Disclaimer: This is for the purpose of education only. Don’t try to self supplement or self medicate.

If you suffer from erectile dysfunction or sub ideal function, please make no adjustments in your medical care without a physician‘s direct involvement. The only other disclaimer is more of a disclosure. I am a SHOCKWave provider. There are only about 200 of us in the country. Strongly consider this therapy if you want to improve erectile function. Ladies, don’t hesitate to be the point of contact in that discussion.


There are guys that are having no problems that are significant with erectile performance that want to be rock stars. You will benefit greatly from reading this. There are guys that are having massive problems with erectile function. You must read this.
I’ve introduced shockwave therapy in both my regenerative and primary care practices to promote erectile function. And now patients I meet through my aesthetic practice are taking an interest in their sexual health. The beneficial results have been dramatic. It works. This is a Q and A of most frequently asked questions. I’ll get two of the biggest questions out-of-the-way upfront. The critics are asking why are we doing this. Well… The thousands of responders, dozens of international studies and societies that have confirmed that it works – – They are asking, why isn’t everybody doing this. Guys that are responding are asking as many questions as the new patients interested in the care. These are the most commonly asked questions.

Who Does Acoustic Shockwave Therapy Help in the World of Erectile Function?

Shockwave therapy treats performance patients, mild erectile dysfunction patients, and moderate to severe erectile dysfunction patients.
A. So, no ED. In other words, we are seeing 23 to 26-year-olds that perform sub ideally getting acoustic therapy and improving dramatically enough to keep coming back for maintenance sessions even weekly. They’re called performance patients. There’s nothing wrong with them. And if you ask them what they want, they say to be “outrageous.“ That’s what pop culture wants today, to go to that next level, that next extreme. As long as it’s done safely. So, shockwave therapy can give them just that!
B. Moderate ED. So, erectile dysfunction patients suffering from erectile dysfunction from years of disuse respond nicely to the increased vascularity the acoustic therapy produces. These guys are getting completely off trucks they have required for erectile function. And they are thrilled.
C. And severe ED. We are seeing frank erectile dysfunction patients with illness and bad ED respond nicely to this care. In combination with medications, these guys are able to penetrate their loved one for the first time in years. And they are thrilled.

When Will Shockwave Therapy Start Working?

You may experience results immediately, and about half the patients do that very night. That’s great. But you should not experience the real effect for two weeks.
Immediate results, some of which occur in the middle of the first session, are largely because of nitric oxide affect results. And that’s benefit with lift off, and that is great. But the real benefit that you are acquiring and doing this for its persistence. And that kicks in in two weeks.

Does Shockwave Therapy Hurt?

The shockwaves are acoustic or sound waves. There is no trauma involved. All they are producing is changes in cell membrane permeability. See physiology below. It doesn’t hurt. It hurts so little that many choose to not use the numbing cream. They choose to not use the numbing cream because they don’t like their penis being numb for four hours.

Standard BLT (benzocaine-lidocaine-tetracaine) is the numbing cream used for the shockwaves.

What Anatomy Is Specifically Treated?

There are seven regions that will receive this therapy: 2 corpus cavernosums or cavernosa, (corporas), 2 crus, the cru of the penis, 2 pudendal canals, and #7 the spongiosis bulb.
In other words, for the lay public (I will do my best to minimize the puns, but some are simply unavoidable), 2 sides of the shaft of the penis, the 2 bases of the penis, right and left, the 2 groins, right and left, and the taint.

Shockwaves benefit erectile function in two ways. One, they induce endothelial nitric oxide synthase release, leading to the formation of nitric oxide. Increased nitric oxide produces the Viagra like effect which helps in the creation of erections phase. Two, when shockwaves hit high impedance tissues, cavitations that form pop producing jet streams that induce cellular changes that angiogenesis, blood vessel formation in the emissary veins that are responsible for the persistence of erections phase.
In summary… It helps the first phase of erectile function, the inflow of blood to produce an erection, by stimulating the formation of nitric oxide, giving a Viagra like arterial effect.
But much more significantly and importantly… It really helps the second phase of erectile function, a process which really relies on the outflow of blood from the penis, or rather the delayed outflow of blood. That is… It increases the emissary venous vasculature that the tunica albuginea distorts to produce persistence of an erection. More veins for the fixed tunica albuginea to distort, more distortion, more erection persistence.

Is Shockwave Therapy Safe?

There are two types of machines which are both extremely safe. Electromagnetic and pneumatic. Electromagnetic machines uses an electromagnetic shock to generate the shockwave. Pneumatic machines fire a jerk against a bullet that produces airwaves to generate shockwaves. Super simple energy transfer methodologies, both camps.
That’s actually the only time there are side effects of shockwave therapy is when it is used for Peyronie’s disease. There will be pain afterwards. There will be a bruise. The higher settings of the shockwave therapy necessary for Peyronie’s and the very disease itself both/all contributes to pain from shockwave therapy for it. But the results if the patient is persistent and tolerant are great. And satisfaction rates are high despite the discomfort.
Shockwave therapy is extremely safe. I’m presently cleared by the feds to say so. No black box warning here folks. How many drugs can say that, right? It’s super safe. There, I said it again.
Other than what I’ve lived above, there is not one adverse reported on study after study examining shockwave therapy for erectile function and dysfunction.
And everybody asks about embolic phenomenon. Remember, shock waves are breaking up clots from diabetes and hypercholesterol in the arteries heading towards the penis, yes (especially bad in Peyronie’s of course). But those tiny little arteries are feeding the enormous cavernous sinuses of the penis. So if you break up a plaque in there, the tiny emboli that it creates are not going to affect anything.
Having said all this, if someone gets bruising or bleeding following shockwave therapy, in any body parts that were exposed to the therapy or not, understanding that they are probably going to be using those body parts in genuine attempt at intercourse… Well, do you see what I’m getting at. There may be bruising or bleeding associated with it, but the shock waves probably didn’t cause it. However, the shockwave therapy would have to stop.
The radial type shockwaves that are used in treating erectile function with acoustic therapy or gentle waves that stimulate bubble formation which upon first thing need to jet streams that trigger new blood vessel formation. So they are more building been destroyed. They are more changing permeabilities than creating bruises or bleeding.

What Makes SHOCKWave So Great for Shockwave Therapy for Erectile Function or Dysfunction in the Acoustic Therapies Space

Like every successful treatment, there’s always an ideal. Not too little, not too much. The SHOCKWave parameters and settings and protocols, all patented by the way, have hit that sweet spot.

Are There Any Contraindications To Shockwave Therapy?

I’d be concerned about an anti-coagulated patient with visible bruises, old and new. He should probably not receive shockwave therapy for erectile function or dysfunction.
Sickle cell disease, a less common situation, presents a probable contradiction to shockwave therapy for erectile dysfunction or improved function. Those unfortunate gentlemen are at risk for priapism even without acoustic therapy. Acoustic care in him is risky.
Post prostatectomy patients that have had cancer should not receive shockwave therapy until their post prostatectomy care is considered complete. However, there should not be extensive delay to receiving shockwave therapy if erectile function is lost for such a patient. So, not immediately after prostatectomy, but yes soon after if there is loss of function.
Penile implant patients are NOT a contraindication to this therapy (Although the acoustic therapy should not be administered directly to the implant of course). Because they have no problems with getting erections, they are of course not buying lift off or persistence of erection like most of the patients getting acoustic therapy for erectile function and dysfunction. Penile implant patients are getting acoustic shockwave therapy for increased sensitivity. That’s right. It works great for that. That’s actually a nice segue into the ladies. Shockwave therapy is now being used in the ladies, although still pending federal approval, for increasing sensitivity to intercourse. Also, there is a new fascination with the color of the female genital organs because reddening color is correlated with increased vascularity which is correlated with increased sensitivity to intercourse. Great new world. More on that to follow I’m sure.

What Is the Physics Behind Shockwave Therapy?

Thus, the therapeutic radial shockwave moves through the tissue to one of two friendly endings. One, it dissipates. Or two, it finds something of acoustic resilience that it bombards.
So, these shockwaves are able to transfer energy THEN. Turns out, they are the most efficient way of transferring energy in nature. Inert is always good when it comes to talking about side effect profiles which are excellent for shockwaves. Essentially none. Anyway, shockwaves are thus able to travel through tissue essentially unchanged.
That is, until there is the sudden change of their motion as a result of the impedance experienced against something more immobile than them like collagen or bone – – which is said to have acoustic impedance – – which leads to the formation of vacuum bubbles in the tissue fluid because of acute pressure gradients that occur.
These bubbles that form are called cavitations. When these cavitations or bubbles pop, they create jet streams. It is the jet streams that stimulate tissues’ cells in many beneficial ways.

What’s the Difference Between Shockwaves Use for Kidney Stones and Shockwaves Used for Blood Vessel Regeneration?

Everyone knows that’s the kidney stone defragmentation usage came first. So, these shockwaves at specific settings (that is, at varying Barr and frequencies; a Barr – – referring to the number of atmospheric pressures per unit of surface area; Hz – – referring to frequency of waves generated, the setting directly correlated with the rate of cavitations formed, those all important bubbles that form in the tissue fluid that are correlated with the therapy in discussion here) were great to break up kidney stones non-invasively. Well it turns out, these kidney stones patients started noticing improvement in their musculoskeletal back pain. When physicians realized that kidney stone lithotripsy patients were getting less back pain and improved hip range of motion and muscle tenderness improvement occurring in addition to the stone care…
Further investigation led to more careful studies of these fascinating sound waves. But there were no drugs involved. So, research has been slow and limited. But… It’s finally happening, over the past decade or so, and things are getting exciting.
We’re starting to get a better handle of what is going on at a more cellular, sub cellular, and even molecular level.
Acoustic therapy, known as shockwave therapy, stimulates blood vessel formation when bubbles generated on impact of the shockwaves against higher inmpedence substances like bone leads to bubbles which eventually pop, generating gentle jet streams which, in the muscles, in the tissues, and in the penis, lead to blood vessel formation… Via induction of intracellular processes and gene expression, we get enzyme production changes leading to angiogenesis.
The shockwaves used to break up kidney stones are more penetrating. They are called focused waves. The shockwaves used to produce vascular-genesis radiate outward more, so they are called radial shockwaves.
So more penetrant waves are meant to be more traumatic, so more defragmenting to things like kidney stones. Less penetrant waves are called radial waves and are found to be more regenerative. The shockwaves that we use for ED are that’s designed to be purely radial.
In summary, both radial and focused shockwaves produce cavitations. The cavitations produced by focused shockwaves are strong enough bubbles to defragment stones. The cavitations produced by radial shockwaves are only strong enough to linger around. Then when they burst, the jet streams they produce eventually generate their therapeutic effect at a cellular level to generate enzyme changes that produce angiogenesis. Bam. Regeneration, tissue healing (or better stated, rejuvenation), clinical improvements, and maybe even wellness.

Do Shockwaves Have Any Other Therapeutic Abilities?

So, shockwave therapy causes angiogenesis. It has other clinical effects, all of which are beneficial. So because that increases your amount of emissary veins which when distorted by the tunica albuginea Alaska persistence of a directions, shockwave therapy leads to increased persistence of erections.
But acoustic shockwave therapy also aids in lift off. Yes, it increases the production of nitric oxide synthetase. That leads to more nitric oxide which draws blood to it where it is. Increased her trail blood flow, increased lift off.
Acoustic shockwaves also have a well-documented numbing effect (nice to know if you were doing the P shot after treatment, but not enough to forfeit the dorsal penis nerve block). That is by COX-2 inhibition… Blocking the inflammation cascade.
Yes… And… So, anti-inflammatory. That’s always a plus. Because if shockwaves are anti-inflammatory, attracting the likes of white blood cells and macrophages to get rid of debris and plaques and any inflammatory problems associated with many erectile disorders, well, it’s all a plus.
As a result of their anti-inflammatory effect, shockwaves help prostatitis patients. They have been shown to increase urine flow in clinically significant urine outflow and prostate problems – – a direct result of acoustic shockwave care.
Also… Shock waves actually turn on cellular mechanisms (RHOA and ROCK pathways) that lead to the formation of the cytokine PK-10. PK-10 Is instrumental in helping cells that have lost their ability to die. It puts those cells back into apoptosis. As such, in theory at least, do shockwaves have anti-neoplastic properties? Further… Are they perhaps rendering that protective capacity in addition to all the other benefits described above? Purely speculation.
And, they are cardio protective (in case your therapist points the shock wave generator too close to your chest; just kidding). Studies have been done in cardiac patients, and the findings have been excellent.
Shockwave therapy also increases wound healing.
Shockwave therapy also increases bone density (Note: if the more penetrating focused waves are used instead of radial waves which are used for the penis).
Angiogenesis so blood vessel regeneration, tissue regeneration beyond just blood vessels, anti-inflammatory, acceleration of wound healing, increasing bone density, cardio protective… You can see, the applications of shockwave therapy may be limitless.

What if Shockwave Therapy Doesn’t Work?

So, if acoustic shockwave therapy doesn’t help the average performer turn into a rockstar, or it doesn’t turn the moderate erectile dysfunction patient into a very happy, functioning patient, using less pills, or it doesn’t turn the severe erectile dysfunction patient into one who can penetrate his mate, then you move into PRP (Platelet Rich Plasma)

What Kind of Caregivers Can Administer Shockwaves?

Radial waves can be administered by therapists as well as doctors. Focused waves are generated by class three devices, so must be administered by doctors.
Focused waves can be made more radial, but the converse is not true.

What Is the Difference Between Sound Waves, Acoustic Waves, Shockwaves, and Ultrasound?

As far as I understand it, soundwaves and acoustic waves are the same thing.
Both shockwaves and ultrasound are faster than the speed of sound. Thus, they are different from sound waves and that’s how.
Many things cause shockwaves it turns out, including thunder. Not so many things cause ultrasound. So shockwaves are more common in nature. So shockwaves are more natural!
The difference between shockwaves and ultrasound waves. That’s easy. Ultrasound waves have both a positive and a negative component to them – – constantly. They bounce forward, they come back. That is why we can use them for imaging soft tissue in the body. Radiologists rely on this physical principle of ultrasound, they move in, they bounce of something, they come back across, they generate nice blacks and whites and grays as a result. Heck, they might even be colored if motion is involved, as is the case with blood flow. And such imaging is getting very clever these days by the way. But… That’s another story.
A shockwave on the other hand is all positive. Every time a shockwave is generated, it’s positive.
And as described earlier and in other talks on this blog,, there are two types of shockwaves: “penetrant shockwaves”; and “radial shockwaves less penetrant”.

What Are My Guarantees Shockwave Therapy Will Work?

Will it work? Heck, yeah! 41 peer-reviewed scientific studies confirm shockwave efficacy for treating erectile dysfunction last time I counted.
There are 92% satisfaction rates in some studies. There are several studies with particularly dramatic statistical significance in respected peer reviewed journals approving it. And the therapeutic modality is very close to federal approval. And thus, such care is available at medical practices that have partnered with SHOCKWave. But, like everything in health, we can’t guarantee things.

How Long Do Beneficial Results Last?

The worst results for lasting effectiveness is 70 % at one year, 50% still working at 2 years. Almost every study or physician treating erectile sub function with shockwave therapy is claiming over 75% at one year.
More severe cases that go onto adding a P shot (PRP) with shockwave therapy (so more severe patients) are yielding 50% lasting success at one year. That may not sound good to you, but in the world of urology, that is spectacular for erectile dysfunction improvement.

The fix is temporary. You must do your part to prolong this. You will need a maintenance program for shockwave therapy if you wish for your erectile function to continue strong.

What’s the Downtime After Therapy?

Is no downtime after therapy. You can go home or go back to work. You don’t have to be fasting before the procedure is done. And you are in fact encouraged to use your penis that night. The numbing lotion sometimes takes as long as four hours to wear off. But then, it’s “function in the junction” time. That is encouraged.

How Does Shockwave Therapy Treat Peyronie’s Disease?

This is when there is a plaque in the penis. It is in one of the arteries that feeds one of the cavernous sinuses, right and left.
Never comfortable, the plaque might be not palpable or just a soft nodule. Or possibly it presents as a pebble. Or it might be a ring that goes around the whole penis.
The plaque leads to a curvature of the penis. Correct. Not a good situation.
When shockwave therapy is used for Peyronie’s disease, the actual shockwaves themselves are what break up the plaque (No, the shockwave destruction of the plaque does not produce emboli; this has been confirmed in study after study, in thousands of patients shockwave therapy has been used for Peyronie’s. Yes, physician and therapist alike administering shockwaves to a Peyronie’s patient who is at risk for emboli because they’re on blood thinners must be cautious.).
So. Big differences here are: scar tissue is being treated; and, so, a little bit of pain may be involved, yes. With the therapy. Then residual pain after the therapy is also extremely likely; it goes away.
Scar tissue is the main problem with Peyronie’s disease. And if treatment is going well, it will start to soften.
This brings up some clever nuances when you consider the value of shockwave therapy for Peyronie’s disease patients.
So, there may be some inflammation and pain involved with acoustic shockwaves if it is working. Right? But not much! If you recall elsewhere in this Q&A review, SHOCKWave care has a Cox 2 inhibition effect. So it’s anti-inflammatory. So, there may not be that much bruising as it turns out!
Shockwaves are anti-inflammatory. So, when it comes to Peyronie’s disease, that’s a huge advantage. Shockwaves will attract white blood cells and macrophages which will help get rid of the plaque.
Furthermore, with the usually no more than moderate pain caused by the acoustic shockwave therapy, especially if there is a little bit of inflammation, that will attract white blood cells too. And… There is inflammation in Peyronie’s in and of itself pre-treatment of any kind – – including shockwave therapy! So, perhaps that WBC drawing in is a good thing. So, maybe it’s all a win-win situation, no matter how you look at it.
So, when it comes to Peyronie’s disease, some extremely unfortunate gentleman and partners and couples, shockwave therapeutics offers them a well-defined modality that is safe. And it works. But it takes a lot of shockwave therapy sessions in some cases. The shockwave treatment protocols maybe slightly more extensive, slightly more aggressive settings, like that.
So It’s very frustrating when Peyronie’s patients ask: how much SHOCKWave ave therapy will be necessary. The answer is whatever it takes; but it will work (i.e., no promises here or ever of course; but, it should work with persistence, that’s how effective this therapy is). In other words, It’s different for different men. The plaque as stated above can be non-palpable, a barely palpable soft nodule, a hard pebble, or a ring that goes around the penis. Understandably, it’s going to take many different amounts of shockwave therapy for the many different types of presentations of Peyronie’s disease.
Persistence, reassurance, keep coming back for more therapy sessions, patience, persistence, reassurance. With enough care, you should be able to eventually penetrate your wife even if there is a 90° angle problem with your Peyronie’s – – if you use shockwave therapy.

Are There Any Supplements a Man Can Take To Maximize Erectile Function?

Nitric oxide. Supplements of it, taking things that increase its production – -vitamin B 12 and folic acid, beet extract, citrulline. Nitric oxide will maximize the lift off component of erectile function.

Is Acoustic Shockwave Therapy a Permanent Fix for Erectile Function?

No, of course not. Many… Comorbidities that led you to erectile dysfunction or sub ideal function aren’t going away. Certainly, aging is not going to stop.
So do you need to do your part. Start working out, eat better, nitric oxide supplements (see elsewhere in this Q&A). And a maintenance program for ongoing shockwave therapy needs to become a part of your life if you want to stay ahead of the function and health game. Every six months or so, yearly even if you can get away with it. Don’t let dysfunction set in.

What Is Acoustic Wave Therapy’s Overall Role in the World of Erectile Function?

If you’re popping pills, and you don’t want to be, shockwave therapy can help you.
If you’re popping pills, and they’re not working anymore, SHOCKWave therapy can help you. And once it helps you, much lower doses will be required, you’ll see.
Erectile function and erectile dysfunction alike benefit from acoustic wave therapy.


As we all begin to fully realize the painful truth how drugs cause more problems than what they were fixing, we turn to therapies or things that make us happy they have little or no side effects.
The medical descriptions of these energy transfers available to us, getting more and more refined every day, are important because they are not only incredibly safe, they are also incredibly efficacious when it comes to treating illness, especially with regards to regenerating healthy tissues! (Remember, please, when it comes to regeneration, it’s really not tissue healing. It’s a new world! Again? You’re getting your tissues back the way they were supposed to be when they came out of your mom! It’s “déjà vu all over again“.)
Shockwave therapy for erectile function is one of those great therapies. Evolving from stone care, indications for shockwave therapy spread into the low back, muscles and tissues, because of angiogenesis and regeneration. From there, the benefits of shockwave therapy literally spread into the penis, again this time, and a regenerative capacity – – increased emissary veins that lead to prolongation of erectile capacity.
I have been truly impressed by how this works. The great safety involved even the Feds have cleared us to reassure all of those considering it.
But what’s most impressive is how every single level of function can improve.
I’ve been approached by 23-year-olds, 26-year-olds. Some swear that there is a new tissue that has been generated. That simply is not the case. We have maximized what their body can do. Yes, new vessels have grown, and in that sense, this is a regenerative process, so exciting at that level.
B minus players are becoming rock stars.
Gentlemen that have illnesses and injuries are now able to penetrate their partner. And they are thrilled. That’s all this population group ever really wanted. Times years. The persistence of an erection that a pump or Viagra or the like could start is what is happening for these gentlemen all over again. And that’s with the care really brings to the table. The persistence of an erection.
The B minus players that hardly need to scare, the really dysfunctional patients that have had problems with erectile dysfunction for a long time due to disuse, illness, or trauma… Both extremes are improving.
Everyone else in between is happy as well, not to mention the ladies.
With essentially complete safety, a profile no drug can claim, shockwave therapy underpromises and overachieves. And it’s yielding terrific satisfaction results. You can read great testimonials on-line. Give it a fair shake when you can.
Your nearby SHOCKWave® provider provides you with the most well-known trademark in the sexual health industry combined with the exclusive now patented methodology.