Does Shockwave Therapy Work for All Types of ED?
If you’ve been reading about shockwave therapy (ESWT), you’ve probably seen impressive claims, things like “reverse ED naturally” or “get your performance back in weeks.”
And while shockwave therapy can be genuinely life-changing, the truth is:
👉 It doesn’t work for everyone.
Understanding why comes down to knowing what’s actually causing your erectile dysfunction. There are several different types - and some respond far better to shockwave therapy than others.
Let’s break it down in simple terms.
1. Vascular ED: The Best Candidate for Shockwave Therapy
This is the group that benefits most from focused shockwave therapy.
Vascular erectile dysfunction happens when there isn’t enough blood flow reaching the penis, or when blood leaks out too quickly. Over time, the tiny blood vessels inside the erectile tissue become stiff, narrow, or damaged - often due to ageing, high blood pressure, cholesterol, or diabetes.
How shockwave therapy helps:
Focused shockwave therapy sends gentle acoustic waves into the erectile tissue, triggering a process called angiogenesis, the growth of new blood vessels and improved circulation.
That means better oxygen delivery, stronger erections, and in many cases, the return of natural function without relying on pills.
In short:
✅ Best results seen in men with mild to moderate vascular ED.
✅ Works by repairing blood flow and vessel health.
✅ Improvements often last months to years with maintenance.
2. Psychological ED: When the Mind Gets in the Way
For some men, erections work perfectly well physically, but stress, anxiety, or fear of failure block the mental side of arousal.
You might get morning erections or have no issue when alone, but lose confidence with a partner. That’s psychological ED, and it’s surprisingly common.
How shockwave therapy helps:
In truth, it doesn’t directly fix psychological ED, because the issue isn’t with blood flow.
However, it can still play an indirect role. If low-level vascular issues are contributing, improving circulation can restore confidence, which helps break the anxiety cycle.
But for men whose ED is purely mental, therapy, coaching, or relationship support will have a far bigger impact than any machine.
In short:
⚖️ Shockwave can help if there’s a vascular component.
💬 Mindset work is essential for lasting results.
3. Neurogenic ED: When the Nerves Are Damaged
This type of ED occurs when the nerves that trigger an erection are damaged or disrupted.
That can happen after spinal cord injury, pelvic trauma, prostate surgery, or conditions like multiple sclerosis or Parkinson’s disease.
How shockwave therapy helps:
Shockwave therapy primarily targets blood vessels, not nerves. However, early research suggests it may help stimulate mild nerve repair or improve the health of surrounding tissues.
That said, if the nerve damage is severe or complete, results are likely to be limited.
In short:
⚡ May help mild nerve-related ED.
🚫 Not a reliable solution for significant neurological injury.
4. Post-Surgery ED: After Prostate or Pelvic Surgery
After prostate surgery (especially radical prostatectomy), many men experience ED because the nerves and vessels around the prostate and penis are disrupted.
How shockwave therapy helps:
If nerve pathways are mostly intact, shockwave can aid rehabilitation by improving blood supply to the recovering tissue and reducing scarring.
It’s not an instant fix, but can support the healing process alongside other therapies like vacuum pumps, pelvic rehab, or medication.
In short:
🩺 Useful as part of a recovery plan.
🕓 Works best once tissues have healed and nerve function begins to return.
5. Diabetes-Related ED: A Complex Combination
Diabetes can cause ED through multiple pathways:
Damage to small blood vessels (vascular).
Nerve damage (neuropathy).
Hormonal changes.
Reduced nitric oxide production (which affects arousal).
How shockwave therapy helps:
It can improve the vascular side of diabetic ED, helping blood flow and sensitivity, but it can’t reverse advanced nerve damage or hormonal issues.
That’s why men with diabetes often need a combined approach:
Shockwave therapy, blood sugar control, exercise, and sometimes medication.
In short:
✅ Can improve function if circulation is the main issue.
⚠️ Limited results if nerve damage is severe or blood sugar is poorly managed.
So… Who Gets the Best Results?
Men who:
Still have some natural erectile response (even if weak).
Have vascular risk factors like high cholesterol or mild diabetes.
Don’t rely entirely on pills for every erection.
Are motivated to improve their overall health and circulation.
Those are the men who tend to see meaningful, lasting improvements with focused shockwave therapy.
Who Might Need More Than Shockwave Alone?
Men with complete ED or severe nerve damage.
Those with uncontrolled diabetes or low testosterone.
Men whose main barrier is stress, anxiety, or relationship pressure.
In these cases, a multifactorial plan, combining medical treatment, hormone support, exercise, and mindset work, is the most effective route forward.
The Takeaway: The Right Treatment for the Right Type of ED
Shockwave therapy is a proven, evidence-backed option for vascular ED, but it’s not a universal cure.
Think of it like physiotherapy for the blood vessels:
it works best when those vessels are weak, not when the nerves or hormones are missing altogether.
The smartest thing you can do is get assessed first, understand whether your ED is vascular, psychological, neurogenic, or diabetic in origin. Once you know that, you can choose the right solution and stop guessing.
Because real progress starts with understanding your body, not chasing promises.
Download our free ED info pack here.