Shockwave therapy is one of the many treatment options for erectile dysfunction (ED). Though it isn’t approved by the Food and Drug Administration (FDA), the science behind this pill-free treatment has been supported by several studies that have turned up encouraging results.
Shockwave therapy appears to work best for those with vasculogenic ED, which is a blood vessel disorder that affects blood flow to the tissue in the penis. The therapy’s effectiveness with other causes of ED remains to be seen.
What is shockwave therapy?
The clinical term for shockwave therapy is low-intensity shockwave therapy (Li-SWT). It’s a noninvasive therapy that’s been used in orthopedics for years to help heal broken bones, injured ligaments, and injured tendons.
Li-SWT has also been used to improve wound healing. Using targeted high-energy sound waves, Li-SWT can speed up tissue repair and cell growth.
Erections rely on healthy blood flow to the penile tissue. Shockwave therapy is viewed favorably as a way of repairing and strengthening blood vessels in the penis and improving blood flow.
Increasing blood flow to the penis is the same goal as more traditional ED treatments, such as oral medications, including sildenafil (Viagra) and tadalafil (Cialis).
How does it work?
Shockwave therapy is administered with a wand-like device placed near different areas of the penis. A healthcare professional moves the device along parts of your penis for about 15 minutes while it emits gentle pulses. No anesthesia is needed.
The pulses trigger improved blood flow and tissue remodeling in the penis. Both of these changes can lead to erections sufficient for sex.
There’s currently no established recommendation for the treatment period or frequency.
However, a 2019 review and meta-analysis of clinical trials found that the most common treatment plan was twice weekly for 3 weeks, followed by 3 weeks without treatments, and another 3 weeks of twice-weekly treatments.
The analysis found that the effects of shockwave therapy lasted about a year.
Candidates for shockwave therapy
As with other types of off-label medical devices, it’s not yet clear who best qualifies for shockwave therapy. In theory, anyone experiencing chronic ED could be a candidate, though current research states it may work best for vasculogenic ED.
However, studies on this end are mixed. A 2021 narrative review found that while some studies show that LiSWT is more effective in cases of mild ED when used with a combination of other treatments, others revealed the opposite, where shockwave therapy worked best in moderate to severe ED.
The best way to determine whether you’re a candidate for this ED treatment is to talk with your doctor about your situation, especially if you haven’t had success with other therapies.
What does the research say?
The same 2019 review and meta-analysis found that erectile function significantly improved with shockwave therapy. Results were best among men with vasculogenic ED.
A 2010 pilot study found that among 20 men with vasculogenic ED, all experienced improved erectile function after 6 months of shockwave treatment. Follow-up with the men found no adverse effects.
Despite this encouraging research, the Food and Drug Administration (FDA) hasn’t approved shockwave therapy as a treatment for ED. Some doctors may still offer shockwave therapy for ED, but use outside of a research setting is considered off-label.
FDA approvals for new treatments are always accompanied by guidelines for doctors to follow and side effects to be shared with patients.
As with any unapproved treatment, if you choose to do shockwave therapy for ED, there may be risks that aren’t properly explained, or you may be spending money on a treatment that doesn’t live up to its promises.
Additionally, treatments that haven’t been approved by the FDA usually aren’t covered by insurance.
According to a statement from the Sexual Medicine Society of North America (SMSNA), there isn’t enough “robust clinical trial data” to support the widespread clinical use of shockwave therapy. The SMSNA recommends that shockwave therapy only be done under strict research protocols.
Risks and side effects
Shockwave therapy is painless for most men. And as previously stated, available research has found few, if any, side effects.
However, that doesn’t mean that the procedure is safe. It’s still a relatively new therapy, and more research needs to be done to determine side effects, complications, and long-term effectiveness.
Occasional episodes of ED are normal. Stress, lack of sleep, alcohol use, or temporary hormonal changes, among other factors, can make it difficult to maintain an erection. However, if ED becomes more frequent and is affecting your sex life, see your doctor.
If you’re interested in shockwave therapy, know that it’s still an experimental therapy. Some doctors don’t want to use it until further research confirms its safety and effectiveness.
Still, if you’re looking for a pill-free treatment and aren’t interested in invasive procedures, talk with your urologist about shockwave therapy and where such a treatment may be available in your area.
Keep in mind that your doctor may also recommend that you try a more commonly used treatment first. Common treatments for ED include:
- Medications. These include sildenafil (Viagra) and tadalafil (Cialis).
- Lifestyle changes. Quitting smoking, changing your diet, and getting enough exercise may help combat ED.
- Counseling. If psychological issues, such as anxiety, stress, or relationship problems, are causing ED, talking with a therapist or counselor may help.
- Treating underlying health conditions. Health conditions such as heart disease, high blood pressure, and diabetes can contribute to ED.
Shockwave therapy costs
Since shockwave therapy is considered an off-label, non-FDA-approved ED treatment, medical insurance likely won’t cover this procedure. The exact costs may vary by provider and location, with an average of $450 per session.
Thus, if a doctor recommends a twice-weekly regimen for 3 weeks at a time, the costs may potentially add up to around $2,700.
However, you may be able to work with your provider for ways to help reduce the cost of your treatment. Possible options include discounted bundle rates or monthly payment plans.
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