{"id":9788,"date":"2026-08-02T19:51:42","date_gmt":"2026-08-02T10:51:42","guid":{"rendered":"https:\/\/kojihifu.com\/english\/?p=9788"},"modified":"2026-08-02T19:51:43","modified_gmt":"2026-08-02T10:51:43","slug":"ed-treatment-cost-tokyo-breakdown","status":"publish","type":"post","link":"https:\/\/kojihifu.com\/english\/ed-treatment-cost-tokyo-breakdown\/","title":{"rendered":"ED Treatment Cost Tokyo: PDE5, ICI, Shockwave"},"content":{"rendered":"<p><script type=\"application\/ld+json\">{\"@context\": \"https:\/\/schema.org\", \"@type\": \"FAQPage\", \"mainEntity\": [{\"@type\": \"Question\", \"name\": \"Is ED treatment covered by Japanese national health insurance?\", \"acceptedAnswer\": {\"@type\": \"Answer\", \"text\": \"In the vast majority of cases, ED treatment \u2014 including oral PDE5 inhibitors, ICI therapy, and shockwave therapy \u2014 is not covered by Japan's national health insurance system and is provided on a self-pay basis. There are narrow exceptions (for example, sildenafil is covered when prescribed for pulmonary arterial hypertension), but for sexual dysfunction these treatments are considered outside insurance scope. All costs should be budgeted as out-of-pocket expenses.\"}}, {\"@type\": \"Question\", \"name\": \"How long before I see results from shockwave therapy?\", \"acceptedAnswer\": {\"@type\": \"Answer\", \"text\": \"Most men who respond to shockwave therapy notice improvement in erectile function four to eight weeks after completing a standard course of six sessions. The improvement reflects underlying vascular regeneration, which is a gradual biological process rather than an immediate pharmacological effect. Follow-up assessment is recommended after the full course to evaluate response and discuss whether additional sessions are warranted.\"}}, {\"@type\": \"Question\", \"name\": \"Is ICI (self-injection) therapy painful?\", \"acceptedAnswer\": {\"@type\": \"Answer\", \"text\": \"The injections use a very fine (27\u201330 gauge) needle and are administered into the side of the penile shaft, an area with relatively few pain receptors. Most men report mild discomfort rather than significant pain, particularly after the first few self-injections once technique is established. Proper training with a physician significantly reduces both discomfort and the risk of complications such as bruising or inadvertent incorrect placement.\"}}, {\"@type\": \"Question\", \"name\": \"Can I combine PDE5 inhibitors with shockwave therapy?\", \"acceptedAnswer\": {\"@type\": \"Answer\", \"text\": \"Some clinical protocols allow for ongoing use of oral PDE5 inhibitors during and after a shockwave therapy course, and some research suggests this combination may improve outcomes in certain patients. However, this decision must be made on an individual basis by a physician who has reviewed your full medical history. Combining treatments without medical oversight is not advisable.\"}}, {\"@type\": \"Question\", \"name\": \"How do I know which ED treatment is right for me?\", \"acceptedAnswer\": {\"@type\": \"Answer\", \"text\": \"The appropriate treatment depends on the severity and likely cause of your ED, your cardiovascular health, any medications you are currently taking, and your personal preferences. A structured consultation \u2014 including a review of medical history and relevant questions about onset, frequency, and associated symptoms \u2014 is the essential first step before any prescription or treatment is initiated.\"}}]}<\/script><\/p>\n<h2>ED Treatment Cost in Tokyo: PDE5 Inhibitors, ICI Therapy, and Shockwave \u2014 A Full Breakdown<\/h2>\n<figure style=\"margin: 1.5em 0;\"><img decoding=\"async\" style=\"width: 100%; max-width: 100%; height: auto; border-radius: 8px;\" title=\"ED treatment cost Tokyo: PDE5 vs ICI vs shockwave  \u2014 ED Treatment Cost in Tokyo: PDE5 Inhibitors, ICI Therapy, an\" src=\"https:\/\/kojihifu.com\/english\/wp-content\/uploads\/2026\/07\/pexels_6285383_1785509781.webp\" alt=\"ED treatment cost Tokyo: PDE5 vs ICI vs shockwave  \u2014 ED Treatment Cost in Tokyo: PDE5 Inhibitors, ICI Therapy, an\" \/><\/figure>\n<p><strong>Erectile dysfunction (ED)<\/strong> is far more common than many men realise, yet it remains one of the most under-discussed health concerns \u2014 particularly for international patients navigating a foreign healthcare system.<\/p>\n<p>Whether you are an expatriate living in Tokyo or a visitor seeking discreet, English-speaking care, understanding your treatment options and what they realistically cost is the first practical step toward finding an answer.<\/p>\n<p>This article walks through the three most commonly available ED treatment pathways in Tokyo \u2014 oral PDE5 inhibitors, intracavernosal injection (ICI) therapy, and low-intensity shockwave therapy \u2014 covering how each works, expected results, and realistic cost ranges in Japan.<\/p>\n<p><strong>What you&#8217;ll learn in this article:<\/strong><\/p>\n<ul>\n<li>How PDE5 inhibitors (sildenafil, tadalafil), ICI therapy, and shockwave therapy each work<\/li>\n<li>Realistic cost ranges for each treatment in Tokyo, including consultation fees<\/li>\n<li>Which option may be appropriate depending on your medical profile<\/li>\n<li>Common misconceptions about ED treatment in Japan<\/li>\n<li>Where to access English-speaking ED consultations in Tokyo<\/li>\n<\/ul>\n<div class=\"kjmc-en-booking-inline\" style=\"background: #f7fbf7; border: 1px solid #d5e6d8; border-radius: 10px; padding: 16px 20px; margin: 26px 0; text-align: center;\">\n<p style=\"margin: 0 0 12px; color: #1a3a1f; font-size: 0.95em; line-height: 1.65;\"><strong>Have a question about this treatment?<\/strong><br \/>\nMessage us on LINE or WhatsApp \u2014 our English-speaking team usually replies the same day.<\/p>\n<p style=\"margin: 0; line-height: 1;\"><a style=\"display: inline-flex; align-items: center; gap: 8px; background: #06C755; color: #fff; padding: 10px 20px; border-radius: 8px; text-decoration: none; font-weight: bold; font-size: 0.92em; margin: 4px 6px; white-space: nowrap; vertical-align: middle;\" href=\"https:\/\/line.me\/R\/ti\/p\/@710uitns?ts=05311801&amp;oat_content=url#~\" target=\"_blank\" rel=\"noopener noreferrer\">Book via LINE<\/a><br \/>\n<a style=\"display: inline-flex; align-items: center; gap: 8px; background: #25D366; color: #fff; padding: 10px 20px; border-radius: 8px; text-decoration: none; font-weight: bold; font-size: 0.92em; margin: 4px 6px; white-space: nowrap; vertical-align: middle;\" href=\"https:\/\/whatsapp.com\/channel\/0029VbCA1v85K3zY4MLX2a1h\" target=\"_blank\" rel=\"noopener noreferrer\">Message on WhatsApp<\/a><\/p>\n<\/div>\n<h2>Understanding ED Treatment: The Three Main Pathways<\/h2>\n<figure style=\"margin: 1.5em 0;\"><img decoding=\"async\" style=\"width: 100%; max-width: 100%; height: auto; border-radius: 8px;\" title=\"ED treatment cost Tokyo: PDE5 vs ICI vs shockwave  \u2014 Understanding ED Treatment: The Three Main Pathways\" src=\"https:\/\/kojihifu.com\/english\/wp-content\/uploads\/2026\/07\/pexels_13060576_1785509782.webp\" alt=\"ED treatment cost Tokyo: PDE5 vs ICI vs shockwave  \u2014 Understanding ED Treatment: The Three Main Pathways\" \/><\/figure>\n<p><strong>ED \u00a0treatment<\/strong> has evolved considerably over the past two decades.<\/p>\n<p>Most men begin with the simplest, most accessible option and progress to alternatives only if the first-line approach is insufficient. Each pathway operates through a different physiological mechanism, which is why they are not interchangeable.<\/p>\n<h3>PDE5 Inhibitors: Oral Medication (First-Line)<\/h3>\n<p><strong>Phosphodiesterase type 5 inhibitors<\/strong> \u2014 commonly known by brand names such as Viagra (sildenafil) and Cialis (tadalafil) \u2014 are the globally established first-line pharmacological treatment for ED. These medications work by inhibiting an enzyme (PDE5) that restricts blood flow to the penis, allowing the smooth muscle to relax and erections to occur in response to natural sexual stimulation.<\/p>\n<p>Sildenafil is taken 30\u201360 minutes before sexual activity and lasts approximately four to six hours. Tadalafil offers a longer window of up to 36 hours and is also available in a low daily-dose form (2.5\u20135 mg) for men who prefer spontaneity. Neither medication produces an erection without arousal \u2014 a critical distinction from ICI therapy.<\/p>\n<p>Clinical evidence for PDE5 inhibitors is robust. Studies suggest response rates of 60\u201385% in men with mild to moderate ED, with somewhat lower efficacy in men with severe vascular disease or post-radical prostatectomy status.<\/p>\n<h3>Intracavernosal Injection (ICI) Therapy: Second-Line<\/h3>\n<p>For men who do not achieve satisfactory results with oral therapy \u2014 or for whom PDE5 inhibitors are contraindicated (for example, those taking nitrate medications for heart conditions) \u2014 intracavernosal injection (ICI) therapy is a proven alternative. ICI involves injecting a vasoactive compound directly into the erectile tissue (corpus cavernosum) of the penis using a very fine needle.<\/p>\n<p>The most widely used formulations are Trimix (a combination of alprostadil, papaverine, and phentolamine) and Bimix (papaverine and phentolamine). These agents directly cause smooth muscle relaxation and arterial dilation, producing an erection typically within five to fifteen minutes that is independent of arousal and lasts 30\u201360 minutes depending on dose.<\/p>\n<p>Clinical reports indicate that ICI therapy achieves satisfactory erections in approximately 70\u201390% of men who have not responded to oral PDE5 inhibitors, making it one of the most effective pharmacological options available. The technique is taught to patients for self-administration at home under initial physician guidance and supervision.<\/p>\n<h3>Low-Intensity Shockwave Therapy (LiSWT): Regenerative Option<\/h3>\n<p>Low-intensity shockwave therapy applies acoustic sound waves to penile tissue, stimulating neovascularisation (formation of new blood vessels) and nerve regeneration. Unlike PDE5 inhibitors or <strong>ICI therapy<\/strong>, shockwave therapy aims to address an underlying vascular cause of ED rather than simply producing a temporary erection.<\/p>\n<p>A typical course involves six to twelve weekly sessions, each lasting approximately fifteen to twenty minutes. Studies suggest that LiSWT improves International Index of Erectile Function (IIEF) scores significantly in men with mild to moderate vasculogenic ED, though response rates in severe cases or neurogenic ED are more modest. Effects may last twelve to twenty-four months in responders, and repeat courses are possible.<\/p>\n<p>It is worth noting that shockwave therapy is not yet universally approved as a standard-of-care treatment in all countries. In Japan, it is offered at specialist clinics on a self-pay basis and should be discussed carefully with a physician to determine whether you are a suitable candidate.<\/p>\n<h2>Comparison: PDE5 vs ICI vs Shockwave Therapy<\/h2>\n<figure style=\"margin: 1.5em 0;\"><img decoding=\"async\" style=\"width: 100%; max-width: 100%; height: auto; border-radius: 8px;\" title=\"ED treatment cost Tokyo: PDE5 vs ICI vs shockwave  \u2014 Comparison: PDE5 vs ICI vs Shockwave Therapy\" src=\"https:\/\/kojihifu.com\/english\/wp-content\/uploads\/2026\/07\/pexels_8313425_1785509783.webp\" alt=\"ED treatment cost Tokyo: PDE5 vs ICI vs shockwave  \u2014 Comparison: PDE5 vs ICI vs Shockwave Therapy\" \/><\/figure>\n<table style=\"border-collapse: collapse; width: 100%; margin: 20px 0; font-size: 0.95em; border: 1px solid #ccc;\">\n<thead>\n<tr>\n<th style=\"border: 1px solid #ccc; padding: 10px 12px; background: #f1faf3; text-align: left; font-weight: bold;\">Feature<\/th>\n<th style=\"border: 1px solid #ccc; padding: 10px 12px; background: #f1faf3; text-align: left; font-weight: bold;\">PDE5 Inhibitors<\/th>\n<th style=\"border: 1px solid #ccc; padding: 10px 12px; background: #f1faf3; text-align: left; font-weight: bold;\">ICI Therapy (Trimix\/Bimix)<\/th>\n<th style=\"border: 1px solid #ccc; padding: 10px 12px; background: #f1faf3; text-align: left; font-weight: bold;\">Shockwave Therapy (LiSWT)<\/th>\n<\/tr>\n<\/thead>\n<tbody>\n<tr>\n<td style=\"border: 1px solid #ccc; padding: 10px 12px; vertical-align: top;\"><strong>Mechanism<\/strong><\/td>\n<td style=\"border: 1px solid #ccc; padding: 10px 12px; vertical-align: top;\">Enzyme inhibition \u2014 enhances natural arousal response<\/td>\n<td style=\"border: 1px solid #ccc; padding: 10px 12px; vertical-align: top;\">Direct smooth muscle relaxation via injection<\/td>\n<td style=\"border: 1px solid #ccc; padding: 10px 12px; vertical-align: top;\">Acoustic wave stimulation \u2014 promotes new blood vessel growth<\/td>\n<\/tr>\n<tr>\n<td style=\"border: 1px solid #ccc; padding: 10px 12px; vertical-align: top;\"><strong>Requires arousal?<\/strong><\/td>\n<td style=\"border: 1px solid #ccc; padding: 10px 12px; vertical-align: top;\">Yes<\/td>\n<td style=\"border: 1px solid #ccc; padding: 10px 12px; vertical-align: top;\">No<\/td>\n<td style=\"border: 1px solid #ccc; padding: 10px 12px; vertical-align: top;\">N\/A (alters underlying physiology)<\/td>\n<\/tr>\n<tr>\n<td style=\"border: 1px solid #ccc; padding: 10px 12px; vertical-align: top;\"><strong>Onset<\/strong><\/td>\n<td style=\"border: 1px solid #ccc; padding: 10px 12px; vertical-align: top;\">30\u201360 min (sildenafil); 15\u201330 min (tadalafil)<\/td>\n<td style=\"border: 1px solid #ccc; padding: 10px 12px; vertical-align: top;\">5\u201315 min<\/td>\n<td style=\"border: 1px solid #ccc; padding: 10px 12px; vertical-align: top;\">Results build over 4\u20138 weeks after course completion<\/td>\n<\/tr>\n<tr>\n<td style=\"border: 1px solid #ccc; padding: 10px 12px; vertical-align: top;\"><strong>Duration per use<\/strong><\/td>\n<td style=\"border: 1px solid #ccc; padding: 10px 12px; vertical-align: top;\">4\u20136 hrs (sildenafil); up to 36 hrs (tadalafil)<\/td>\n<td style=\"border: 1px solid #ccc; padding: 10px 12px; vertical-align: top;\">30\u201360 min<\/td>\n<td style=\"border: 1px solid #ccc; padding: 10px 12px; vertical-align: top;\">Long-term (months)<\/td>\n<\/tr>\n<tr>\n<td style=\"border: 1px solid #ccc; padding: 10px 12px; vertical-align: top;\"><strong>Self-administered?<\/strong><\/td>\n<td style=\"border: 1px solid #ccc; padding: 10px 12px; vertical-align: top;\">Yes (oral tablet)<\/td>\n<td style=\"border: 1px solid #ccc; padding: 10px 12px; vertical-align: top;\">Yes (after physician training)<\/td>\n<td style=\"border: 1px solid #ccc; padding: 10px 12px; vertical-align: top;\">No (clinic-based sessions)<\/td>\n<\/tr>\n<tr>\n<td style=\"border: 1px solid #ccc; padding: 10px 12px; vertical-align: top;\"><strong>Best suited for<\/strong><\/td>\n<td style=\"border: 1px solid #ccc; padding: 10px 12px; vertical-align: top;\">Mild to moderate ED; first-line candidates<\/td>\n<td style=\"border: 1px solid #ccc; padding: 10px 12px; vertical-align: top;\">PDE5 non-responders; contraindications to oral therapy<\/td>\n<td style=\"border: 1px solid #ccc; padding: 10px 12px; vertical-align: top;\">Mild\u2013moderate vasculogenic ED; desire to reduce medication dependence<\/td>\n<\/tr>\n<tr>\n<td style=\"border: 1px solid #ccc; padding: 10px 12px; vertical-align: top;\"><strong>Main risks<\/strong><\/td>\n<td style=\"border: 1px solid #ccc; padding: 10px 12px; vertical-align: top;\">Flushing, headache, drug interactions (nitrates)<\/td>\n<td style=\"border: 1px solid #ccc; padding: 10px 12px; vertical-align: top;\">Priapism (prolonged erection), bruising, fibrosis with long-term use<\/td>\n<td style=\"border: 1px solid #ccc; padding: 10px 12px; vertical-align: top;\">Mild discomfort; limited long-term safety data<\/td>\n<\/tr>\n<tr>\n<td style=\"border: 1px solid #ccc; padding: 10px 12px; vertical-align: top;\"><strong>Cost level (Tokyo)<\/strong><\/td>\n<td style=\"border: 1px solid #ccc; padding: 10px 12px; vertical-align: top;\">Low\u2013moderate<\/td>\n<td style=\"border: 1px solid #ccc; padding: 10px 12px; vertical-align: top;\">Moderate<\/td>\n<td style=\"border: 1px solid #ccc; padding: 10px 12px; vertical-align: top;\">High (course-based)<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<h2>ED Treatment Cost in Tokyo: What to Expect<\/h2>\n<figure style=\"margin: 1.5em 0;\"><img decoding=\"async\" style=\"width: 100%; max-width: 100%; height: auto; border-radius: 8px;\" title=\"ED treatment cost Tokyo: PDE5 vs ICI vs shockwave  \u2014 ED Treatment Cost in Tokyo: What to Expect\" src=\"https:\/\/kojihifu.com\/english\/wp-content\/uploads\/2026\/07\/pexels_4021794_1785509784.webp\" alt=\"ED treatment cost Tokyo: PDE5 vs ICI vs shockwave  \u2014 ED Treatment Cost in Tokyo: What to Expect\" \/><\/figure>\n<p><strong>All ED treatments<\/strong> in Japan are provided on a self-pay (out-of-pocket) basis, as they fall outside the scope of the national health insurance system for most indications. Costs vary depending on the specific treatment, the clinic, and the volume or duration of care required.<\/p>\n<h3>PDE5 Inhibitor Costs<\/h3>\n<p>In Tokyo, oral sildenafil (generic) typically costs approximately \u00a5500\u2013\u00a51,500 per tablet at a men&#8217;s health clinic, depending on dosage and quantity. Branded Viagra and Cialis command a premium, often \u00a52,000\u2013\u00a54,000 per dose. Tadalafil daily low-dose therapy (for those preferring a continuous regimen) may run \u00a510,000\u2013\u00a530,000 per month.<\/p>\n<p>A mandatory initial consultation is required at any reputable clinic before prescribing \u2014 standard initial consultation fees in Tokyo typically start around \u00a53,300. Ongoing prescription renewal consultations are generally less expensive.<\/p>\n<h3>ICI Therapy Costs<\/h3>\n<p>ICI therapy involves both a physician consultation and training session, plus the ongoing cost of compounded medication. An initial ICI consultation and in-clinic instruction session in Tokyo typically ranges from \u00a510,000 to \u00a530,000. The compounded Trimix or Bimix formulation itself \u2014 usually dispensed in a multi-dose vial \u2014 may cost \u00a515,000 to \u00a540,000 per supply cycle, depending on concentration and volume.<\/p>\n<p>Because ICI requires careful dose titration and injection technique training, follow-up appointments are standard practice, adding to the overall cost. Men considering ICI should budget for a full initiation course rather than a single visit.<\/p>\n<h3>Shockwave Therapy Costs<\/h3>\n<p>Shockwave therapy in Tokyo is session-based and represents the highest upfront cost among the three options. A single shockwave session at a Tokyo clinic typically costs \u00a520,000\u2013\u00a550,000. A standard course of six sessions therefore carries a total cost in the range of \u00a5120,000\u2013\u00a5300,000, though package pricing at some clinics may offer a modest discount.<\/p>\n<p>It is important to note that results from shockwave therapy are not guaranteed and individual response varies. For an accurate quote tailored to your specific situation, a consultation is strongly recommended before committing to a full course.<\/p>\n<blockquote style=\"border-left: 4px solid #5a8a5a; padding: .75em 1.1em; margin: 1.8em 0; background: #f7fbf7; border-radius: 0 6px 6px 0; font-size: .93em;\">\n<p style=\"margin: 0 0 .45em; font-weight: bold; color: #3a6e3a;\">Dr. Karibe&#8217;s Note<\/p>\n<p style=\"margin: 0; color: #333; line-height: 1.7;\">Many of our international patients are surprised to find that<strong> ED consultations<\/strong> in Tokyo can be conducted with complete discretion and in English.<\/p>\n<p style=\"margin: 0; color: #333; line-height: 1.7;\">A common question I receive is whether<strong> ICI therapy<\/strong> is &#8220;too complicated&#8221; for self-administration \u2014 in practice, most patients find the technique straightforward after a proper training session, and the option significantly broadens the range of men we can help, particularly those who have not responded well to oral medications. At <strong>BIOTOPE CLINIC<\/strong>, we offer both PDE5 inhibitor prescriptions and ICI therapy (Trimix\/Bimix) under physician guidance for appropriate candidates. Feel free to raise any questions during a consultation.<\/p>\n<\/blockquote>\n<div class=\"kjmc-en-booking-inline\" style=\"background: #f7fbf7; border: 1px solid #d5e6d8; border-radius: 10px; padding: 16px 20px; margin: 26px 0; text-align: center;\">\n<p style=\"margin: 0 0 12px; color: #1a3a1f; font-size: 0.95em; line-height: 1.65;\"><strong>Have a question about this treatment?<\/strong><br \/>\nMessage us on LINE or WhatsApp \u2014 our English-speaking team usually replies the same day.<\/p>\n<p style=\"margin: 0; line-height: 1;\"><a style=\"display: inline-flex; align-items: center; gap: 8px; background: #06C755; color: #fff; padding: 10px 20px; border-radius: 8px; text-decoration: none; font-weight: bold; font-size: 0.92em; margin: 4px 6px; white-space: nowrap; vertical-align: middle;\" href=\"https:\/\/line.me\/R\/ti\/p\/@710uitns?ts=05311801&amp;oat_content=url#~\" target=\"_blank\" rel=\"noopener noreferrer\">Book via LINE<\/a><br \/>\n<a style=\"display: inline-flex; align-items: center; gap: 8px; background: #25D366; color: #fff; padding: 10px 20px; border-radius: 8px; text-decoration: none; font-weight: bold; font-size: 0.92em; margin: 4px 6px; white-space: nowrap; vertical-align: middle;\" href=\"https:\/\/whatsapp.com\/channel\/0029VbCA1v85K3zY4MLX2a1h\" target=\"_blank\" rel=\"noopener noreferrer\">Message on WhatsApp<\/a><\/p>\n<\/div>\n<h2>Who Is a Good Candidate \u2014 and Who Should Use Caution<\/h2>\n<figure style=\"margin: 1.5em 0;\"><img decoding=\"async\" style=\"width: 100%; max-width: 100%; height: auto; border-radius: 8px;\" title=\"ED treatment cost Tokyo: PDE5 vs ICI vs shockwave  \u2014 Who Is a Good Candidate \u2014 and Who Should Use Caution\" src=\"https:\/\/kojihifu.com\/english\/wp-content\/uploads\/2026\/07\/pexels_8312811_1785509785.webp\" alt=\"ED treatment cost Tokyo: PDE5 vs ICI vs shockwave  \u2014 Who Is a Good Candidate \u2014 and Who Should Use Caution\" \/><\/figure>\n<h3>Suitable Candidates<\/h3>\n<p>Most adult men experiencing persistent or recurring difficulty achieving or maintaining erections are reasonable candidates for an initial ED consultation. PDE5 inhibitors are appropriate for men with mild to moderate ED and no contraindications to vasodilatory medications. ICI therapy is particularly suitable for men with severe vascular ED, those who have undergone prostate surgery, or those for whom oral therapy has proven ineffective or inadvisable.<\/p>\n<p>Shockwave therapy is generally most appropriate for men with vasculogenic (blood-flow-related) ED of mild to moderate severity who are motivated to reduce long-term medication use. Psychological or hormonal causes of ED should be identified and addressed separately, as shockwave therapy targets vascular physiology only.<\/p>\n<h3>Who Should Exercise Caution or Seek Specialist Guidance First<\/h3>\n<p>Men taking nitrate medications (commonly prescribed for angina or heart conditions) must not use PDE5 inhibitors, as the combination can cause a dangerous drop in blood pressure. ICI therapy carries a risk of priapism \u2014 a prolonged, painful erection requiring urgent medical treatment \u2014 if dose is not correctly calibrated, which is why initial titration under physician supervision is essential.<\/p>\n<p>Men with bleeding disorders, penile anatomical abnormalities (such as Peyronie&#8217;s disease with significant curvature), or active penile infections should discuss these conditions with a physician before commencing any treatment. A full medical history review at consultation is not optional \u2014 it is a safety requirement.<\/p>\n<h2>Common Misconceptions About ED Treatment in Tokyo<\/h2>\n<p><strong>Misconception 1: &#8220;I can just buy ED medication online and skip the consultation.&#8221;<\/strong> While generic sildenafil is widely available through internet pharmacies without a prescription, this approach bypasses the necessary screening for cardiovascular contraindications and drug interactions. A face-to-face (or video-based) consultation with a licensed physician is a safety step, not a formality, and is required at any legitimate clinic in Japan.<\/p>\n<p><strong>Misconception 2: &#8220;Shockwave therapy is a cure for all types of ED.&#8221;<\/strong> Shockwave therapy is best suited to vasculogenic ED \u2014 that is, ED caused primarily by insufficient blood flow. It is unlikely to meaningfully benefit men whose ED is predominantly psychological, hormonal, or neurological in origin. Clinical reports indicate response rates are notably lower outside the vasculogenic subgroup. A proper assessment before choosing any modality is essential.<\/p>\n<h2>Where to Get ED Treatment in Tokyo (English-Speaking)<\/h2>\n<figure style=\"margin: 1.5em 0;\"><img decoding=\"async\" style=\"width: 100%; max-width: 100%; height: auto; border-radius: 8px;\" title=\"ED treatment cost Tokyo: PDE5 vs ICI vs shockwave  \u2014 Where to Get ED Treatment in Tokyo (English-Speaking)\" src=\"https:\/\/kojihifu.com\/english\/wp-content\/uploads\/2026\/07\/pexels_5593720_1785509785.webp\" alt=\"ED treatment cost Tokyo: PDE5 vs ICI vs shockwave  \u2014 Where to Get ED Treatment in Tokyo (English-Speaking)\" \/><\/figure>\n<p>Navigating the Japanese healthcare system as a non-Japanese speaker can be genuinely difficult, particularly for sensitive men&#8217;s health concerns where clear communication is essential.<\/p>\n<p>Within our clinic group, English-speaking consultations are handled at <strong>BIOTOPE CLINIC in Shirokanedai (Minato-ku, Tokyo)<\/strong> by Dr. Jun Karibe. BIOTOPE CLINIC offers ED treatment including PDE5 inhibitor prescriptions (sildenafil\/tadalafil) and intracavernosal injection (ICI) therapy with Trimix\/Bimix under physician guidance \u2014 both available as part of the clinic&#8217;s men&#8217;s health programme. These treatments are available at BIOTOPE CLINIC in Shirokanedai; feel free to ask about them during a consultation with Dr. Karibe.<\/p>\n<p>Our sister clinic, <strong>Kojimachi Dermatology &amp; Plastic Surgery Clinic<\/strong>, located in Ichigaya (Chiyoda-ku), is the group&#8217;s main office and specialises in insurance-covered dermatology conducted in Japanese. English-speaking patients should direct all enquiries and bookings to BIOTOPE CLINIC. Bookings and enquiries in English: LINE or WhatsApp.<\/p>\n<p>In Dr. Karibe&#8217;s clinical experience at BIOTOPE CLINIC, international patients often arrive having already self-treated with online-purchased medications for some time without a proper diagnosis or dose assessment. An initial consultation allows for a thorough review of medical history, relevant cardiovascular screening questions, and an informed discussion of which treatment pathway is most appropriate for each individual.<\/p>\n<h2>Frequently Asked Questions<\/h2>\n<dl class=\"kj-faq\">\n<dt>Q. Is ED treatment covered by Japanese national health insurance?<\/dt>\n<dd>In the vast majority of cases, ED treatment \u2014 including oral PDE5 inhibitors, ICI therapy, and shockwave therapy \u2014 is not covered by Japan&#8217;s national health insurance system and is provided on a self-pay basis. There are narrow exceptions (for example, sildenafil is covered when prescribed for pulmonary arterial hypertension), but for sexual dysfunction these treatments are considered outside insurance scope. All costs should be budgeted as out-of-pocket expenses.<\/dd>\n<dt>Q. How long before I see results from shockwave therapy?<\/dt>\n<dd>Most men who respond to shockwave therapy notice improvement in erectile function four to eight weeks after completing a standard course of six sessions. The improvement reflects underlying vascular regeneration, which is a gradual biological process rather than an immediate pharmacological effect. Follow-up assessment is recommended after the full course to evaluate response and discuss whether additional sessions are warranted.<\/dd>\n<dt>Q. Is ICI (self-injection) therapy painful?<\/dt>\n<dd>The injections use a very fine (27\u201330 gauge) needle and are administered into the side of the penile shaft, an area with relatively few pain receptors. Most men report mild discomfort rather than significant pain, particularly after the first few self-injections once technique is established. Proper training with a physician significantly reduces both discomfort and the risk of complications such as bruising or inadvertent incorrect placement.<\/dd>\n<dt>Q. Can I combine PDE5 inhibitors with shockwave therapy?<\/dt>\n<dd>Some clinical protocols allow for ongoing use of oral PDE5 inhibitors during and after a shockwave therapy course, and some research suggests this combination may improve outcomes in certain patients. However, this decision must be made on an individual basis by a physician who has reviewed your full medical history. Combining treatments without medical oversight is not advisable.<\/dd>\n<dt>Q. How do I know which ED treatment is right for me?<\/dt>\n<dd>The appropriate treatment depends on the severity and likely cause of your ED, your cardiovascular health, any medications you are currently taking, and your personal preferences. A structured consultation \u2014 including a review of medical history and relevant questions about onset, frequency, and associated symptoms \u2014 is the essential first step before any prescription or treatment is initiated.<\/dd>\n<\/dl>\n<div class=\"kjmc-en-booking-inline\" style=\"background: #f7fbf7; border: 1px solid #d5e6d8; border-radius: 10px; padding: 16px 20px; margin: 26px 0; text-align: center;\">\n<p style=\"margin: 0 0 12px; color: #1a3a1f; font-size: 0.95em; line-height: 1.65;\"><strong>Have a question about this treatment?<\/strong><br \/>\nMessage us on LINE or WhatsApp \u2014 our English-speaking team usually replies the same day.<\/p>\n<p style=\"margin: 0; line-height: 1;\"><a style=\"display: inline-flex; align-items: center; gap: 8px; background: #06C755; color: #fff; padding: 10px 20px; border-radius: 8px; text-decoration: none; font-weight: bold; font-size: 0.92em; margin: 4px 6px; white-space: nowrap; vertical-align: middle;\" href=\"https:\/\/line.me\/R\/ti\/p\/@710uitns?ts=05311801&amp;oat_content=url#~\" target=\"_blank\" rel=\"noopener noreferrer\">Book via LINE<\/a><br \/>\n<a style=\"display: inline-flex; align-items: center; gap: 8px; background: #25D366; color: #fff; padding: 10px 20px; border-radius: 8px; text-decoration: none; font-weight: bold; font-size: 0.92em; margin: 4px 6px; white-space: nowrap; vertical-align: middle;\" href=\"https:\/\/whatsapp.com\/channel\/0029VbCA1v85K3zY4MLX2a1h\" target=\"_blank\" rel=\"noopener noreferrer\">Message on WhatsApp<\/a><\/p>\n<\/div>\n<h2>Summary<\/h2>\n<p><strong>ED treatment<\/strong> in Tokyo spans three well-established pathways: oral PDE5 inhibitors (sildenafil\/tadalafil) as a first-line option, ICI therapy (Trimix\/Bimix) for men who require a more direct pharmacological approach, and low-intensity shockwave therapy for those seeking a regenerative, longer-term vascular intervention. Each carries a different cost profile, mechanism, and appropriate patient profile.<\/p>\n<p>Cost ranges in Tokyo are broadly: \u00a5500\u2013\u00a54,000 per dose for oral PDE5 inhibitors; \u00a510,000\u2013\u00a530,000 for ICI initiation plus \u00a515,000\u2013\u00a540,000 per medication cycle; and \u00a5120,000\u2013\u00a5300,000 for a standard six-session shockwave course. All require an initial consultation, which typically starts at \u00a53,300. For an accurate quote, we recommend booking a consultation.<\/p>\n<p>No treatment option is appropriate for every patient, and self-medicating without physician assessment carries genuine cardiovascular and safety risks. The most important step is an informed consultation with a doctor who can assess your individual situation and speak with you in clear, accurate English.<\/p>\n<p>If you have questions about ED treatment in Tokyo, English-speaking consultations are handled at <strong>BIOTOPE CLINIC in Shirokanedai (Minato-ku, Tokyo)<\/strong> by Dr. Jun Karibe. Our sister clinic, <strong>Kojimachi Dermatology &amp; Plastic Surgery Clinic<\/strong> in Ichigaya (Chiyoda-ku), handles Japanese-language insurance dermatology. English enquiries: LINE or WhatsApp.<\/p>\n<div class=\"kjmc-en-booking-box\" style=\"background: linear-gradient(135deg,#f1faf3 0%,#e6f3ea 100%); border-radius: 14px; padding: 32px 24px; margin: 36px 0 24px; border: 1px solid #c5dccd; text-align: center;\">\n<h3 style=\"margin: 0 0 8px; color: #3a6e3a; border: none; padding: 0; font-size: 1.3em;\">24\/7 Consultation &amp; Booking<\/h3>\n<div style=\"width: 48px; height: 2px; background: #3a6e3a; margin: 0 auto 22px;\"><\/div>\n<p style=\"margin: 0 0 12px; color: #1a3a1f; font-size: 1.1em; font-weight: bold;\">Book a Consultation or Treatment<\/p>\n<p style=\"margin: 0 0 24px; color: #2c4a35; line-height: 1.75;\">Our English-speaking team responds via LINE or WhatsApp \u2014 usually the same day.<\/p>\n<p style=\"margin: 0 0 10px; line-height: 1;\"><a style=\"display: inline-flex; align-items: center; justify-content: center; gap: 10px; background: #06C755; color: #fff; padding: 14px 32px; border-radius: 10px; text-decoration: none; font-weight: bold; font-size: 1.02em; box-shadow: 0 2px 8px rgba(6,199,85,0.25); min-width: 240px; white-space: nowrap;\" href=\"https:\/\/line.me\/R\/ti\/p\/@710uitns?ts=05311801&amp;oat_content=url#~\" target=\"_blank\" rel=\"noopener noreferrer\">Book via LINE<\/a><\/p>\n<p style=\"margin: 0; line-height: 1;\"><a style=\"display: inline-flex; align-items: center; justify-content: center; gap: 10px; background: #25D366; color: #fff; padding: 14px 32px; border-radius: 10px; text-decoration: none; font-weight: bold; font-size: 1.02em; box-shadow: 0 2px 8px rgba(37,211,102,0.25); min-width: 240px; white-space: nowrap;\" href=\"https:\/\/whatsapp.com\/channel\/0029VbCA1v85K3zY4MLX2a1h\" target=\"_blank\" rel=\"noopener noreferrer\">Message on WhatsApp<\/a><\/p>\n<\/div>\n<h2>References<\/h2>\n<ol>\n<li>Burnett AL, Nehra A, Breau RH, et al. Erectile Dysfunction: AUA Guideline. Journal of Urology. 2018;200(3):633\u2013641.<\/li>\n<li>Tsertsvadze A, Fink HA, Yazdi F, et al. Oral Phosphodiesterase-5 Inhibitors and Hormonal Treatments for Erectile Dysfunction: A Systematic Review and Meta-analysis. Annals of Internal Medicine. 2009;151(9):650\u2013661.<\/li>\n<li>Gruenwald I, Appel B, Vardi Y. Low-Intensity Extracorporeal Shock Wave Therapy \u2014 a Novel Effective Treatment for Erectile Dysfunction in Severe ED Patients Who Respond Poorly to PDE5 Inhibitor Therapy. Journal of Sexual Medicine. 2012;9(1):259\u2013264.<\/li>\n<li>Montorsi F, Deho F, Salonia A, et al. Penile Implants in the Era of Oral Drug Treatment for Erectile Dysfunction. BJU International. 2004;94(5):745\u2013751.<\/li>\n<li>Heidelbaugh JJ. Management of Erectile Dysfunction. American Family Physician. 2010;81(3):305\u2013312.<\/li>\n<\/ol>\n<h2>Related Articles<\/h2>\n<p>You may also find these articles useful.<\/p>\n<ul>\n<li><a href=\"https:\/\/kojihifu.com\/english\/medical-weight-loss-tokyo-guide\/\" target=\"_blank\" rel=\"noopener\">Medical Weight Loss Tokyo: Options, Cost &amp; Clinic Guide<\/a><\/li>\n<li><a href=\"https:\/\/kojihifu.com\/english\/medical-weight-loss-tokyo-expats\/\" target=\"_blank\" rel=\"noopener\">Medical Weight Loss Tokyo for Expats: Consultation<\/a><\/li>\n<li><a href=\"https:\/\/kojihifu.com\/english\/fat-dissolving-injections-tokyo-english\/\" target=\"_blank\" rel=\"noopener\">Fat Dissolving Injections Tokyo: Cost &amp; English Guide<\/a><\/li>\n<li><a href=\"https:\/\/kojihifu.com\/english\/english-speaking-dermatologist-tokyo-fees\/\" target=\"_blank\" rel=\"noopener\">English-Speaking Dermatologist Tokyo: Fees &amp; Costs<\/a><\/li>\n<\/ul>\n<div style=\"margin: 2.5em 0 1em; padding: 1.5em; border: 1px solid #d5d5d5; border-radius: 10px; background: #fafafa; font-size: .9em;\">\n<p style=\"font-size: .72em; font-weight: bold; color: #888; margin: 0 0 1.2em; letter-spacing: .08em;\">SUPERVISED BY<\/p>\n<div style=\"display: flex; align-items: flex-start; gap: 1.2em; flex-wrap: wrap;\">\n<div style=\"flex-shrink: 0; text-align: center; min-width: 110px;\"><img decoding=\"async\" style=\"width: 100px; height: 100px; border-radius: 50%; object-fit: cover; object-position: top center; display: block; margin: 0 auto; border: 3px solid #e0e0e0;\" src=\"https:\/\/kojihifu.com\/hon\/wp-content\/uploads\/2022\/01\/photo-karibejun-400-3_re-300x300.jpg\" alt=\"Dr. Jun Karibe MD \u2014 Board-certified Plastic Surgeon, Director of Kojimachi Dermatology &amp; Plastic Surgery Clinic\" \/><\/p>\n<p style=\"margin: .6em 0 .1em; font-weight: bold; font-size: .95em; color: #222;\">Dr. Jun Karibe<\/p>\n<p style=\"margin: 0 0 .1em; font-size: .75em; color: #999;\">MD<\/p>\n<p style=\"margin: 0; font-size: .75em; color: #555; font-weight: bold;\">Director<\/p>\n<\/div>\n<div style=\"flex: 1; min-width: 200px;\">\n<div style=\"margin-bottom: .75em; background: #fff; border: 1px solid #ebebeb; border-radius: 6px; padding: .7em 1em;\">\n<p style=\"margin: 0 0 .35em; font-size: .78em; font-weight: bold; color: #666; border-bottom: 1px solid #f2f2f2; padding-bottom: .3em;\">Education &amp; Career<\/p>\n<div style=\"font-size: .82em; color: #444; line-height: 1.75;\">\n<div>Juntendo University School of Medicine<\/div>\n<div>Department of Plastic Surgery, University of Tokyo Hospital<\/div>\n<div>Assistant Professor, Plastic &amp; Cosmetic Surgery, Saitama Medical University<\/div>\n<div>Assistant Professor &amp; Chief Resident, Yamanashi University Hospital<\/div>\n<div>2019: Founded Kojimachi Dermatology &amp; Plastic Surgery Clinic (Ichigaya, Tokyo)<\/div>\n<div>2021: Founded BIOTOPE CLINIC Shirokanedai (Minato-ku, Tokyo)<\/div>\n<\/div>\n<\/div>\n<div style=\"margin-bottom: .75em; background: #fff; border: 1px solid #ebebeb; border-radius: 6px; padding: .7em 1em;\">\n<p style=\"margin: 0 0 .35em; font-size: .78em; font-weight: bold; color: #666; border-bottom: 1px solid #f2f2f2; padding-bottom: .3em;\">Certifications<\/p>\n<div style=\"font-size: .82em; color: #444; line-height: 1.75;\">\n<div>Board-certified Plastic Surgeon \u2014 Japan Society of Plastic and Reconstructive Surgery<\/div>\n<div>Specialist \u2014 Japan Society of Anti-Aging Medicine<\/div>\n<div>Certified Industrial Physician \u2014 Japan Medical Association<\/div>\n<div>Allergan VST-certified Injector (Botox &amp; Hyaluronic Acid)<\/div>\n<\/div>\n<\/div>\n<div style=\"background: #fff; border: 1px solid #ebebeb; border-radius: 6px; padding: .7em 1em;\">\n<p style=\"margin: 0 0 .35em; font-size: .78em; font-weight: bold; color: #666; border-bottom: 1px solid #f2f2f2; padding-bottom: .3em;\">Awards<\/p>\n<div style=\"font-size: .82em; color: #444; line-height: 1.75;\">\n<div>Best Presentation Award \u2014 Dept. of Plastic Surgery, University of Tokyo (2016)<\/div>\n<div>Excellence Award \u2014 Japan Society of Plastic and Reconstructive Surgery (2018)<\/div>\n<div>Featured Presentation \u2014 ASPS Annual Scientific Meeting, USA (2018)<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<div style=\"margin-top: 1em; padding-top: .75em; border-top: 1px solid #e8e8e8; display: flex; flex-wrap: wrap; align-items: center; gap: .5em;\"><a style=\"display: inline-block; background: #e1306c; color: #fff; padding: .4em .9em; border-radius: 4px; text-decoration: none; font-size: .8em; font-weight: bold;\" href=\"https:\/\/www.instagram.com\/dr.jun_\/\" target=\"_blank\" rel=\"noopener noreferrer\">Instagram<\/a><\/div>\n<\/div>\n","protected":false},"excerpt":{"rendered":"Compare ED treatment costs in Tokyo: PDE5 inhibitors, ICI therapy, shockwave. Realistic pricing, how each works, English-speaking clinics. Find your best option.","protected":false},"author":4,"featured_media":9787,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[21],"tags":[586,580,583,584,585,539,26],"class_list":["post-9788","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-skin-dermatology","tag-english-speaking-care","tag-ed-treatment","tag-pde5-inhibitors","tag-ici-therapy","tag-shockwave-therapy","tag-mens-health","tag-tokyo-clinic"],"aioseo_notices":[],"_links":{"self":[{"href":"https:\/\/kojihifu.com\/english\/wp-json\/wp\/v2\/posts\/9788","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/kojihifu.com\/english\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/kojihifu.com\/english\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/kojihifu.com\/english\/wp-json\/wp\/v2\/users\/4"}],"replies":[{"embeddable":true,"href":"https:\/\/kojihifu.com\/english\/wp-json\/wp\/v2\/comments?post=9788"}],"version-history":[{"count":1,"href":"https:\/\/kojihifu.com\/english\/wp-json\/wp\/v2\/posts\/9788\/revisions"}],"predecessor-version":[{"id":9919,"href":"https:\/\/kojihifu.com\/english\/wp-json\/wp\/v2\/posts\/9788\/revisions\/9919"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/kojihifu.com\/english\/wp-json\/wp\/v2\/media\/9787"}],"wp:attachment":[{"href":"https:\/\/kojihifu.com\/english\/wp-json\/wp\/v2\/media?parent=9788"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/kojihifu.com\/english\/wp-json\/wp\/v2\/categories?post=9788"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/kojihifu.com\/english\/wp-json\/wp\/v2\/tags?post=9788"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}