Shockwave therapy for ED: what the research says

What it is and how it is thought to work

Low-intensity shockwave therapy uses a handheld device that sends gentle sound-wave pulses into the penis. It’s done in an office, with no needles and no surgery. Each session usually takes about 15 to 20 minutes.

The term is used loosely. Not every machine sold as shockwave therapy makes the same kind of waves. Some devices make focused or linear shockwaves, and others make radial waves, which have been studied less.

Erections depend on good blood flow. Researchers think the pulses cause tiny, controlled stress in the tissue. That may prompt the body to grow new small blood vessels and may help repair nerves. Most of this comes from lab and animal studies, and the exact way it works is still being studied.

Who it has been studied in

Most studies have looked at men whose ED is caused by blood flow problems, called vasculogenic ED. Many of these men had mild to moderate ED. Reviews suggest it may be most likely to help men with mild or moderate ED and few other health problems.

There is less research in men whose ED comes from nerve damage, such as after prostate surgery.

What the studies show

The results are mixed. Some trials found better erections after treatment, and others found little or no difference compared with a fake treatment.

A large review of the research found that shockwave therapy may have a small effect in the first few months, but that effect may be too small to notice. It may help erections more over a longer time. The reviewers rated the certainty of all this evidence as low, which means future studies could change the picture.

Results may also fade. In one follow-up study, only about half of the men who first improved still had that benefit two years later.

Expert groups don’t agree yet. U.S. urology experts say it needs more study, while a European guideline lists it as an option for some men based on weak evidence.

FDA status and a typical course

In the United States, shockwave therapy has not been approved by the FDA specifically to treat ED, and researchers describe it as investigational for this use.

There is no single standard plan. In studies, men often had one or two sessions a week for several weeks. Many protocols used around 12 sessions in total, though the number varied.

Possible side effects

In studies, side effects were usually mild and short-lived, and they were about as common as with a fake treatment. Bruising is the most common and usually needs no treatment. Less often, men may have blood in the urine, a skin infection on the penis, or a painful erection.

Where it fits with proven options

Experts say more research is needed before shockwave therapy can be called standard care. Established treatments are still the usual place to start. These include lifestyle changes, counseling, pills, vacuum devices, injections, medicine placed in the urethra, and implants.

Pills work well for many men, and they are often where treatment begins. If pills aren’t a good fit or haven’t worked for you, there are other proven options to talk through with your doctor.

Questions to ask a provider

If you’re thinking about it, talk to a doctor first, ideally one who knows your full health history. These questions can help:

• Is my ED caused by blood flow, nerves, hormones or something else?
• Have my heart health, blood pressure and blood sugar been checked?
• What kind of device do you use, focused or radial?
• How many sessions do you suggest, and what does the research say about results like mine?
• What will the full course cost, and is any of it covered by insurance?
• What other options should I try first?

Common questions

Does shockwave therapy for ED really work?

The research is mixed. A large review found it may give a small benefit, especially over a longer time, but the evidence is low certainty and more research is needed.

Is shockwave therapy for ED FDA approved?

In the United States, it has not been approved by the FDA specifically to treat ED, and researchers consider it investigational for this use.

How many shockwave sessions are needed for ED?

There is no single standard. Studies often used one or two sessions a week for several weeks, with many protocols using around 12 sessions in total.

Is shockwave therapy for ED painful or risky?

In studies, side effects were usually mild and short-lived. Bruising was the most common, and serious problems were rare.

Ready for next steps? Read how to find ED care in New Orleans and Metairie, including what a good first visit looks like and the questions worth asking.

Not sure where to start? We list trusted places to get checked in Louisiana, from community health centers to men’s health clinics. See where to get care.

Sources

• Cochrane Database of Systematic Reviews (via PMC): Low-intensity shockwave therapy for erectile dysfunction
• Translational Andrology and Urology (via PMC): Low-intensity shock wave therapy for vasculogenic erectile dysfunction, a narrative review
• Sexual Medicine Reviews (via PMC): The basic physics of waves, soundwaves, and shockwaves for erectile dysfunction
• Arab Journal of Urology (via PMC): Low-intensity extracorporeal shockwave therapy for erectile dysfunction
• NIDDK: Treatment for Erectile Dysfunction