of it. Let's say you exercised your whole life compared to someone who was sedentary their whole life, and you both had a heart attack. From the books, remember some of these studies, the person who exercises is going to have a smaller heart attack. The person who doesn't exercise will have a larger heart attack. What does exercise do?
The Dr. Hyman Show
Erectile Dysfunction: The Warning Signs You Shouldn’t Ignore
Grows new blood vessels. So if someone who exercises a lot, who has some blood vessel growth, but sort of like is having a lot of ED issues because they changed their diet, they have some inflammation, and their blood vessels are kind of like constricted, this will help knock off some of the calcium inside the vessel wall.
The Dr. Hyman Show
Erectile Dysfunction: The Warning Signs You Shouldn’t Ignore
It'll increase dilation of blood flow, bring in more growth factors, and basically- So it's like regenerative medicine for the penis, basically.
The Dr. Hyman Show
Erectile Dysfunction: The Warning Signs You Shouldn’t Ignore
correct and it and it may allow you to throw away your viagra or sialis right so so you know sialis and viagra work locally on the penis by phosphodiesterase uh pde5 you know uh receptor inhibitors and what this is doing is you're inhibiting constriction so you're dilating but there's other side effects with with some of these medications it reduces blood flow to the eye
The Dr. Hyman Show
Erectile Dysfunction: The Warning Signs You Shouldn’t Ignore
sometimes you can have uh increased yeah visual changes you can have increased reflux by reducing lower esophageal sphincter pressure in the esophagus um i mean you know sometimes they're great like sialis five milligrams daily is great for people with bph because it reduces the pressure on the prostate and and able you know allows you to urinate better that's been a help with a lot of patients but sometimes combination therapies help yeah um
The Dr. Hyman Show
Erectile Dysfunction: The Warning Signs You Shouldn’t Ignore
like we mentioned exosomes before so now we're taking exosomes and we're and we're doing what's called uh uh an xx shot uh or an xy shot and basically what that does we call it a p shot is that it so so i actually trained with dr rannells and learned prp and did a lot of prp the p shot the o shot which helps a lot of women and men uh but that's with their own blood we spin it down and we re-inject it back into them so we're getting some growth factors yeah
The Dr. Hyman Show
Erectile Dysfunction: The Warning Signs You Shouldn’t Ignore
But if you compare PRP with some of the new therapy exosomes, you know, exosomes, you're talking about, you know, a tremendous increase in growth factors that basically make the result so much more powerful. So, you know, I'm doing some PRP now, not as much. I'm doing a lot more exosomes. I think exosomes will be the future.
The Dr. Hyman Show
Erectile Dysfunction: The Warning Signs You Shouldn’t Ignore
So, you know... Sexual organs. You go right into the penis. You numb up the area. Sometimes you can do a nerve block. It's no pain at all. and it takes about 15 minutes, and the response is significant. Patients with prostate cancer who have decreased sensitivity, who got radiation, who now can't get an erection, now suddenly can get an erection after an exosome injection.
The Dr. Hyman Show
Erectile Dysfunction: The Warning Signs You Shouldn’t Ignore
Well, because Gaines Wave is the only therapy that's basically using low intensity shockwave therapy.
The Dr. Hyman Show
Erectile Dysfunction: The Warning Signs You Shouldn’t Ignore
It's drug-free, non-invasive, surgery-free, improves blood flow, gives a better erection quality. You have harder erections, more full erections, sexual performance is improved. And actually a lot of patients will come who are younger who want to increase performance. They have good erections, but they want performance. They want to be able to last longer.
The Dr. Hyman Show
Erectile Dysfunction: The Warning Signs You Shouldn’t Ignore
So they come in for performance issues, not ED issues. And then we have maintenance. Once a patient goes through their six or 12 sessions, they'll come back once a season and get a maintenance treatment. But the combination thing of exosomes, PRP, or... Diet, exercise, all of that. And gains weight, exercise, so important. Diet, eating less sugar, keeping those vessels dilated, very important.
The Dr. Hyman Show
Erectile Dysfunction: The Warning Signs You Shouldn’t Ignore
And we're seeing it's a safe procedure too. Everyone's concerned about surgery. I used to send a lot of patients for bypass, coronary artery bypass, graft surgery.
The Dr. Hyman Show
Erectile Dysfunction: The Warning Signs You Shouldn’t Ignore
you know if you need it you get it but i mean right now we're trying to do multi-vessel stenting and i i i can speak for hours on just cardiology and traditional you know disease management but i mean here we're talking about you know more natural ways to to stay younger and healthier and live longer