What Is Shock Wave Therapy for Erectile Dysfunction?

physical therapy of the knee and the foot with shock wave
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Low-intensity shock wave therapy, also known as shock wave therapy, uses sound waves to stimulate tissues inside the body. Originally developed as a treatment for wounds and injuries, shock wave therapy is thought to stimulate increased blood flow in order to promote healing.

Erectile dysfunction (ED) is sometimes associated with blood flow problems, and shock wave therapy has been proposed as a possible treatment for ED. It has also been proposed as a potential therapy for Peyronie's disease and other sexual health problems. However, there is only limited and inconsistent evidence that it works.

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Erectile Function Measurement

In general, trials studying shock wave therapy use patient self-reports to determine the effectiveness of treatment. Those reports usually include methods of measuring erectile function—the International Index of Erectile Function (IIEF) and/or the Erection Hardness Scale (EHS). These scales are used by healthcare providers and researchers to assess erectile dysfunction.

The EHS asks men to rate the hardness of their erection on a scale from 1 (no enlargement) to 5 (completely hard and fully rigid).

Questions on the IIEF are about the quality of an individual's erections and their effect on sexual satisfaction and function.

Patients rate each question on a scale of 1 to 5, and topics include:

  • How do you rate your confidence that you could get and keep an erection?
  • When you had erections with sexual stimulation, how often were your erections hard enough for penetration?
  • During sexual intercourse, how often were you able to maintain your erection after you had penetrated your partner?
  • When you attempted sexual intercourse, how often was it satisfactory for you?

Together, these two scales can give a reasonable assessment of men's erectile function without requiring men to get an erection during a medical or research visit. They can also be used to determine how much of an improvement occurs with the treatment.

Research on Shock Wave Therapy for Erectile Dysfunction

To date, there have been a number of randomized controlled trials looking at the effects of shock wave therapy on men with erectile dysfunction. Most of those trials have been small—including between 30 to 60 men per group.

The results have varied substantially across studies, with some studies suggesting that the procedure helps and others suggesting that it does not help. None of the studies have reported any adverse events from undergoing shock wave therapy. It's just unclear whether or not it's useful. Furthermore, even those meta-analyses that have found a significant improvement in men's IIEF scores have only found them to go up by 2 to 3 points.

Basic science research and animal research on shock wave therapy has been more promising.

  • In animal studies, shock wave therapy has been shown to both improve the growth of blood vessels and stimulate growth and differentiation of penile tissue.
  • In the lab, studies show that shock wave therapy may help with tissue growth.

This gives plausible mechanisms by which shock wave therapy could be useful in humans. However, that does not mean shock wave therapy will be found to be an effective treatment for erectile dysfunction.

Should Men Consider Shock Wave Therapy for ED?

In 2019, scientists from the European Society of Sexual Medicine reviewed the evidence for the use of shock wave therapy in sexual health.

What did they find? There is some evidence that shock wave therapy may help with erectile dysfunction. However, the evidence is inconsistent, and even where there were reported improvements, those improvements reflected only a small improvement in erectile function.

As for men with Peyronie's disease, there is some evidence that shock wave therapy may help with the pain. However, there is no evidence that it improves penile curvature or gets rid of the plaques that cause those curves. Therefore, men who are considering this form of treatment should not go in expecting changes in their penile function, although it could be a way to deal with discomfort.

A Word From Verywell

Shock wave therapy appears to be safe, and most men do not have side effects. However, there is only limited and inconsistent evidence that it works. It may make sense to wait for further evidence before investing in this type of treatment, particularly for men who have not yet tried proven treatment options. The treatment is generally not covered by insurance and it can be costly to do. Therefore it is recommended you research all options and speak to a sexual health expert before moving forward with treatment.

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6 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. Parisot J, Yiou R, Salomon L, De la taille A, Lingombet O, Audureau E. Erection hardness score for the evaluation of erectile dysfunction: further psychometric assessment in patients treated by intracavernous prostaglandins injections after radical prostatectomy. J Sex Med. 2014;11(8):2109-18. doi:10.1111/jsm.12584

  2. Van kollenburg RAA, De bruin DM, Wijkstra H. Validation of the electronic version of the International Index of Erectile Function (IIEF-5 and IIEF-15): A Crossover Study. J Med Internet Res. 2019;21(7):e13490. doi:10.2196/13490

  3. Capogrosso P, Frey A, Jensen CFS, et al. Low-intensity shock wave therapy in sexual medicine—clinical recommendations from the European Society of Sexual Medicine (ESSM). J Sex Med. 2019;16(10):1490-1505. doi:10.1016/j.jsxm.2019.07.016

  4. Man L, Li G. Low-intensity extracorporeal shock wave therapy for erectile dysfunction: A systematic review and meta-analysis. Urology. 2018;119:97-103. doi:10.1016/j.urology.2017.09.011

  5. Sokolakis I, Dimitriadis F, Psalla D, Karakiulakis G, Kalyvianakis D, Hatzichristou D. Effects of low-intensity shock wave therapy (LiST) on the erectile tissue of naturally aged rats. Int J Impot Res. 2019;31(3):162-169. doi:10.1038/s41443-018-0064-0

  6. Lin G, Reed-Maldonado AB, Wang B, et al. In situ activation of penile progenitor cells with low-intensity extracorporeal shockwave therapyJ Sex Med. 2017;14(4):493-501. doi:10.1016/j.jsxm.2017.02.004

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