Who tends to respond to shockwave?
Men with ED caused by reduced blood flow, especially when it is mild to moderate. Cleveland Clinic describes good candidates as men with mild to moderate vascular ED who respond well to medicines like sildenafil. The trial data line up with that:
- In a 2012 sham-controlled trial of men with organic ED who still responded to pills, 12 sessions raised erectile function scores by 6.7 points on average, against 3.0 with sham, and penile blood flow improved.
- In a 2016 sham-controlled trial of men with vascular ED for whom pills had stopped working, 54.1% could get an erection firm enough for penetration (with their pills) after treatment, compared with none after sham.
- In a two-year follow-up, 76% of responders with milder ED and no diabetes still had the benefit at two years.
So the classic candidate is a man whose pills work, or partly work, who would like better natural function or less reliance on medication.
Who is unlikely to respond?
Men whose ED is not mainly about blood flow. Cleveland Clinic notes that ED from nerve damage or psychological causes typically does not respond. The NIDDK lists damage from pelvic surgery among the nerve-related causes of ED, which is why ED after prostate removal is a poor fit.
Diabetes with severe ED is the other weak spot. In the two-year follow-up, the benefit was lost in every man who had diabetes and severe ED at baseline, and severe ED in general faded sooner.
| Profile | Likely response | What the evidence shows |
|---|---|---|
| Mild to moderate vascular ED, pills help | Most likely | Benefit over sham; longer-lasting in milder ED |
| Vascular ED, pills no longer work | Possible | About half reached penetration-firm erections with pills after treatment |
| Severe ED with diabetes | Unlikely to last | Benefit lost in all such men within two years |
| ED after prostate removal or other nerve damage | Unlikely | Nerve-related ED typically does not respond |
| Mainly psychological ED | Unlikely | Not a blood flow problem |
What does the evaluation check?
Enough to tell what kind of ED you have. That means a history of when it started, whether morning erections still happen, any pelvic surgery or radiation, your medicines, and how you respond to pills. Labs look for the conditions that damage blood vessels or lower desire, which our page on blood tests for erectile dysfunction lists.
Blood pressure, weight and smoking history also count, since they shape how healthy your blood vessels are. Age is not a cutoff. The 2017 meta-analysis of seven shockwave trials included 602 men with an average age of 60.7. The cause and severity of your ED matter more.
Related question: what if shockwave is not for me?
You still have options. Our pages on ED after prostatectomy and ED with diabetes cover what tends to help in those situations, and our page on treatment when pills stop working explains injectable options such as Trimix and Quadmix. If anxiety plays a big part, see performance anxiety and ED.
How Ultimate Male decides whether shockwave fits
It starts with the free phone call, then same-day labs at our San Gabriel or Downey clinic and a private consultation. The provider puts your history, labs and pill response together and tells you honestly whether shockwave is likely to help.
Shockwave is not FDA-cleared for ED, and the AUA considers it investigational, so you will hear that too. If you are a good fit, the next step is a course plan on our shockwave therapy page. If you are not, you will leave with a different plan rather than a series that is unlikely to work.
