If your erections have gotten softer or less reliable and the little blue pill works less well than it used to, there's a non-drug option worth understanding. Pills like Viagra borrow function for a few hours and give it back when they wear off - they never fix what's wrong with the tissue. Shockwave therapy takes aim at the actual cause: the blood supply.
Low-intensity shockwave therapy is an in-office treatment that uses gentle sound-wave pulses to encourage new small blood vessels to grow in the penis. The aim isn't one good night - it's to repair the blood flow that decides whether an erection happens at all. It's a core part of the root-cause approach in ED is a blood-flow problem, not an age problem. Arbour's erectile dysfunction program in Ann Arbor evaluates that blood-flow root cause directly.
What it actually does
“Shockwave” sounds intense, but these are gentle focused pulses - about a tenth of the energy used to break up kidney stones. The mild pressure signals the blood-vessel cells to release growth factors, and over the following weeks your body grows new tiny vessels. The effect is gradual: you don't leave the first session improved. You do a series of sessions, and the benefit keeps building for two to three months afterward, peaking around the three-month mark.
What the evidence shows
Pooled analyses of randomized trials (comparing real treatment to a sham) show meaningful improvement in erection scores at 1, 3, 6, and 12 months, with the best results in men who have mild-to-moderate blood-flow-related ED. European urology guidelines now list it as an option for mild ED and for men who'd rather not rely on pills. Important honesty: in the U.S., shockwave for ED is considered investigational by the American Urological Association and has not been reviewed or approved by FDA for this use. We tell every patient that up front.
Who it helps - and who it doesn't
Best candidates are usually men 45–70 whose ED came on gradually over one to four years, who still get some morning erections, and who are working on their heart-health risk factors. It's not the right tool for severe long-standing diabetic ED, ED after prostate surgery with nerve damage, ED that's mainly psychological, significant Peyronie's curvature, or ED that appeared suddenly over a few weeks (which usually points to a medication or hormone cause that needs a workup first). Low testosterone is worth checking either way - see testosterone therapy and low libido in men.
What treatment is like at Arbour
A typical course is 6–12 sessions over 4–6 weeks, usually twice a week, about 20 minutes each. No numbing, no prep, no downtime - most men feel a mild tapping, and you can resume sex the same day. We often pair it with the P-Shot and hormone optimization, and we check your response at three months.
What I see in clinic: the men happiest with shockwave are the ones who treated the whole picture - blood flow, hormones, weight, and sleep - rather than expecting the device to do everything alone.
Frequently Asked Questions
What is the regulatory status of shockwave therapy for ED?
In the U.S. it has not been reviewed or approved by FDA for ED, and the American Urological Association considers it investigational. European guidelines recommend it for certain men. We explain this clearly as part of your consent.
How is this different from GAINSWave?
GAINSWave is a brand name, not a separate technology. The underlying treatment is the same low-intensity shockwave therapy. We describe the treatment by what it is rather than a licensed brand.
Will insurance cover it?
Usually not - most insurers, including Medicare, treat it as a non-covered service. We can provide receipts for HSA or FSA reimbursement where eligible.
Does it hurt, and is there downtime?
Most men feel only a mild tapping, there's no numbing needed, and there's no downtime - you can return to normal activity, including sex, the same day.
What if it doesn't work for me?
If you don't see meaningful improvement by the three-month check, we reassess - looking at your heart health, testosterone, and adherence - and consider combination approaches like daily low-dose tadalafil, hormone optimization, or a referral for injection therapy. Our guide to erectile dysfunction treatment in Ann Arbor reviews the full range of options we consider at that point.
Arbour Longevity · 2217 Packard St #15, Ann Arbor, MI 48104 · (734) 436-3357 · Thursday through Monday, 10am to 7pm.
References
- Sokolakis I, Dimitriadis F, et al. (2024). The Basic Science Behind Low-Intensity Shockwave Therapy for ED. Int J Impot Res.
- Capogrosso P, et al. (2024). Extracorporeal shock wave therapy for ED. Review.
- Effectiveness of Low-Intensity Shockwave Therapy in ED: An Umbrella Review. (2024). J Pers Med.
- European Association of Urology. Guidelines on Sexual and Reproductive Health.
- Burnett AL, et al. (2018). Erectile Dysfunction: AUA Guideline.
Low-intensity shockwave therapy for ED is classified as investigational by the AUA. This article is educational and does not replace individualized medical advice.
Gandhi Bhattarai, FNP-BC, PMHNP-BC, Anti-Aging/Functional Medicine BC
Triple board-certified nurse practitioner and founder of Arbour Longevity in Ann Arbor. Every article is written from clinic practice and reviewed against current guidelines.
✓ Medically reviewed · Last updated August 21, 2026
How we reviewed this article
Arbour Longevity articles are written by the treating clinician, checked against primary sources (peer-reviewed journals, FDA labeling, Endocrine Society and other specialty guidelines) and re-reviewed when guidance changes. See our editorial policy. Spotted an error? Email info@arbourlongevity.com.
This article is educational and is not a substitute for individualized medical advice. Whether a treatment is appropriate for you is determined during consultation.
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