There are several ways to treat erectile dysfunction (ED). Shockwave therapy could serve as a long-term treatment for underlying physical causes of ED.

Aside from penile implants and lifestyle changes, techniques that include medication and injections represent on-demand treatment options. Shockwave therapy could be an alternative.

Inadequate blood supply to the penis is a common underlying cause of ED, known as vasculogenic ED. Shockwave therapy may work best for people with this condition, as experts believe it increases blood supply.

Keep reading to learn more about how shockwave therapy for ED works, the potential risks and side effects, and where people can receive treatment.

What is shockwave therapy?

People with ED may consider shockwave therapy, which is still in the experimental phase, for treatment.
Shockwave therapy is an alternative, non-invasive treatment for ED. It is a fairly recent technique that has emerged over the last decade.

Practitioners may refer to shockwave therapy for ED as low-intensity extracorporeal shock wave treatment (LI-ESWT).

Research continues to examine the effects of LI-ESWT to determine if it is a safe and successful treatment option.

How does it work?
LI-ESWT for ED works by applying low-intensity shock waves to the penis. A practitioner uses a handheld probe to administer these. A gel is used as an interface to conduct the shock pulses.

People do not usually need an anesthetic, but they may experience a tingling sensation in the treatment area.

A practitioner will apply a set amount of shocks per minute, for a fixed amount of time. A session may last 15–20 minutes, and people may require repeat treatments.

The energy from shock wave therapy stimulates new blood vessel growth through a process called angiogenesis. This increases penile blood flow, which may improve erectile function.

LI-ESWT may also improve the effectiveness of pde5 inhibitors, which are oral drugs to treat ED.

A 2017 study looked at the effects of LI-ESWT on ED in 710 people. Each participant received five weekly 20-minute sessions. Some also had additional drug treatments for ED.

The study results showed LI-ESWT caused a significant improvement in erection quality in people with and without additional medication.

A month after the sessions, there was a decrease in improvement. The researchers suggest that a longer treatment duration may provide better and longer-lasting results.

Penile shockwave therapy is still experimental since it is a relatively new therapy with no long-term data. However, research is ongoing about its effectiveness as a treatment for ED.

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Risks and side effects
Currently, shockwave therapy for ED does not have approval from the U.S. Food and Drug Administration (FDA). This means it is presently still seen as an investigational or experimental treatment.

Side effects of shockwave therapy for ED may include:

• bruising of penile skin
• blood in urine
• penile skin infection
• painful erection

pain or difficulty during sexual intercourse, due to the above
A 2019 review of clinical studies reports positive initial results from LI-EWST, with a good safety record and an improvement in erectile function. However, more research is needed to determine the best treatment practices.

Where to get treatment
As the technique is yet to gain FDA approval, there is no standard treatment for shockwave therapy for ED.

It is currently only available as part of a clinical trial, which means treatments should only take place in research settings.

People can research providers to see if they offer experimental shockwave therapy for ED.

As part of their own research, people may wish to take the following steps before they decide to undergo shockwave therapy:

Consulting with a primary care doctor before they decide on a treatment option.
Talking with a urologist for further information. Urologists are doctors who specialize in urinary and reproductive health.
Finding out about the experience, knowledge, and background of the practitioner providing ED treatment.
Checking practitioners use a recognized shockwave machine, as some devices may not deliver effective levels of energy.
Researching the total cost of treatment beforehand, and research the legitimacy of any high-cost therapies.
People should also note that as the technique does not have FDA approval, they will need to cover the cost of treatments themselves, unless they are part of a research study.

Alternatives
There are many alternative treatments for ED, including medications, lifestyle changes, and surgery. Strategies depend on the cause of ED and an individual’s medical history.

People may find oral medication effective, which doctors refer to as pde5 inhibitors. These include:

• sildenafil
• tadalafil
• vardenafil
• avanafil

People should not take pde5 inhibitors if they also take nitrate medication, as the combination can cause severe side effects. Individuals should speak with a doctor or healthcare provider to help minimize possible drug interactions.

Learn more about ED pills here.

Other treatment options include lifestyle changes. These include:

making dietary changes
considering alternatives to certain medications that may exacerbate ED, such as beta-blockers and antidepressants
avoiding smoking and alcohol
managing stress, emotional, or relationship issues, through relaxation or therapy
increasing exercise
Other treatment options for ED include:

vacuum erection devices, or penis pumps, which are tubes that cover the penis and to create a vacuum, to sustain erections
alprostadil, a drug that doctors can administer as a urethral suppository or inject directly into the penis
ED rings
surgical penile implant
supplements, though the FDA advises people to exercise caution with these
Summary
LI-ESWT is a new and non-invasive potential treatment for ED. It is still under investigation and is yet to gain approval from the FDA as a treatment option. The only legitimate LI-ESWT for ED available currently is through clinical trials.

So far, research suggests it has some promise as a treatment for ED. Further studies will show whether LI-ESWT is an effective, safe, and long-term option for ED.

Several FDA-approved treatments for ED are currently available, and people can discuss options with their doctor.