Introduction
About 30 million men in the United States suffer from erectile dysfunction (ED). The problem becomes more common as men age. Pills like Viagra and Cialis have helped many, but they don’t work for everyone. They also only treat symptoms, not causes.
Doctors now explore other options, including low-intensity extracorporeal shockwave therapy (LI-ESWT). Most people call it simply “shockwave therapy.”
This treatment doesn’t involve surgery. It aims to improve erections by fixing the underlying problems. But does it really work? Let’s look at the science, results, limits, and what you should know if you’re thinking about trying it.
What Is Shockwave Therapy?
The Basics of Shockwave Technology
Shockwave therapy uses sound waves that carry energy to specific body areas. Doctors first used stronger versions to break up kidney stones. Now they use gentler waves to treat muscle problems and erectile dysfunction.
The low-energy waves used for ED don’t harm tissue. Instead, they trigger healing effects that may help tissues repair and grow.
How Shockwave Therapy Is Done for ED
Here’s what happens during treatment:
- You lie down comfortably on an exam table
- The doctor applies gel to your penis to help conduct the waves
- A handheld device delivers gentle shock waves to specific areas
- Each session lasts about 15-20 minutes
- You’ll typically need 6-12 sessions over several weeks
Most men feel little or no pain during treatment. You can return to normal activities right away.
How Does Shockwave Therapy Work for ED?
The Science Behind It
Shockwave therapy may help erectile dysfunction in several ways:
- Growing new blood vessels: The waves stimulate your body to form new blood vessels in the penis. Better blood flow means better erections.
- Healing damaged tissue: The therapy may wake up stem cells and growth factors that repair penile tissue.
- Reducing plaque: For men with Peyronie’s disease (curved penis), the waves might help break down plaque.
- Helping nerves heal: Some research suggests the therapy might help damaged nerves recover.
Dr. Irwin Goldstein, a sexual medicine expert, explains: “The treatment seems to release nitric oxide and growth factors. It also stimulates stem cells. These all help improve blood vessel function in the penis.”
The Evidence: Does Shockwave Therapy Work?
Research Findings
Studies show mixed results for shockwave therapy and ED:
Good News:
A 2019 review of 10 studies with 873 men found that shockwave therapy improved erection scores better than fake treatments. This was especially true for men with mild to moderate ED caused by blood vessel problems.
Another study followed men for a year after treatment. About 63% of those who improved initially still had better erections 12 months later, without taking ED pills.
Study Limitations:
Despite these positive findings, the research has some problems:
- Many studies tested only small groups of men
- Treatment methods vary widely between studies
- Few studies track results beyond one year
- Most positive results involve men with blood vessel-related ED only
- Few studies compare shockwave therapy directly to other ED treatments
Expert View
Dr. Rafael Carrion, a urology professor, says: “The early data looks promising, especially for men with mild ED from blood vessel issues. But we need larger studies with standard methods before making it a first-line treatment. Given its safety, though, it’s a reasonable option for men who don’t respond well to pills.”
Who Might Benefit from Shockwave Therapy?
This treatment seems to work best for:
- Men with mild to moderate erectile dysfunction
- ED cases caused mainly by blood vessel problems
- Patients who don’t respond well to ED pills
- Men seeking a treatment that might fix underlying causes
- Patients who can’t take ED medications for health reasons
Dr. Anne Katz, a sexuality counselor, notes: “Men who’ve had ED for a shorter time tend to respond better. This suggests earlier treatment might work better.”
Limitations and Side Effects
Safety Profile
One big advantage of shockwave therapy is its safety. Studies report very few side effects, which typically include:
- Mild pain during treatment (less than 10% of men report this)
- Temporary skin redness
- Occasional bruising
- Rarely, small surface blood vessels may break
No serious side effects have been reported in clinical trials.
Key Limitations
Despite being safe, shockwave therapy has important limits:
- It doesn’t work for everyone: About 60-70% of carefully selected patients show improvement.
- Results may not last: Some men see benefits fade after 1-2 years and need more treatments.
- Not FDA-approved for ED: While the FDA approves these devices for other uses, they aren’t specifically approved for ED treatment in the US.
- Cost concerns: Most insurance plans don’t cover it. Out-of-pocket costs range from $3,000-$5,000 for a full treatment.
- Limited availability: Treatment is mostly offered at special sexual medicine clinics or research centers.
Comparing Shockwave Therapy to Other ED Treatments
Treatment Options Compared
| Treatment | How It Works | Invasiveness | Effectiveness | How Long It Lasts | Cost | Side Effects |
|---|---|---|---|---|---|---|
| Shockwave Therapy | Tissue healing, better blood flow | Non-invasive | Moderate (for some men) | Months to years | $3,000-$5,000 per course | Minimal |
| ED Pills (Viagra, Cialis) | Improved blood flow | Non-invasive (pill) | High (60-70% success) | 4-36 hours per dose | $10-70 per pill | Headache, flushing, stuffy nose |
| Vacuum Devices | Mechanical blood trapping | Non-invasive (external) | Moderate to high | Temporary | $100-$500 (one-time) | Bruising, numbness, unnatural feel |
| Penile Injections | Direct blood vessel widening | Minimally invasive | Very high (>80% success) | 30-60 minutes per dose | $20-40 per dose | Pain, scarring, risk of priapism |
| Penile Implants | Mechanical erection | Surgical | Very high (>90% satisfied) | Permanent solution | $15,000-$25,000 (often covered by insurance) | Infection, mechanical failure, irreversible |
Combining Treatments
Some doctors now recommend combining approaches. Dr. Mohit Khera, a urology professor, says: “We see good results when combining shockwave therapy with ED pills or platelet-rich plasma treatments. Using multiple methods may work better than just one.”
The Patient Experience
Men report different experiences with shockwave therapy:
John, 58, who has diabetes-related ED, shares: “Pills didn’t work for me. After shockwave therapy, I noticed better spontaneous erections within three months. The effect started to fade after about a year, but it gave me a good period of improvement.”
Robert, 62, had a different experience: “I did the full treatment but didn’t see any real improvement. I eventually switched to penile injections, which worked right away for me.”
These stories show that results vary. It’s important to keep your expectations realistic.
Practical Tips for Patients
Finding Good Providers
As shockwave therapy becomes more popular, be careful when choosing where to get treatment:
- Look for board-certified urologists or sexual medicine specialists
- Ask which device they use (some have more research behind them)
- Find out the provider’s experience and success rates
- Be wary of clinics promising guaranteed results
- Check if they follow methods backed by research
Questions to Ask Your Doctor
Before trying shockwave therapy, ask:
- Am I a good candidate based on my ED type and severity?
- What results can I realistically expect?
- How many sessions will I need, and what’s the total cost?
- What’s your success rate with patients like me?
- What other options should I consider if this doesn’t work?
- Should I keep taking ED medications during or after treatment?
Future Research Directions
The field continues to develop, with several promising areas:
- Better treatment methods: Researchers are studying the best number of pulses, energy settings, and session frequency.
- Finding ideal patients: Studies aim to predict who will respond best.
- Combination treatments: Early research combines shockwave therapy with stem cells, platelet-rich plasma, or medications.
- Long-term results: Ongoing studies track patients for years to see how long benefits last.
Dr. Trinity Bivalacqua, a urologic oncology director, says: “The next step will be personalized treatment plans based on specific ED causes and patient factors, rather than the one-size-fits-all approach we use now.”
Conclusion
Shockwave therapy offers a promising option for ED treatment. It works best for men with mild to moderate erectile problems caused by blood vessel issues who haven’t responded well to pills. The non-invasive nature and excellent safety record make it worth considering.
Keep your expectations realistic, though. The therapy doesn’t work for everyone. Benefits may not last forever. The treatment costs a lot out-of-pocket. Talk with a qualified sexual medicine specialist to decide if shockwave therapy makes sense for your specific situation.
More research will help establish its proper place in ED treatment. For now, shockwave therapy offers hope that treatments might fix underlying causes of erectile dysfunction rather than just managing symptoms.
Frequently Asked Questions
How many shockwave therapy sessions will I need for ED?
Most treatment plans include 6-12 sessions over 6-9 weeks. Some clinics offer maintenance sessions every few months afterward.
Does the treatment hurt?
Most men report little or no pain. Some feel mild discomfort that doesn’t require pain medication.
How soon might I see results?
Response times vary widely. Some men notice improvements within weeks. Others may take 1-3 months to see benefits. Some men see no improvement at all.
Can shockwave therapy permanently cure erectile dysfunction?
Current evidence doesn’t support it as a permanent cure. Some men maintain benefits for 1-2 years. Others see effects fade sooner and may need more treatments.
Does insurance cover this treatment?
Most insurance plans, including Medicare, don’t cover shockwave therapy for ED yet. They consider it experimental. Most men pay $3,000-$5,000 out-of-pocket for a full treatment course.
Can I use ED pills along with shockwave therapy?
Yes, many doctors recommend continuing ED medications during and after shockwave therapy. Some research suggests this combination may work better than either treatment alone.
Do at-home shockwave devices work for ED?
Several at-home devices claim to provide shockwave therapy. However, they deliver much less energy than medical devices. They have little research support. Most experts advise against these unproven alternatives to in-office treatment.
References
- University of Utah Health: Shockwave Therapy: Erectile Dysfunction
- Urology Care Foundation: Shockwave Therapy for Erectile Dysfunction
- PubMed: Shockwave treatment of erectile dysfunction
- Cleveland Clinic: Does Shockwave Therapy Help ED?
- Healthline: Shockwave Therapy for Erectile Dysfunction: Does It Work?
- AAFP: Shockwave Therapy for Erectile Dysfunction