ED Treatment

Shock Wave Therapy: ED Cure or Unproven Treatment

June 16, 2021

While prescription ED medications like Viagra® and Cialis® have long been accepted as the most effective treatments for erectile dysfunction (ED), new research suggests the possibility of an alternative treatment.

Shockwave therapy has become a hot topic of debate in the world of erectile dysfunction – and may be one of the most viable alternatives to medications. 

What Is Shockwave Therapy? 

Known clinically as low intensity extracorporeal shockwave therapy, this noninvasive treatment modality has been around for a few decades and is used for a variety of conditions. Its original use was in breaking up kidney stones through intense ultrasound frequencies, but it has since been used as an effective treatment for healing broken bones as well as damaged or inflamed ligaments and tendons. This therapeutic approach is known for wound healing due to its ability to speed up tissue repair and encourage cell growth. 

It’s been only in the last decade or so that shockwave therapy has been suggested as a possible treatment for erectile dysfunction. The belief is that shockwave therapy pulses may trigger an improvement in blood flow as well as a remodeling of penile tissues. The intent is to stimulate healing sufficient for the patient to achieve an erection firm enough for sex.

Shockwave Therapy and Erectile Dysfunction 

As of 2020, the Food and Drug Administration (FDA) had yet to approve a shockwave therapy devise specifically as a treatment for erectile dysfunction. However, studies suggest that it may be able to treat the symptoms of vasculogenic erectile dysfunction. This is the most common type of erectile dysfunction and occurs as the result of a blood vessel issues or dysfunctions. 

Because erections rely heavily on the blood flow to the penile tissues, any issues involving the circulatory or cardiovascular system can severely impact the ability to achieve an erection. 

Shockwave therapy is intended to help by strengthening or repairing damaged blood vessels in the penis as well as breaking up plaque build up that might be slowing or preventing proper blood flow. By increasing the flow of blood to the penis, erections should be easier to achieve and maintain. 

This is similar to popular pharmacological treatments for erectile dysfunction like Viagra® and Cialis®, both of which are PDE5 inhibitors that work to improve erections through increased blood flow. In fact, using shockwave therapy in addition to these medications has been shown to improve their overall effectiveness. 

While shockwave therapy may boost the effectiveness of PDE5 inhibitors, its typically recommended as an alternative to these medications. 

How Does Shockwave Therapy Work?

While the technology behind shockwave therapy is complex, the procedure itself is fairly simple. 

A healthcare professional applies a device resembling a large wand near and around the penis and pelvic area. The entire procedure usually takes 10 to 20 minutes as the wand emits gentle low-frequency pulses at a set frequency.

In most cases, there's no need for anesthesia; however, some doctors may apply a gel numbing agent that may result in a light tingling sensation. 

Shockwave therapy typically requires several sessions over the course of a few weeks for noticeable results, and has been found to have a 60% efficacy rate when treating vasculogenic erectile dysfunction. It doesn’t appear to have an effect on erectile function as a result of nerve damage, prostate or pelvic cancer, or psychological causes. 

Although shockwave therapy is largely considered low-risk because it's non-invasive, there are a few possible side effects:

  • Bruising and swelling of the penis
  • Blood in urine
  • Penile skin infection
  • Pain during an erection or intercourse
  • Numbness or tingling sensation
  • Worsening of penile curvature

How Effective Is Shockwave Therapy? 

The research into shockwave therapy is fairly conclusive that it can be effective for the right kinds of ED. 

One study, performed in 2010, found that all 20 of its male participants experienced significant improvement to their erectile function after six months of treatment. 

Another study involved over 700 men treated once a week over the course of five weeks. Significant improvements in erectile function were seen, but just one month after the sessions stopped, they did experience a decrease in function. It's not clear whether this decline was due to insufficient length of treatment, or whether the treatment must be continued periodically beyond the initial phase.

During a clinical trial that included nearly 900 men, shockwave treatment showed a significant increase in blood flow and erectile function when compared to a sham treatment used as a control. These treatments were performed twice a week for three weeks followed by a three week hiatus, and concluding with another round of twice weekly treatment for another three weeks. After completion, men receiving the active treatment maintained improvement out to one year.

How Long Do You Have To Undergo Shockwave Therapy? 

One of the continuing issues with shockwave therapy is the treatment time requirement and cost. These treatments typically cost between $300 and $600 dollars per session in a clinician's office, with multiple sessions required. In one of the longer experiments listed above, the number of required treatment sessions was 12, though similar results have been seen with fewer visits. Since most insurance plans don’t cover this therapy, it can get fairly expensive quickly.

For the most part, shockwave therapy requires at least one treatment per week over the course of six weeks. Results should be experienced within the first three months, but may occur as early as the first few weeks of treatment. 

Some urologists claim the effects of shockwave therapy can last for up to two years, whiles others indicate the effects will last only six months before re-treatment is required. 

Other Ways To Treat Erectile Dysfunction 

Shockwave therapy could be an effective solution for men who are unable to take prescription medications for erectile dysfunction. 

While Viagra (sildenafil) and Cialis (tadalafil) are highly effective for ED, they also come with a few health risks and contraindications. In the event that your doctor does not recommend either treatment, there are ways that you can improve erectile dysfunction naturally.

The first thing to remember is that erections are made possible by blood flow: anything that's good for the cardiovascular system (i.e. your heart, blood vessels, and blood) is good for erections. Vice versa, anything harmful to cardiovascular health is potentially harmful to erection quality. 

With these principles in mind, here are a few tips that may help to reduce the frequency and severity of erectile dysfunction. No surprise, they're all things you should probably be doing anyway.

  • Eat a balanced diet
  • Get regular exercise
  • Eliminate bad habits like smoking and excessive alcohol

All of these contribute to quality cardiovascular and metabolic function, key to overall longevity and avoiding key risk factors for ED like heart disease, diabetes, and obesity.

The Takeaway: The research on shockwave therapy suggests it's an effective treatment for ED, but the FDA has yet to approved any device for this indication.

When it comes to treating the symptoms of erectile dysfunction, it’s hard to top the efficacy of prescription ED medications. There's a reason why PDE5 inhibitors like sildenafil (viagra) and tadalafil (Cialis) are so popular -- they work for most guys. Want to learn more? Rex MD can help.