50–75%
of men report meaningful improvement
Our services
Shockwave Therapy for Erectile Dysfunction
A non-invasive, drug-free treatment that targets a vascular factor that may contribute to ED in selected men.
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The Treatment
What Is Focused Shockwave Therapy for ED?
Focused extracorporeal shockwave therapy (F-ESWT) uses precisely targeted acoustic energy pulses to stimulate neovascularization — the growth of new blood vessels — in penile tissue. More blood vessels mean better blood flow, which is the physiological foundation of a healthy erection.
Unlike Viagra or Cialis, which temporarily mask the problem by forcing blood into the penis, F-ESWT treats the underlying vascular cause. Clinical data from multiple randomized controlled trials show that 50–75% of men who complete a full treatment course experience meaningful improvement in erectile function — including men for whom oral medications no longer work.
At City Integrative Rehab, we use focused shockwave — not radial shockwave. The distinction matters: only focused shockwave has been validated by randomized controlled studies for erectile dysfunction. Radial shockwave devices are less expensive but lack the clinical evidence base for ED treatment.
6
typical treatment sessions
15 min
per session — no anesthesia
2+ yrs
results can last in responders
Candidacy
Who Is a Good Candidate?
Shockwave therapy works best for men whose ED has a vascular component — meaning the issue is insufficient blood flow to the penis rather than a purely neurological or hormonal cause. Good candidates typically include:
- Men with mild to moderate ED who respond partially or fully to oral medications (Viagra, Cialis, tadalafil)
- Men whose ED has not fully responded to oral medications and are seeking an alternative
- Men with vascular risk factors: high blood pressure, type 2 diabetes, elevated cholesterol, obesity, or a history of smoking
- Men whose ED developed gradually over time (as opposed to sudden onset, which often suggests a neurological or psychological cause)
- Men who have had prostate surgery and experience post-prostatectomy ED
Shockwave therapy is generally not the first choice for severe ED, pure psychological ED, or men with active penile conditions. A consultation with one of our providers will clarify whether it is appropriate for you.
The Protocol
What to Expect: From First Visit to Results
Step 1 — Consultation & Assessment
Your provider reviews your history, current medications, and ED severity. We discuss whether F-ESWT alone or in combination with other treatments (testosterone optimization, DNS, lifestyle changes) is the right approach for you.
Step 2 — Treatment Sessions
A typical course is 6 sessions over 3 weeks (2 per week). Each session lasts approximately 15–20 minutes. A handheld applicator delivers focused shockwave pulses to specific penile tissue zones. There is no anesthesia or needles, and most patients resume routine activity after the visit.
Step 3 — Response Window
Most men begin noticing improvement 4–6 weeks after completing their course, as new blood vessel growth takes time to manifest. Some men notice changes as early as after sessions 4–6. The full effect is typically assessed at the 2–3 month mark.
Step 4 — Follow-Up & Maintenance
In clinical studies, 50% of responders maintain benefit for over 2 years after a single course. Men with more significant vascular disease may require a maintenance session after 12–18 months. Your provider will guide you based on how you respond.
Comparison
Shockwave Therapy vs. Viagra or Cialis
This is the question most men ask us. The honest answer: they work differently, and for many men, the right answer is both — at least initially.
Oral Medications (PDE5 Inhibitors)
- Temporary — must be taken before each sexual encounter
- Do not address the underlying vascular problem
- Stop working for 30–40% of men over time
- Side effects: headache, flushing, vision changes, contraindicated with nitrates
- Covered by some insurance
Focused Shockwave (F-ESWT)
- Targets a vascular factor and aims to support local circulation
- Results persist for 1–2+ years in responders
- Can restore response to oral medications in men for whom pills no longer work
- No systemic side effects
- Not covered by insurance; out-of-pocket cost
Men who respond well to Viagra or Cialis but want to reduce their dependence on medication are strong candidates for F-ESWT. Men for whom medications have stopped working are also candidates — studies show shockwave can restore pharmaceutical response.
Why CityIR
An Integrative Approach to Men’s Sexual Health
Most ED clinics offer one tool. We offer a coordinated treatment framework that addresses the physiological, hormonal, and neuromuscular factors that contribute to erectile dysfunction.
Focused Shockwave (F-ESWT)
The only shockwave modality with RCT evidence for ED. We use focused — not radial — technology.
DNS & Neuromuscular Work
Dynamic Neuromuscular Stabilization addresses pelvic floor function, which plays a direct role in erectile and ejaculatory control.
Coordinated Care
We work alongside your primary care physician or urologist. Shockwave is one component of a complete management plan.
Private, Discreet Environment
Appointments are fully confidential. We see a broad range of patients, so your reason for visiting is never visible or implied.
FAQ
Frequently Asked Questions
Does shockwave therapy for ED hurt?
Most patients describe the sensation as mild pressure or a slight tingling — not pain. Sessions require no anesthesia, numbing cream, or recovery time. Mild soreness at the treatment site is occasionally reported and typically resolves within 24 hours.
Is shockwave therapy for ED covered by insurance?
No. F-ESWT for erectile dysfunction is not covered by any US insurance plans, including Medicare, because it is currently classified as investigational by the American Urological Association. Treatment is an out-of-pocket expense. We provide transparent pricing at your consultation.
How is “focused” shockwave different from “radial” shockwave?
Focused shockwave concentrates energy at a precise depth in tissue, generating true acoustic shockwaves. Radial shockwave disperses pressure waves over a broader, shallower area. For erectile dysfunction, only focused shockwave technology has been tested and validated in randomized controlled trials. We use focused shockwave exclusively for ED treatment.
How soon will I see results?
Neovascularization — the growth of new blood vessels that drives improvement — takes time. Most men notice meaningful improvement 4–8 weeks after completing their 6-session course. Some respond earlier. The full effect is typically assessed at 2–3 months post-treatment.
What if shockwave doesn’t work for me?
Approximately 25–50% of men do not achieve their desired outcome from a single course of shockwave therapy. If that’s the case, we discuss next steps honestly — whether a second course with adjusted parameters, combination approaches, or referral to a urologist for medication management or other interventions. We don’t keep treating what isn’t working.
Can I use shockwave therapy alongside Viagra or Cialis?
Yes. Many men continue oral medications during and after shockwave therapy. The goal for many patients is to reduce medication dependence over time — using shockwave to restore the vascular capacity that medications can then work with more effectively. This is not a binary choice.
Take the First Step
Ready to Learn If You’re a Candidate?
A consultation takes 20–30 minutes. We’ll review your history, answer your questions without pressure, and give you an honest assessment of whether F-ESWT is right for you.