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Shockwave Therapy for ED: How It Works, Effectiveness and More

Katelyn Brenner FNP

Reviewed by Katelyn Hagerty, FNP

Written by Geoffrey Whittaker

Published 01/06/2021

Updated 07/27/2023

If you’ve been up late Googling the latest ED treatments, you’ve probably managed to wade through the banner ads and supplement pitches to find something called shockwave therapy.

This treatment for erectile dysfunction goes by many names, the nerdiest being low-intensity extracorporeal shockwave therapy (LI-ESWT). But unlike those pill packets sold at the gas station, treating ED with sound waves may actually be legit.

Most treatments for erectile dysfunction work by temporarily increasing blood flow to the penile tissue.

For example, the medication sildenafil (the active ingredient in Viagra) works by inhibiting the effects of an enzyme called phosphodiesterase type 5, or PDE5. This enhances blood flow to the penis, allowing you to get an erection while the medication is active.

Shockwave therapy is different — and it may be longer-lasting. That said, questions still remain about this largely untested men’s health boon. 

So what should you think? Below, we’ll explain how shockwave therapy works, as well as the effects it could have on your erectile health and sexual performance. We’ll also look into the scientific research on shockwave therapy to see whether it works over the long term.

Finally, we’ll go over other treatments you may want to consider if you have erectile dysfunction and want to improve your sexual performance.

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Medications like sildenafil are highly effective, but they have a problem: A single dose doesn’t last forever. The medications currently on the market don’t actually restore full erectile function for men with ED. Shockwave therapy is different.

Instead of temporarily increasing blood flow to the penis like most ED medications, shockwave therapy restores the erectile mechanism and allows men with ED to get erections spontaneously and naturally.

It does this by stimulating healing with sonic waves. Studies show that these waves create all sorts of positive responses in your immune system and circulatory system. An example of this is the GAINSWave procedure.

Shockwave therapy uses linear, low-intensity shockwaves to target tissues near and in the penis. The goal isn’t simply to temporarily treat erectile dysfunction like medications do — it aims to improve blood flow to the penis and allow for erections to occur naturally.

The technology behind shockwave therapy has been used to treat other medical conditions for some time now. For instance, orthopedists have used extracorporeal shock wave therapy for more than 20 years to treat injuries to bones, joints and ligaments.

For ED, shockwave therapy involves placing a wand-shaped electronic device against the penis. The wand applies linear shockwaves to the penile tissue, producing a type of injury called microtrauma.

This microtrauma triggers a process called neovascularization, which involves the creation of new blood vessels. These may enhance blood flow and allow men affected by ED to regain their ability to get an erection without medication. 

Shockwave therapy sounds appealing and is certainly interesting from a scientific perspective. But does it actually work? 

It depends on how confident you are in the research — and right now, we’re not so sure. 

It’s not that there’s no evidence yet — several studies have looked at the effects of shockwave therapy for ED, with some noting significant improvements. 

One recent systematic review looked at nine clinical studies and 10 animal studies involving males with erectile dysfunction and diabetes. Researchers concluded that LI-ESWT was generally an effective treatment in those with diabetes, though more randomized controlled trials and peer-reviewed studies are needed.

A different meta-analysis looked at data from seven clinical trials with more than 600 participants. It concluded that shockwave therapy produced a significant improvement in erectile function — at least compared to non-therapeutic treatment.

And the hits keep stacking up. A more recent study published in 2020 produced similar results, though with a small sample size. Of the 25 men with ED who took part in the study, 15 responded successfully, albeit with mild results.

In short, the research largely shows that shockwave therapy works as a treatment for erectile dysfunction, particularly for men with mild to moderate ED. 

However, it’s important to note a few things. First, shockwave therapy is a relatively new, largely experimental treatment for ED. Those were pretty much the only studies we could find, and while they did show improvements, there isn’t a lot of long-term data on its effectiveness over years or decades.

The second thing worth noting is that, although shockwave therapy has produced improvements in some studies, not all men who undergo shockwave ED treatment have positive results.

While shockwave for ED may be effective, it’s by no means a perfect treatment for everyone with erectile dysfunction.

The problem with shockwave therapy for ED is that the costs won’t necessarily be standardized.

The GAINSWave company suggests prices could be anywhere between $400 and $500 a treatment. But remember, you’ll typically need a half-dozen or more treatments to see results on this therapy — potentially more when it comes to ED.

There’s more bad news. Unfortunately, since shockwave therapy isn’t FDA-approved, insurance won’t cover it. So if this is the route you choose, you’ll have to pay for it out of pocket.

You may not choose to go the wave-therapy route at the end of the day, anyway. Why? There are some risks and potential drawbacks to consider.

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According to most of the research we found, there are few (if any) risks associated with wave therapy for erectile dysfunction. In fact, some studies posit that if wave therapy continues to deliver results in future testing, it is an ideal treatment option for ED, given its essentially risk-free nature.

That being said, the biggest risk of wave therapy as an ED treatment is that there could be yet-to-be-discovered adverse effects of long-term treatment. And as studies continue, it’s possible it’ll no longer show to be as effective as it was once thought to be.

How likely is this? Not terribly — but it’s certainly not impossible. So if your primary concern is having something already approved by the FDA for ED treatment, you might want to explore other options.

Choose your chew

Shockwave therapy is undoubtedly an interesting idea for ED. And as many jokes as we could make, the truth is it’s a potentially effective option for treating erectile dysfunction over the long term — one day.

However, it’s far from ready for the mainstream right now. So for the time being, it’s not the only option available — or the one we’d pick first. 

Several other treatments are available for ED, including:

  • Medication. Medications like avanafil, sildenafil, tadalafil and their brand-name counterparts are considered effective at treating ED. They work by increasing blood flow to your penis, making it easier to get and keep an erection. You can even get ED medications online, including our chewable ED meds. Learn more about how these medications work in our guide to PDE5 inhibitors.

  • Psychotherapy. Sometimes, the cause of ED is psychological rather than physical. If your erection issues are due to performance anxiety, stress or another psychological factor, you may benefit from online therapy more than medication or other treatments.

  • ED devices. Several devices are available to improve erectile function in men with ED, including options like vacuum constriction devices (aka penis pumps). These may be an option if you can’t use ED medication due to a health condition or injury.

  • Other treatments. From injectable medications to suppositories and surgery, there are several other treatments available for erectile dysfunction. We’ve covered these in more detail in our full guide to ED treatment options.

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Shockwave therapy is one of the most promising erectile dysfunction treatments that hasn’t been proven to work — yet.

You may have been hoping the miracle cure was finally here, but for the time being, there’s no cure for ED.

If you want to deal with your ED, shockwave therapy might be one option to talk to healthcare providers about. But generally, the most important thing you can do if you’re struggling to get hard is remember the facts:

  • ED is one of the most common sexual dysfunctions experienced by men. Roughly 30 million men in the United States alone are affected by some degree of erectile dysfunction.

  • Many health conditions may cause erectile dysfunction. Diseases and conditions that affect blood flow, such as heart disease, high blood pressure (hypertension) and diabetes, can contribute to ED. If you have ED because of a physical issue, such as poor blood flow, shockwave therapy could be a good treatment option.

  • Your behavior may increase your risk of ED. Things like drinking too much alcohol, smoking, using recreational drugs, being overweight or living a sedentary lifestyle may give you an increased risk of developing ED.

  • Shockwave therapy might treat ED. Instead of making it easier to get an erection temporarily, this non-invasive treatment is designed to promote erectile health and restore your ability to get and maintain an erection naturally.

  • You can try wave therapy for ED. If you’re interested in trying shockwave therapy for erectile dysfunction, it’s best to schedule an appointment with a urologist or an ED specialist.

  • Shockwave hasn’t been proven to work yet. While several clinical studies have shown that shockwave treatment can be effective, there currently isn’t much research on its long-term results. 

  • Proven treatments are what you should focus on. In the meantime, ED pills like sildenafil and tadalafil can provide relief from ED and improve your sexual performance.

Ready to get help? Numerous treatments are available for erectile dysfunction, from medications — like sildenafil (generic Viagra), tadalafil (generic Cialis) and avanafil (generic Stendra) — to lifestyle changes, vacuum devices and more.

9 Sources

  1. U.S. Department of Health and Human Services. (n.d.-h). Treatment for erectile dysfunction - NIDDK. National Institute of Diabetes and Digestive and Kidney Diseases. https://www.niddk.nih.gov/health-information/urologic-diseases/erectile-dysfunction/treatment.
  2. U.S. Department of Health and Human Services. (n.d.-g). Symptoms & causes of erectile dysfunction - NIDDK. National Institute of Diabetes and Digestive and Kidney Diseases. https://www.niddk.nih.gov/health-information/urologic-diseases/erectile-dysfunction/symptoms-causes.
  3. Nunes, K. P., Labazi, H., & Webb, R. C. (2012). New insights into hypertension-associated erectile dysfunction. Current opinion in nephrology and hypertension, 21(2), 163–170. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4004343/.
  4. Gruenwald, I., Appel, B., Kitrey, N. D., & Vardi, Y. (2013). Shockwave treatment of erectile dysfunction. Therapeutic advances in urology, 5(2), 95–99. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3607492/.
  5. Lurz, K., Dreher, P., Levy, J., McGreen, B., Piraino, J., Brevik, A., Edwards, D., & Belkoff, L. H. (2020). Low-Intensity Shockwave Therapy in the Treatment of Erectile Dysfunction. Cureus, 12(11), e11286. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7707887/.
  6. Clavijo, R. I., Kohn, T. P., Kohn, J. R., & Ramasamy, R. (2017). Effects of Low-Intensity Extracorporeal Shockwave Therapy on Erectile Dysfunction: A Systematic Review and Meta-Analysis. The journal of sexual medicine, 14(1), 27–35. https://urology.wisc.edu/wp-content/uploads/2018/11/meta_analysis_LI_ESWL.pdf
  7. Schmitz, C., Császár, N. B., Milz, S., Schieker, M., Maffulli, N., Rompe, J., & Furia, J. P. (2015). Efficacy and safety of extracorporeal shock wave therapy for orthopedic conditions: A systematic review on studies listed in the PEDro database. British Medical Bulletin, 116(1), 115-138. https://academic.oup.com/bmb/article/116/1/115/401264.
  8. LiverTox: Clinical and Research Information on Drug-Induced Liver Injury [Internet]. Bethesda (MD): National Institute of Diabetes and Digestive and Kidney Diseases; 2012-. Phosphodiesterase Type 5 (PDE5) Inhibitors. [Updated 2017 Aug 2]. Available from: https://www.ncbi.nlm.nih.gov/books/NBK548192/.
  9. Mason MM, et al. Low-intensity extra corporeal shockwave therapy for diabetic men with erectile dysfunction: A systematic scoping review. (2023). https://onlinelibrary.wiley.com/doi/epdf/10.1111/andr.13197
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Hims & Hers has strict sourcing guidelines to ensure our content is accurate and current. We rely on peer-reviewed studies, academic research institutions, and medical associations. We strive to use primary sources and refrain from using tertiary references. See a mistake? Let us know at [email protected]!

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