Shockwave Therapy Side Effects: What to Expect

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Key takeaways

• Shockwave therapy side effects are typically mild: bruising, tenderness, and minor swelling that resolve quickly.
• It uses acoustic waves to stimulate blood vessel growth over 6–12 sessions, aiming to improve spontaneous erections.
• Not routinely available on NHS; most provision is private and costs several hundred to over a thousand pounds.
• Oral ED tablets remain first-line treatment: licensed, well-studied, and available from £0.45 per tablet.
• Discuss all options with your GP to identify underlying causes and choose the safest, most effective treatment.

What Is Shockwave Therapy for Erectile Dysfunction?

Low-intensity shockwave therapy (Li-SWT) is a non-invasive treatment that delivers gentle acoustic waves to penile tissue. The sound waves are thought to trigger a process called neovascularisation—the formation of new blood vessels—and may improve blood flow to the penis. Unlike oral tablets such as sildenafil or tadalafil, which work on-demand to help achieve an erection when sexually aroused, shockwave therapy aims to address the underlying vascular cause of erectile dysfunction over a course of several sessions.

A typical course involves 6–12 sessions, each lasting around 15–20 minutes, usually spread over several weeks. The device applies low-energy pulses to different areas of the penis and sometimes the perineum. Shockwave therapy is not currently licensed as a medicine in the UK, and most provision is through private clinics. It is not routinely available on the NHS, and clinical guidelines do not yet recommend it as a standard treatment because more high-quality research is needed to confirm long-term effectiveness.

Common Shockwave Therapy Side Effects and Safety

The most frequently reported shockwave therapy side effects are mild and temporary. These include bruising or redness at the treatment site, a tingling or warm sensation during the session, minor swelling, and short-lived discomfort or tenderness in the treated area. Most men find the procedure tolerable without anaesthesia, though some clinics offer a numbing cream if needed. Serious adverse events are rare in published studies, and the treatment does not involve surgery, needles, or medication entering the bloodstream.

Because shockwave therapy is a relatively new approach for erectile dysfunction, long-term safety data are still being gathered. It is important to choose a reputable clinic with trained practitioners and to discuss your full medical history beforehand. Men with certain conditions—such as blood clotting disorders, active infections in the genital area, or those taking anticoagulant medicines—may not be suitable candidates. Always inform the provider of any current medications or health concerns before starting treatment.

Who Should Avoid Shockwave Therapy?

Shockwave therapy may not be suitable for everyone. It is generally not recommended for men with bleeding disorders, those taking blood-thinning medicines (such as warfarin or rivaroxaban), or anyone with an active infection or skin condition in the treatment area. Men with penile implants or anatomical abnormalities should discuss suitability with a specialist. If you have a pacemaker or other implanted electronic device, inform the clinic, as some protocols advise caution. As with any treatment, a thorough assessment by a qualified healthcare professional is essential to ensure shockwave therapy is safe and appropriate for your individual circumstances.

At a glance

How Effective Is Shockwave Therapy for ED?

Evidence for shockwave therapy is still evolving. Some clinical trials have reported improvements in erectile function scores and spontaneous erections in men with mild to moderate vascular erectile dysfunction, particularly those who respond partially to oral tablets. However, study quality varies, and results have been inconsistent. The European Association of Urology guidelines note that while Li-SWT shows promise, more robust, long-term studies are needed before it can be recommended as a standard treatment [8].

Shockwave therapy appears to work best for men whose ED has a clear vascular cause—such as reduced blood flow due to age, diabetes, or cardiovascular risk factors—and who have some residual natural erectile function. It is less likely to help men with severe ED, nerve damage (for example, after prostate surgery), or psychological causes. Response rates and duration of benefit vary widely between individuals, and some men may need repeat courses to maintain any improvement. It is not a guaranteed cure, and many men continue to use oral ED tablets alongside or after shockwave therapy.

Shockwave Therapy Side Effects vs Tablet Side Effects

When comparing shockwave therapy side effects with those of oral ED tablets, the profiles are quite different. Shockwave therapy's side effects are localised and mechanical—bruising, tenderness, or mild discomfort at the treatment site—and typically resolve within a few days. Oral PDE5 inhibitors such as sildenafil, tadalafil, vardenafil, and avanafil can cause systemic side effects including headache, flushing, indigestion, nasal congestion, and visual disturbances, though most men tolerate them well [3][4][5][6].

Tablets work on-demand and require sexual stimulation to be effective; shockwave therapy aims to improve spontaneous function over time but requires multiple clinic visits and does not produce immediate results. Tablets have decades of safety data and are licensed, regulated treatments available on prescription after a clinical assessment. Shockwave therapy is not licensed as a medicine, is not widely available on the NHS, and evidence for long-term benefit is still being established. For most men, oral tablets remain the first-line treatment recommended by UK clinical guidelines [2].

Can You Use Shockwave Therapy and Tablets Together?

Yes, shockwave therapy and oral ED tablets can be used together, and some men choose to do so. There is no known interaction between the two approaches, as they work by different mechanisms. Some clinics recommend continuing your usual tablet during a shockwave therapy course, then reassessing whether you can reduce the dose or frequency afterwards. Always discuss your treatment plan with both your prescriber and the shockwave therapy provider to ensure a coordinated, safe approach. Do not stop or change any prescribed medicine without professional advice.

NHS Availability and Cost of Shockwave Therapy

Shockwave therapy for erectile dysfunction is not routinely available on the NHS. It is considered an emerging treatment, and NICE (the National Institute for Health and Care Excellence) has not issued guidance recommending its use in standard practice. Most provision is through private clinics, and costs vary widely—typically ranging from several hundred to over a thousand pounds for a full course of sessions. Because it is not an NHS-funded treatment, you will need to pay privately if you wish to try it.

In contrast, some oral ED tablets are available on NHS prescription for men with certain medical conditions (such as diabetes, prostate cancer treatment, or severe distress), though many men obtain them privately. At Cured Pharmacy, prescription ED tablets are available after an online consultation with a UK-registered prescriber, with prices starting from as little as £0.45 per tablet for generic sildenafil. This makes tablets a more accessible and evidence-based option for most men. If you are considering shockwave therapy, it is worth discussing all available treatments—including tablets—with your GP or a specialist to make an informed choice.

How Shockwave Therapy Compares with Other Non-Tablet Treatments

Shockwave therapy is one of several non-tablet options for erectile dysfunction. Other alternatives include vacuum erection devices (VEDs), which use negative pressure to draw blood into the penis and are held in place with a constriction ring; alprostadil treatments (Vitaros cream applied to the urethra, or Caverject injections into the penis), which work by dilating blood vessels locally [7]; and topical gels such as Eroxon, a medical device available without prescription that uses a cooling-then-warming effect to stimulate blood flow.

Each approach has different side effects, convenience, and suitability. VEDs can cause bruising and require practice; alprostadil can cause penile pain, prolonged erection (priapism), or urethral discomfort; Eroxon may cause mild irritation. Shockwave therapy side effects are generally limited to temporary bruising and discomfort, with no systemic effects, but it requires multiple clinic visits and is not yet supported by robust long-term evidence. For men who cannot take tablets due to contraindications (such as nitrate use for angina), these non-tablet options—including shockwave therapy—may be worth exploring with a healthcare professional. However, for most men, oral PDE5 inhibitors remain the most convenient, well-studied, and effective first-line treatment [2][8].

What to Discuss with Your Doctor Before Trying Shockwave Therapy

Before starting shockwave therapy, arrange a consultation with your GP or a specialist to discuss your erectile dysfunction. It is important to identify any underlying causes—such as cardiovascular disease, diabetes, low testosterone, or psychological factors—as treating these can improve ED and overall health [1]. Your doctor can review your current medications, assess whether you are a suitable candidate for shockwave therapy, and explain all available treatment options, including tablets, injections, devices, and lifestyle changes. If you decide to proceed with shockwave therapy, choose a reputable clinic, ask about the practitioner's training and experience, and ensure you understand the costs, expected number of sessions, and realistic outcomes. Keep your GP informed of any private treatments you undertake.

When to get urgent help

• Erection lasting more than 4 hours (priapism) – go to A&E immediately
• Sudden loss of vision or hearing after any ED treatment – seek urgent medical help
• Chest pain during sexual activity – stop and call 999
• Severe bruising, swelling, or pain after shockwave therapy that worsens or does not improve – contact the clinic or your GP
• Signs of infection at the treatment site (redness, warmth, discharge) – see your GP the same day

Call 999 or go to A&E in an emergency, or contact NHS 111 for urgent advice.