Erectile Dysfunction Information
Shockwave Therapy for Erectile Dysfunction: Does It Actually Work?
Medically Reviewed by Damson Pharmacy Medical Review Board
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Published on: september 24, 2026
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Last Updated: september 24, 2026
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Low-intensity sound waves are used in shockwave therapy for erectile dysfunction to improve blood flow in the penis. This treatment does not involve surgery. Unlike on-demand ED medications, which generally work around the time they are taken, LiSWT is being studied as a treatment that may produce longer-lasting improvements in erectile function. The therapy is thought to stimulate biological processes involved in blood-vessel formation and tissue repair, which may improve penile blood flow in some men. It can be done without surgery or anesthesia, and Treatment protocols vary, but clinical studies commonly use several sessions over multiple weeks. The optimal number and frequency of sessions have not been firmly established.
How Does Shockwave Therapy for Erectile Dysfunction Work?
- Low-intensity extracorporeal shockwave technology is used in Shockwave Therapy for Erectile Dysfunction to send sound waves into the erectile tissue.
- Low-intensity shockwaves are thought to stimulate cellular signaling and angiogenic pathways that may promote tissue remodeling and improve penile blood flow.
- If penile blood flow improves, some men may experience better erectile function and rigidity.
- In selected patients, clinicians may combine LiSWT with treatments such as PDE5 inhibitors or a vacuum erection device. Some clinical studies have reported additional improvements with combination therapy, but the evidence remains limited.
Why Does Blood Flow Matter for Erections?
For an erection to be healthy, the penis needs to get enough blood flow. Conditions and lifestyle factors such as diabetes, hypertension, obesity, smoking and cardiovascular disease can contribute to vascular dysfunction and increase the risk of erectile dysfunction. LiSWT is primarily being studied for vasculogenic ED, where impaired blood-vessel function contributes to erectile difficulties. It does this by improving circulation and stimulating blood vessel repair.
Does Shockwave Therapy Actually Work for Erectile Dysfunction?
Research suggests that low-intensity shockwave therapy (LiSWT) may improve erectile function in some men, particularly those with vasculogenic erectile dysfunction. However, the strength of the evidence varies, and researchers have not established a single standardized treatment protocol.
Randomized clinical trials and systematic reviews have reported improvements in erectile-function measures such as the International Index of Erectile Function (IIEF). However, results have not been consistent across all studies, and differences in shockwave devices, treatment schedules, energy settings and patient populations make comparisons difficult.
A 2025 Cochrane review of 21 randomized controlled trials involving 1,357 men found that LiSWT may produce a small improvement in erectile function compared with sham treatment, but the certainty of the evidence was low. The review also found that the long-term clinical importance of the improvement remains uncertain.
The European Association of Urology gives low-intensity shockwave therapy a weak recommendation for selected men, particularly those with mild vasculogenic erectile dysfunction and some men who respond inadequately to PDE5 inhibitors. Other professional organizations have taken a more cautious position and continue to regard the treatment as investigational.
For this reason, shockwave therapy should not be presented as a guaranteed cure for erectile dysfunction. A healthcare professional can determine whether vascular disease is likely to be contributing to ED and discuss established treatments and the potential benefits and limitations of LiSWT.
What Research Says About Its Effectiveness
Randomized trials and systematic reviews suggest that LiSWT may produce a modest improvement in erectile function, particularly in some men with vasculogenic ED. The International Index of Erectile Function–Erectile Function domain (IIEF-EF) is commonly used to assess changes in erectile function in clinical trials.
Because erectile dysfunction causes vary, including poor circulation, diabetes, and cardiovascular disease, researchers continue studying long-term outcomes as treatment protocols and follow-up periods differ across published studies.
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Who is the Best Candidate?
Evidence is most supportive for selected men with mild vasculogenic ED, although some studies have also evaluated men with more severe disease. LiSWT has also been studied in men who have an inadequate response to PDE5 inhibitors, although treatment response can vary. A medical evaluation can help identify whether vascular disease or another underlying condition is contributing to ED.
Who Might Not Get Better with Treatment?
Evidence is less established for ED caused primarily by severe neurological injury, extensive post-surgical nerve damage, advanced diabetes-related complications, or other non-vascular causes.
People who have erectile dysfunction because of untreated hormonal disorders or psychological issues often need different types of treatment to get to the root of the problem.
Can Shockwave Therapy Restore Natural Erections?
One potential advantage being studied is whether LiSWT can produce improvements in erectile function that persist beyond the treatment period. Some studies have investigated whether LiSWT can reduce dependence on PDE5 inhibitors, but evidence is not sufficient to conclude that most patients can discontinue medication.
Different people have different results, but some say that after Shockwave Therapy for Erectile Dysfunction treatment, they feel more confident and perform better in bed for months.
How Many Sessions Are Usually Required?
- Clinical studies have used different treatment schedules, commonly involving several sessions over several weeks. Six to twelve sessions are used in some protocols, but there is no universally standardized regimen.
- Individual treatment sessions are typically brief; for example, University of Utah Health describes a treatment time of approximately 15 minutes.
- Depending on the device and the patient’s condition, doctors may use different steps.
- Standardized treatment schedules are still being worked out, so advice from doctors and research centers may not be the same.
- Treatment success may also vary depending on erection and the severity of erectile dysfunction.
Is the Procedure Painful?
LiSWT is generally described as well tolerated, although some patients may experience discomfort or pain during treatment. When the acoustic pressure waves hit, they feel like light taps and not severe pain. Because the procedure is non-invasive, there is no need for surgery or injections.
Proposed mechanisms include activation of angiogenic signaling pathways, including pathways involving vascular endothelial growth factor (VEGF). Because the procedure is non-invasive, it generally does not require a prolonged recovery period, although individual instructions may vary.
How Long Do Results Last?
Studies have reported improvements lasting several months and, in some studies, longer. However, the long-term durability of treatment remains uncertain, and the magnitude and duration of benefit vary among patients. Long-term success rests on keeping your cardiovascular health and dealing with risk factors like smoking, being overweight, diabetes, and high blood pressure that isn’t under control.
The therapy is hypothesized to promote tissue remodeling and angiogenic signaling within erectile tissue. There is currently no universally established maintenance schedule, and more research is needed to determine whether repeat treatment is beneficial
Can Shockwave Therapy Be Combined with ED Medications?
LiSWT may be used alongside PDE5 inhibitors in selected patients. Some clinical studies suggest that combining LiSWT with tadalafil may provide additional improvement in erectile-function scores compared with LiSWT alone, although further research is needed.
Making changes to your lifestyle, like working out regularly, watching your weight, eating well, and quitting smoking, can help your treatment work better by improving your blood flow and overall vascular function.
Other ED treatments include vacuum erection devices, intracavernosal injections and penile implants. Testosterone therapy may be considered when clinically significant testosterone deficiency is confirmed.
Potential Benefits Beyond Better Erections
- Some studies have reported improvements in erectile-function measures and sexual satisfaction, although evidence for broader quality-of-life benefits remains limited.
- Some men also say their overall quality of life has improved and they are happier when they are intimate.
- These benefits are most commonly observed in men with vasculogenic ED candidacy, where poor penile blood flow is the primary cause of erectile dysfunction.
- Even though the results are good, everyone’s experience and treatment effect may be different.
Are There Any Side Effects?
Most clinical studies that have looked at shockwave therapy have found it to be safe. Because the treatment doesn’t involve surgery or drugs, serious side effects are very rare. Some patients have brief redness, mild pain, or small swelling that usually goes away on its own without any medical help.
Treatment frequency varies between protocols, with studies using schedules ranging from once weekly to several sessions per week.
Is Shockwave Therapy FDA Approved for Erectile Dysfunction?
In the United States, low-intensity shockwave therapy is not FDA-approved specifically for the treatment of erectile dysfunction. The treatment remains investigational, although some urology guidelines discuss its potential use in selected patients. Men considering LiSWT should discuss its potential benefits, limitations, costs and alternatives with a qualified healthcare professional.
When Should You See a Doctor?
If erectile difficulties are persistent or recurring, speak with a healthcare professional. Erectile failure can sometimes be a sign of a deeper problem, like heart disease, diabetes, hormonal problems, or neurological problems. Early diagnosis lets you identify and address the underlying cause and improves your health in general, not just your sexual performance.
Conclusion
Low-intensity shockwave therapy is an emerging treatment option being studied for vasculogenic erectile dysfunction. Clinical trials suggest that LiSWT may produce modest improvements in erectile function in some men, particularly those with vasculogenic ED.
Even though it doesn’t work for everyone, a professional evaluation and realistic goals can help you decide if this new therapy is a good choice for you.
Reference
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