Medically reviewed by Mary Lucas, RN
Written by Our Editorial Team
Last updated 1/06/2021
Erectile dysfunction, or ED, is one of the most common sexual dysfunctions experienced by men. Although it’s usually associated with older men, ED can affect men of all ages, with 30 million men in the United States alone affected by some degree of erectile dysfunction.
Numerous different treatments are available for erectile dysfunction, from medications such as sildenafil (the active ingredient in Viagra®, generic Viagra), tadalafil (Cialis®) and avanafil (Stendra®) to habits and lifestyle changes, vacuum devices and more.
One treatment for erectile dysfunction that’s less well known than others is shockwave therapy, or low-intensity extracorporeal shockwave therapy (LI-ESWT).
Shockwave therapy involves the use of 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, but to improve blood flow to the penis and allow for erections to occur naturally.
If you have ED because of a physical issue, such as poor blood flow, shockwave therapy may be a good treatment option for you.
Below, we’ve explained how shockwave therapy works, as well as the effects it could have on your erectile health and sexual performance. We’ve also looked into the scientific research on shockwave therapy to see whether or not it works over the long term.
Finally, we’ve talked about other treatments that you may want to consider if you have erectile dysfunction and want to improve your sexual performance.
Erectile dysfunction can occur at any age. ED is usually associated with older men, but it can happen at any age. According to data from a large-scale study carried out in the 1980s and 1990s, 46.4 percent of men in their 40s are affected by some level of ED.
Erections are all about blood flow. Your penis becomes hard when blood flows into the blood vessels in the corpora cavernosa — the two areas of soft, spongy tissue that run along the entire length of your penis. This blood then gets trapped in the penis due to the compression of the veins by the expanding penile tissue, leading to a sustained erection.
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 all contribute to ED.
Your behavior may increase your risk of ED. Things like drinking too much alcohol, smoking, using certain drugs, being overweight or living a sedentary lifestyle may give you an increased risk of developing ED.
Most treatments for erectile dysfunction work by temporarily increasing blood flow to the tissue of the penis.
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 someone with ED to get an erection while the medication is active.
We’ve talked about this process more in our guide to PDE5 inhibitors, which explains how the most common ED medications work.
Medications like sildenafil are highly effective, but they have a problem: like most medications, a single dose doesn’t last forever. While medications like sildenafil can treat erectile dysfunction temporarily, they 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 is designed to restore the erectile mechanism and allow men with ED to get erections spontaneously and naturally.
The technology behind shockwave therapy has been used to treat other medical conditions for years. For example, 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 the use of a wand-shaped electronic device that’s placed against the penis. The wand applies linear shockwaves to the tissue of the penis, 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 for men affected by ED to get back 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? Several studies have looked at the effects of shockwave therapy for ED, with some noting significant improvements.
One systematic review published in 2017 looked at 14 studies involving 833 men with erectile dysfunction. Although the studies varied in focus, all involved men with ED who were treated using low-intensity shockwave therapy.
The review concluded that shockwave therapy caused a significant improvement in the men’s erectile health.
While shockwave therapy caused a significant improvement overall, the biggest improvement was observed in men with mild to moderate ED.
A different meta-analysis, also published in 2017, looked at data from seven clinical trials with more than 600 participants. It also concluded that shockwave therapy produced a significant improvement in erectile function compared to a non-therapeutic treatment.
A more recent study published in 2020 produced similar results. Of the 25 men with ED who took part in the study, 15 responded successfully. The overall improvement in erectile function and blood flow recorded in the men was mild but still clinically and statistically significant.
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. The first is that shockwave therapy is a relatively new, largely experimental treatment for ED. While studies show improvements, there isn’t a lot of long-term data on its effectiveness over a period of years or decades.
The second is that although shockwave therapy has produced improvements in some studies, not all men who undergo shockwave therapy notice positive results. While it may be effective, it’s by no means a perfect treatment for everyone with erectile dysfunction.
Shockwave therapy is an interesting, potentially effective option for treating erectile dysfunction over the long term. However, it’s far from the only option available. Several other treatments are available for ED, including the following:
Medications. Medications like sildenafil (Viagra), tadalafil (Cialis), vardenafil (Levitra) and avanafil (Stendra) are very effective at treating ED. These work by increasing the blood flow to your penis, making it easier to get and keep an erection.
We offer several ED medications online, following a private consultation with a licensed healthcare provider who’ll determine if a prescription is appropriate. You can also learn more about how these medications work in our guide to PDE5 inhibitors.
Psychotherapy. Sometimes, ED is psychological rather than physical. If your erection issues are caused by performance anxiety, stress or another psychological factor, you may benefit from psychotherapy 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. These may be an option if you can’t use ED medication due to a health condition or injury.
Other treatments. From injectable medications and suppositories to surgery, there are also several other treatments available for erectile dysfunction. We’ve covered these in more detail in our full guide to ED treatment options.
Shockwave therapy is a promising treatment option for erectile dysfunction. Instead of making it easier to get an erection temporarily, it’s designed to create new blood vessels and restore your ability to get and maintain an erection naturally.
While several studies have shown that shockwave therapy can be effective, there currently isn’t much research on its long-term results.
If you’re interested in trying shockwave therapy for erectile dysfunction, it’s best to schedule an appointment with a urologist or other ED specialist. In the meantime, ED pills like sildenafil, tadalafil and others can provide relief from ED and improve your sexual performance.
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