Minimally Invasive Shockwave Therapy for Erectile Dysfunction: Does It Really Work? 

Having erectile dysfunction (ED) can be challenging, both physically and mentally — but it is far more common than most men realise. In fact, it’s estimated that up to 50% of men over the age of 40 experience some degree of ED, with prevalence increasing with age [1]. That said, ED isn’t just about ageing. It can be linked to stress, lifestyle habits, underlying health conditions, and even psychological factors.

For many, the first line of treatment has traditionally been oral medications like sildenafil (Viagra) or tadalafil (Cialis). Others may opt for more invasive treatments such as injections or implants.

In recent years, there has been growing interest in minimally invasive therapies — treatments that offer a non-surgical approach with fewer risks and downtime. One such method is extracorporeal shockwave therapy (EWST), a treatment that utilises low-intensity sound waves to improve blood flow and restore erectile function naturally. Unlike medications that only provide temporary relief, shockwave therapy aims to tackle the root cause of ED by encouraging new blood vessel growth and enhancing circulation in the penile tissue.

But does it actually work? Is it just another trend in the world of men’s health, or does the science back it up? In this article, we’ll take an in-depth look at minimally invasive shockwave therapy for erectile dysfunction: how it works, who it’s for, and whether it delivers effective results.

Shockwave Therapy for ED: Explained 

Shockwave therapy, also known as low-intensity extracorporeal shockwave therapy (EWST), is a non-invasive medical treatment that utilises low-intensity acoustic waves to stimulate healing and regeneration in penile tissues [2], stimulating blood vessel growth and improving blood flow in the penis. 

Unlike treatments that provide only symptomatic relief, shockwave therapy aims to address the underlying cause of ED by enhancing blood flow and promoting natural tissue repair [4]. It also offers a unique alternative to conventional options like medication and surgical interventions for ED.

In a nutshell: 

How Shockwave Therapy Improves Erectile Function

Erections depend on a healthy vascular system. When blood flow to the penis is restricted due to ageing, diabetes, high cholesterol, or other cardiovascular conditions, erectile function deteriorates. Shockwave therapy works by delivering low-intensity sound waves to the erectile tissue, triggering a series of physiological responses that help to restore normal function.

• Neovascularisation (New Blood Vessel Formation) — Shockwaves stimulate the release of growth factors that encourage the formation of new blood vessels (angiogenesis) [5]. This process improves circulation, ensuring that more oxygen-rich blood reaches the erectile tissue, leading to stronger and more sustainable erections.

• Repair of Damaged Blood Vessels — Over time, poor lifestyle habits and medical conditions can damage the delicate blood vessels in the penis. Shockwave therapy promotes the regeneration of these vessels, improving their ability to expand and contract efficiently [6].

• Activation of Stem Cells and Tissue Regeneration — The mechanical stimulation from shockwaves encourages stem cell activation, which enhances the repair and regeneration of erectile tissue. This contributes to improved elasticity and responsiveness of the penile tissue.

• Breakdown of Micro-Plaque in Blood Vessels — Plaque build-up in the arteries can restrict blood flow, a condition often linked to vascular-related ED. Shockwave therapy helps to break down micro-plaque, restoring normal blood flow and improving overall vascular health [7].

Clinical Evidence and Effectiveness of Shockwave Therapy for Erectile Dysfunction

Short-Term Efficacy

Low-Intensity Extracorporeal Shockwave Therapy (EWST) has been the subject of numerous studies assessing its immediate impact on erectile function. A systematic review and meta-analysis encompassing 14 studies demonstrated that EWST significantly improved erectile function in men with erectile dysfunction (ED) [13]. The analysis reported that participants experienced notable enhancements in their International Index of Erectile Function (IIEF) scores compared to control groups, suggesting that EWST can effectively ameliorate ED symptoms in the short term. ​

Another study evaluated the short-term efficacy and safety of EWST in patients with ED [14]. The findings indicated that EWST could improve erectile function, with participants showing significant improvements in IIEF scores post-treatment. This underscores the potential of EWST as a viable short-term treatment option for ED. ​

Long-Term Outcomes

The sustainability of EWST’s benefits has been a focal point in recent research. A prospective study with a minimum five-year follow-up assessed the long-term efficacy of EWST in men with vascular ED [15]. The study revealed that participants maintained significant improvements in erectile function over the five-year period, as evidenced by sustained IIEF scores. Moreover, a high rate of patient satisfaction was reported, which indicates that the therapeutic benefits of EWST can endure over extended periods. ​

Additionally, a recent study investigated the durability of ESWT’s effects [16]. The results demonstrated that the improvements in erectile function were sustained, which reinforces the potential of EWST as a long-term treatment modality for ED. ​

Ideal Candidates for Shockwave Therapy

It’s important to note that not all individuals with ED will benefit equally from the therapy. Your doctor will work with you in determining your suitability for the treatment.

Patient Profiles: Who Benefits Most from Shockwave Therapy?

Shockwave therapy is most effective for individuals with vascular-related ED, as it directly targets blood flow and tissue regeneration. The following groups are considered ideal candidates:

• Men with Mild to Moderate Erectile Dysfunction — Those who still experience some degree of natural erections but struggle with consistency. Shockwave therapy is also a better option for patients who have not responded well to oral medications such as sildenafil (Viagra) or tadalafil (Cialis).

• Individuals with ED Caused by Poor Blood Circulation — Men with vascular insufficiency, where reduced blood flow is the primary cause of erectile difficulties. Those with conditions such as hypertension, diabetes, high cholesterol, or cardiovascular disease, which impair circulation.

• Patients Looking for a Drug-Free, Long-Term Solution — Ideal for men who prefer a natural treatment that promotes the body’s own repair mechanisms rather than relying on ongoing medication. Additionally, those who experience side effects from PDE5 inhibitors or who are unable to take them due to existing health conditions may also benefit from the therapy.

• Men with Peyronie’s Disease (Mild Cases) — Some studies suggest that shockwave therapy may help reduce penile curvature and pain associated with Peyronie’s disease, although results can vary [19].

• Younger Men with ED Due to Lifestyle Factors — Those experiencing ED due to stress, smoking, obesity, or sedentary habits may see greater improvements when combining shockwave therapy with lifestyle changes.

• Men Seeking to Improve Overall Erectile Health — Even men without severe ED but who notice a gradual decline in erectile function may benefit from the vascular regenerative effects of shockwave therapy.

Who Should Avoid Shockwave Therapy?

While shockwave therapy is generally considered safe, certain conditions or factors may make it unsuitable or less effective for some individuals. These include:

• Men with Severe or Neurogenic ED — Individuals with severe erectile dysfunction caused by nerve damage, spinal cord injury, or advanced diabetes-related neuropathy may not benefit from the treatment, as the therapy primarily targets vascular causes of ED.

• Patients with Active Cancer or Serious Medical Conditions — Those undergoing treatment for prostate cancer or other serious malignancies should consult their doctor before considering shockwave therapy. Patients with severe cardiovascular disease or recent stroke/heart attack should prioritise cardiac health management before seeking ED treatments.

• Men with Severe Peyronie’s Disease or Fibrotic Plaques — While shockwave therapy may help with mild Peyronie’s disease, men with extensive fibrotic plaques or severe penile curvature may require other medical interventions.

• Individuals Taking Anticoagulants or Blood Thinners — Since shockwave therapy involves minor vascular stimulation, patients on blood thinners may have an increased risk of bruising or bleeding.

• Men with Penile Implants or Prior Reconstructive Surgery — Patients who have undergone penile implant surgery may not be suitable candidates, as the therapy focuses on natural tissue regeneration rather than mechanical solutions.

• Unrealistic Expectations — While many men experience significant improvements, shockwave therapy is not an instant cure and requires multiple sessions with results varying based on individual health factors. Those expecting immediate or guaranteed success may be better suited for alternative treatments like combination therapy or lifestyle modifications.

What to Expect During and After Shockwave Treatment

During the Treatment Session

• The procedure is non-invasive and does not require anaesthesia, injections, or numbing agents.
• The patient lies comfortably while the clinician applies a handheld shockwave device to various points on the penis.
• The device emits low-intensity acoustic waves, which may cause a mild tapping sensation but is generally painless.
• Each session is quick and straightforward, which allows patients to resume their daily activities immediately afterward.

After the Treatment Session

• Immediate Recovery — There is no downtime, and patients can return to work, exercise, or normal activities right away.

• Mild Sensations — Some men may experience slight redness in the treated area, but this usually resolves within a few hours.

• No Medication or Special Aftercare Required — Unlike other ED treatments that involve pills or injections, shockwave therapy does not require post-treatment medication or restrictions.

When to Expect Results:

Some men notice mild improvements within a few weeks, while for others, optimal results take two to three months as the body gradually repairs and regenerates blood vessels. Results tend to improve progressively rather than being immediate, as the therapy works at a cellular level rather than providing a short-term fix like PDE5 inhibitors (e.g., Viagra or Cialis).

Is Shockwave Therapy a Viable Solution for Erectile Dysfunction?

Erectile dysfunction is a deeply personal and often frustrating condition, but advancements in medical technology have introduced promising alternatives to traditional treatments. 

Ultimately, clinical research suggests that EWST can significantly improve erectile function, particularly in men with mild to moderate ED linked to poor blood circulation. Unlike oral medications that provide only temporary relief, shockwave therapy stimulates natural healing, promoting new blood vessel growth and tissue regeneration. This makes it a long-term solution rather than a short-term fix.

If you’re considering shockwave therapy for ED, it is crucial to seek treatment from a qualified clinic that utilises clinically approved devices and medically trained professionals. 

For personalised guidance and to determine your suitability, consult our doctor for a detailed evaluation and comprehensive treatment plan.

References 

1. Çayan, S., Kendirci, M., Yaman, Ö., Aşçı, R., Orhan, İ., Usta, M. F., Ekmekçioğlu, O., & Kadıoğlu, A. (2017). Prevalence of erectile dysfunction in men over 40 years of age in turkey: Results from the turkish society of andrology male sexual health study group. Turkish Journal of Urology, 43(2), 122–129. https://doi.org/10.5152/tud.2017.24886 
2. Rola, P., Włodarczak, A., Barycki, M., & Doroszko, A. (2022). Use of the shock wave therapy in basic research and clinical applications—From bench to bedsite. Biomedicines, 10(3), 568. https://doi.org/10.3390/biomedicines10030568 
3.  d’Agostino, M. C., Craig, K., Tibalt, E., & Respizzi, S. (2015). Shock wave as biological therapeutic tool: From mechanical stimulation to recovery and healing, through mechanotransduction. International Journal of Surgery, 24, 147–153. https://doi.org/10.1016/j.ijsu.2015.11.030 
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://doi.org/10.1177/1756287212470696 
5. Shockwave therapy for ed: Does it work? (2020, March 9). Healthline. https://www.healthline.com/health/shockwave-therapy-for-ed 
6. Chung, D. Y., Ryu, J.-K., & Yin, G. N. (2023). Regenerative therapies as a potential treatment of erectile dysfunction. Investigative and Clinical Urology, 64(4), 312–324. https://doi.org/10.4111/icu.20230104 
7. Sound wave therapy for peyronie’s disease. (n.d.). Academic Urology & Urogynecology of Arizona. Retrieved March 18, 2025, from https://www.academic-urology.com/soundwave-peyronies-disease.html 
8. Bocchino, A. C., Pezzoli, M., Martínez-Salamanca, J. I., Russo, G. I., Lo Giudice, A., & Cocci, A. (2023). Low-intensity extracorporeal shock wave therapy for erectile dysfunction: Myths and realities. Investigative and Clinical Urology, 64(2), 118–125. https://doi.org/10.4111/icu.20220327 
9. Drury, R., Natale, C., & Hellstrom, W. J. G. (2021). Reviewing the evidence for shockwave- and cell-based regenerative therapies in the treatment of erectile dysfunction. Therapeutic Advances in Urology, 13, 17562872211002059. https://doi.org/10.1177/17562872211002059 
10. Chung, D. Y., Ryu, J.-K., & Yin, G. N. (2023). Regenerative therapies as a potential treatment of erectile dysfunction. Investigative and Clinical Urology, 64(4), 312–324. https://doi.org/10.4111/icu.20230104 
11. Wu, S. S., Ericson, K. J., & Shoskes, D. A. (2020). Retrospective comparison of focused shockwave therapy and radial wave therapy for men with erectile dysfunction. Translational Andrology and Urology, 9(5), 2122–2128. https://doi.org/10.21037/tau-20-911 
12. Bocchino, A. C., Pezzoli, M., Martínez-Salamanca, J. I., Russo, G. I., Lo Giudice, A., & Cocci, A. (2023). Low-intensity extracorporeal shock wave therapy for erectile dysfunction: Myths and realities. Investigative and Clinical Urology, 64(2), 118–125. https://doi.org/10.4111/icu.20220327 
13. Chung, E., & Cartmill, R. (2021). Evaluation of long-term clinical outcomes and patient satisfaction rate following low intensity shock wave therapy in men with erectile dysfunction: A minimum 5-year follow-up on a prospective open-label single-arm clinical study. Sexual Medicine, 9(4), 100384. https://doi.org/10.1016/j.esxm.2021.100384 
14. Zou, Z., Tang, L., Liu, Z., Liang, J., Zhang, R., Wang, Y., Tang, Y., Gao, R., & Lu, Y. (2017). Short-term efficacy and safety of low-intensity extracorporeal shock wave therapy in erectile dysfunction: A systematic review and meta-analysis. International Braz j Urol, 43, 805–821. https://doi.org/10.1590/S1677-5538.IBJU.2016.0245 
15. Chung, E., & Cartmill, R. (2021). Evaluation of long-term clinical outcomes and patient satisfaction rate following low intensity shock wave therapy in men with erectile dysfunction: A minimum 5-year follow-up on a prospective open-label single-arm clinical study. Sexual Medicine, 9(4), 100384. https://doi.org/10.1016/j.esxm.2021.100384 
16. Medrano-Sánchez, E. M., Peña-Cantonero, B., Candón-Ballester, P., Blanco-Díaz, M., & Díaz-Mohedo, E. (2024). Effectiveness of low-intensity extracorporeal shock wave therapy in erectile dysfunction: An analysis of sexual function and penile hardness at erection: an umbrella review. Journal of Personalized Medicine, 14(2), 177. https://doi.org/10.3390/jpm14020177 
17. A comparison evaluation of novel treatments for erectile dysfunction: Benefits of shockwave therapy: vantage medical associates, p. C. : internal medicine. (n.d.). Retrieved March 18, 2025, from https://www.vantagemedicalassociates.com/blog/a-comparison-evaluation-of-novel-treatments-for-erectile-dysfunction-benefits-of-shockwave-therapy 
18. Yao, H., Wang, X., Liu, H., Sun, F., Tang, G., Bao, X., Wu, J., Zhou, Z., & Ma, J. (2022). Systematic review and meta-analysis of 16 randomized controlled trials of clinical outcomes of low-intensity extracorporeal shock wave therapy in treating erectile dysfunction. American Journal of Men’s Health, 16(2), 15579883221087532. https://doi.org/10.1177/15579883221087532 
19.  Wang, X., Liu, H., Tang, G., Wu, G., Chu, Y., Wu, J., & Cui, Y. (2023). Updated recommendations on the therapeutic role of extracorporeal shock wave therapy for peyronie’s disease: Systematic review and meta-analysis. BMC Urology, 23, 145. https://doi.org/10.1186/s12894-023-01320-8 
20. Kalyvianakis, D., Memmos, E., Mykoniatis, I., Kapoteli, P., Memmos, D., & Hatzichristou, D. (2018). Low-intensity shockwave therapy for erectile dysfunction: A randomized clinical trial comparing 2 treatment protocols and the impact of repeating treatment. The Journal of Sexual Medicine, 15(3), 334–345. https://doi.org/10.1016/j.jsxm.2018.01.003 
21. Campbell, J. D., Trock, B. J., Oppenheim, A. R., Anusionwu, I., Gor, R. A., & Burnett, A. L. (2019). Meta-analysis of randomized controlled trials that assess the efficacy of low-intensity shockwave therapy for the treatment of erectile dysfunction. Therapeutic Advances in Urology, 11, 1756287219838364. https://doi.org/10.1177/1756287219838364 
22. 7 common side effects of erectile dysfunction medication. (2019, January 3). Healthline. https://www.healthline.com/health/erectile-dysfunction-medications-common-side-effects