column (e.g. in newspaper)
2026.11.06
What's the Difference Between AlmaDuo and ED Medications? A Comparison of Effectiveness, Number of Treatments, and How to Choose
Driven by the belief of “bringing happiness to more people,” I pursued a career in aesthetic medicine after gaining experience in general internal medicine and emergency surgery, along with overseas training. As an internationally oriented doctor holding a UN English Proficiency Test Special Grade A, I treat a diverse range of patients. My goal is to become a true all-rounder, spanning cosmetic surgery, cosmetic medicine, and cosmetic dermatology. With a deep understanding of global beauty standards, I serve as a Key Opinion Leader (KOL) for TargetCool, NEAUVIA®, and CORETOX®. Known for my gentle manner, I provide accessible consultations in both Japanese and English. I pursue aesthetic medicine that transforms not just appearance, but also enhances overall happiness.

The main differences between AlmaDuo and ED medications lie in how they work and how their effects manifest. AlmaDuo is a treatment that uses low-intensity shock waves to improve blood flow, while ED medications support erections through oral administration. The number of treatment sessions and the duration of their effects also differ.
"If I take ED medication, I can get an erection. But what happens when I don't take it?"
Have you ever wondered about this while undergoing treatment for ED?
In addition to medications that help you achieve an erection when needed, there are also treatments for ED (erectile dysfunction) that aim to improve blood flow to the genital area.
In this article, we’ll compare AlmaDuo with ED medications in terms of how quickly they take effect, how long their effects last, the number of treatments required, and side effects.
What is the difference between AlmaDuo and ED medications?
Both AlmaDuo and ED medications are treatments designed to improve erectile function, but they differ in their mechanisms of action and the time it takes for their effects to become apparent. AlmaDuo aims to improve blood flow through continuous light therapy, while ED medications support erections after they are taken.
| Comparison Items | armaduo | ED Medications |
|---|---|---|
| Treatment Methods | Irradiation with low-intensity shock waves | Take the medication |
| Main Effects | Aiming to Improve Blood Flow | Assists with erections resulting from sexual stimulation |
| How the Effects Manifest | Evaluation based on multiple treatment sessions | Takes effect relatively quickly after taking it |
| Number of treatments | Standard 6 Sessions (BIANCA) | Take as needed |
| Duration of Effect | Follow-up Observation of Changes After Treatment | The duration of action varies depending on the type of medication. |
| Key Points to Note | Pain or discomfort at the treatment site, etc. | Headaches, Hot Flashes, Contraindicated Medications, etc. |
*Note: "ED medications" primarily refers to PDE5 inhibitors such as Viagra and Cialis.
Both are used to treat ED, but the most appropriate option depends on the cause of the symptoms and the patient's preferred treatment method.
If you'd like to learn more about the indications for AlmaDuo,"Who is Alma Duo best suited for?"Please take a look at this as well.
AlmaDuo and ED medications work differently.
AlmaDuo aims to improve blood flow around the genital area using shock waves, while ED medications help facilitate erections by making blood vessels more likely to dilate. Each works on the body in a different way.
AlmaDuo aims to improve blood flow using shock waves
AlmaDuo is a treatment that delivers low-intensity extracorporeal shock waves to the area around the penis. The stimulation from the shock waves acts on tissues related to blood flow, with the goal of improving erectile function. A key feature of this treatment is that it does not require any incisions or medication.

In particular, this medical device is being researched as a treatment for ED caused by vascular issues.
The mechanism and features of the treatment are as follows:"What Is Alma Duo? An Explanation of Its Effects and Features"Please see.
ED medications help support erections when taken.
Medications for erectile dysfunction include sildenafil and tadalafil. They work by making it easier for the blood vessels in the penis to dilate when sexually aroused, thereby aiding in achieving an erection.
Taking the medication does not automatically cause an erection; sexual stimulation is required. Also, the duration of the medication's effects varies depending on the type.
Differences in Efficacy and Duration of Effect Between AlmaDuo and ED Medications
AlmaDuo aims to improve erectile function through multiple treatment sessions, while ED medications support erections for a certain period of time after ingestion. The way the effects manifest varies from person to person for both treatments.
Alma Duo aims to bring about change through ongoing treatments
AlmaDuo is not a treatment designed to produce immediate results with a single session. The standard treatment plan consists of 6 sessions—twice a week for 3 weeks.
A clinical study on ED treatment using AlmaDuo reported that, among patients who underwent a total of six treatments over three weeks, approximately 33% showed improvement in their erectile function severity classification at the three-month follow-up. [1]
However, changes in erectile function and duration after treatment vary from person to person and depend on the cause of ED and the severity of symptoms. It is essential to monitor progress as needed and consider additional treatment if necessary.
ED medications remain effective for a certain period of time after they are taken.
ED medications take effect relatively quickly after ingestion and help maintain an erection for a certain period of time.
For example, sildenafil has been shown to be effective for up to about 4 hours after administration, while tadalafil has been shown to be effective for up to about 36 hours. [2–4] However, an erection does not last for the entire duration of the drug’s effect.
Even after the medication's effects wear off, the underlying cause of ED may not necessarily have been resolved.
Differences in Side Effects and Precautions Between AlmaDuo and ED Medications
With AlmaDuo, you may experience pain or discomfort at the treatment site, while ED medications may cause side effects such as headaches or hot flashes. It is important to review the potential side effects and precautions for each treatment before undergoing treatment.
AlmaDuo: Pain, Side Effects, and Precautions
Alma Duo is a procedure that does not involve incisions and places relatively little strain on the body.
During the treatment, you may feel a sensation similar to a light tapping, and you may experience temporary pain, numbness, or discomfort after the procedure.
Side Effects of ED Medications and Situations in Which They Should Not Be Taken
Erectile dysfunction medications may cause side effects such as headaches, facial flushing, nasal congestion, and indigestion. Additionally, they should not be taken in combination with nitrates—which are used to treat conditions such as angina—or certain medications for pulmonary hypertension.
If you have a heart or blood vessel condition, or if you are taking other medications, be sure to consult your doctor.
If ED medications don't work, is AlmaDuo an option?
If ED medications do not provide sufficient results, low-intensity shock wave therapy—such as AlmaDuo—may be an option for cases of ED related to impaired blood flow.
However, the first step is to determine why the medication isn't working.
Identifying the Reasons Why ED Medications Don't Work
If you find it difficult to feel the effects of ED medication, factors such as the timing of administration, dosage, and the impact of meals may be contributing factors.
In addition, underlying causes may include diabetes, atherosclerosis, hormonal changes, and psychological factors.
Do not increase the dosage on your own; consult your doctor.
Shockwave therapy may be considered for ED related to blood flow
The clinical guidelines of the European Association of Urology recommend ED medications as the primary treatment.
Meanwhile, low-intensity shock wave therapy is also presented as a treatment option for patients with mild vascular ED or those with vascular ED who do not respond adequately to ED medications. [5]
Can AlmaDuo be taken with ED medication?
Low-intensity shock wave therapy and ED medications can be used together at the doctor’s discretion. Whether this combination is appropriate depends on the cause of ED and the patient’s overall health.
In some cases, a treatment approach is considered that combines erectile dysfunction medication to aid in achieving an erection with shockwave therapy to improve blood flow.
Tell your doctor about your current medications and medical history, and discuss the best course of action.
Things to Consider When Exploring ED Treatment at BIANCA
At Bianca Clinic, we evaluate your eligibility for AlmaDuo based on your concerns regarding erectile function, your overall health, and your medical history.

The causes of ED are diverse and include not only blood flow issues but also lifestyle-related diseases, hormonal factors, and psychological factors. Therefore, it is important to assess the progression of symptoms, any medications currently being taken, and the patient’s history of treatment.
If you are considering alternatives to ED medications or have concerns about your current treatment, please consult BIANCA CLINIC.
Frequently Asked Questions
We answer frequently asked questions about the differences between AlmaDuo and ED medications, including their effectiveness, use in combination with other medications, and changes after treatment.
Q. Is AlmaDuo more effective than ED medications?
A. It’s impossible to say definitively which one is better.
AlmaDuo and ED medications (PDE5 inhibitors such as sildenafil) work differently, and the most appropriate treatment depends on the cause and symptoms of ED.
Q. Is there a difference in the time it takes for AlmaDuo and ED medications to take effect?
A. While ED medications take effect relatively quickly after ingestion, AlmaDuo aims to improve erectile function through multiple treatment sessions.
For this reason, the time it takes for results to appear and the course of treatment will vary. However, it is important to note that the way results manifest can vary from person to person.
Q. If I take AlmaDuo, will I no longer need ED medication?
A. It doesn't necessarily mean it will become unnecessary.
Depending on your erectile function and symptoms after treatment, you may need to continue taking ED medication.
Q. Can AlmaDuo be taken with ED medications?
A. A doctor may decide to prescribe them in combination. However, the most appropriate approach varies depending on your health condition, the cause of your ED, and your current medication regimen.
Q. Is AlmaDuo effective even for people who don't respond to ED medications?
A. It may be an option for ED caused by poor blood flow. However, since it may not be effective for everyone, it is necessary to determine the underlying cause.
▶︎Details on Alma Duo at Bianca Clinic