Shockwave Therapy (ESWT) for Erectile Dysfunction

What is Extracorporeal Shockwave Therapy (ESWT)?

Extracorporeal Shockwave Therapy (ESWT) is a non-surgical outpatient treatment that delivers low-intensity acoustic waves to the penis. These pulses create controlled mechanical stress that triggers the body’s natural healing cascade, encouraging tissue regeneration and the growth of new micro-blood vessels (neo-angiogenesis). By improving penile blood flow rather than simply masking symptoms, ESWT targets one of the root vascular causes of erectile dysfunction (ED).

How prevalent is Erectile Dysfunction in Singapore?

ED is a common yet often under-recognised condition among men in Singapore. Despite its impact on quality of life, intimate relationships, and psychological well-being, many men are reluctant to seek help due to stigma, embarrassment, or the misconception that ED is a normal part of ageing.

A landmark population-based study surveyed over 700 Singaporean men aged 30 to 70. It found that more than half (51.3%) reported some degree of erectile difficulty. The prevalence of ED increased significantly with age:

• 42.8% of men in their forties experienced ED
• 57.8% in their fifties
• 77.4% in their sixties

This trend suggests a strong association between age and vascular health, one of the leading contributors to ED. However, it is important to note that ED is not solely an issue of ageing. Many men in their 30s and 40s also experience ED due to lifestyle factors, stress, or underlying health conditions such as diabetes or hypertension.

How does Extracorporeal Shockwave Therapy help in treating Erectile Dysfunction?

To achieve an erection, penile arteries and smooth muscle fibres relax, allowing a surge of blood into the corpora cavernosa and corpus spongiosum. When this vascular system is damaged, often by cardiovascular disease, hypertension or atherosclerosis, blood flow is curtailed, and erections weaken.

Low-intensity ESWT targets the vascular injury directly. Acoustic pulses penetrate the shaft, crura and perineal base, triggering several complementary repair pathways:

• Mechanical stress – shockwaves create minute shear forces that cause micro-injuries in the vessel walls. The body responds by activating its healing cycle and laying down fresh, healthy capillaries.

• Microbubble cavitation – rapid pressure changes generate microscopic bubbles. Their collapse disrupts endothelial cells just enough to release potent chemical signals that drive neo-angiogenesis.

• Anti-inflammatory polarisation – ESWT shifts tissue macrophages from the pro-inflammatory M1 phenotype to the regenerative M2 phenotype. M2 cells orchestrate cell proliferation, collagen remodelling and vascular repair.

• Surge in growth factors – animal and human studies show a rise in endothelial nitric-oxide synthase (eNOS), vascular endothelial growth factor (VEGF) and proliferating cell nuclear antigen (PCNA) after treatment. All of which accelerate vessel formation and improve endothelial health.

How effective is Extracorporeal Shockwave Therapy for Erectile Dysfunction?

As interest in non-invasive treatment options grows, ESWT has emerged as a credible solution for ED. Scientific findings continue to show positive results, especially in men with mild to moderate symptoms who are looking to restore natural erectile function.

Some of the evidence is:

• Clinical studies show that ESWT can lead to noticeable improvements in erectile function. In one study, men with blood flow-related ED showed clear improvement 6 months after treatment, while those who did not receive treatment saw no progress. 

• Research also suggests that ESWT works best for men with mild to moderate ED, especially those without serious heart or metabolic conditions like diabetes.

• About 60% of men who undergo ESWT report being able to achieve erections on their own within 6 months. Some men who previously did not respond to ED medications also became more responsive after ESWT, often needing lower doses or no medication at all.

Are there any risks associated with Extracorporeal Shockwave Therapy for Erectile Dysfunction?

Although side effects are uncommon, patients may experience:

• Localised aching, bruising, or redness at the treatment sites
• Spotting of blood in the urine
• Temporary penile swelling or tenderness
• Superficial skin infection, however, very rarely

What can I expect from ESWT Therapy for Erectile Dysfunction?

Each ESWT session is conducted in a comfortable outpatient setting and typically takes 15 to 20 minutes. You will be asked to lie down in a relaxed position. At the same time, a handheld device is applied to targeted areas of the penis and surrounding region, specifically the penile shaft, crura, and perineal base (the area between the scrotum and anus).

A layer of conductive gel is applied to ensure smooth transmission of the acoustic waves. No needles, injections, or anaesthesia are involved. Most men describe the sensation as a mild tapping or tingling, and the procedure is generally well tolerated without significant discomfort.

There is no downtime required. You can resume normal activities, including exercise, work, and sexual activity, the same day. The non-invasive nature of ESWT makes it an ideal option for men seeking a discreet and low-risk treatment for ED.

What results can I expect from the treatment?

Results vary from person to person, but many men notice subtle improvements, such as firmer or more frequent morning erections, within 4 to 6 weeks after starting treatment. These changes are a sign that the blood vessels are beginning to regenerate and blood flow is improving.

Objective improvements, often measured through standardised erectile function questionnaires (IIEF-5), typically become evident within 1 month and continue to build over the following 2 to 3 months as tissue repair and new vessel formation progress.

For many men, these benefits are long-lasting. Clinical studies have shown that results from a full course of ESWT can persist for up to 2 years or more. However, as with most medical treatments, outcomes can vary based on age, overall health, and the severity of the ED. In some cases, top-up or maintenance sessions may be recommended to sustain results over the long term.

If you have previously requested oral ED medications, you may find that your response to these improves, or that you no longer need them at all.

How many ESWT sessions do I need?

A standard course involves 6 sessions, twice weekly for three weeks, followed by a 3-week pause to allow tissue remodelling. Some protocols extend to 12 sessions for severe or long-standing ED.

Why consider ESWT for Erectile Dysfunction at Phoenix Medical?

ED can affect more than just physical performance. It often impacts self-esteem, relationships, and overall quality of life. Seeking help is not a sign of weakness, but a proactive step towards reclaiming your well-being.

At Phoenix Medical Group, we offer low-intensity ESWT as a safe, clinically supported option for men seeking natural and lasting improvement in erectile function, without the need for long-term medication. We:

• Provide discreet, respectful, and non-judgmental care in a private setting.
• Offer a modern, non-invasive ED solution backed by international clinical research.
• Tailor each treatment plan to your specific needs, health profile, and lifestyle goals.
• Combine treatment with holistic men's health support, from screening to lifestyle optimisation.
• Empower you with education and guidance every step of the way, because confidence begins with clarity.

Whether you are exploring alternatives to oral ED medication or seeking a solution that supports long-term vascular health, ESWT offers a promising path forward. Our team is here to support you with professionalism, compassion, and a clear focus on achieving meaningful, lasting results. Take the first step towards restoring natural performance today by booking a confidential consultation and find out if ESWT is right for you.

Frequently Asked Questions

Is the treatment painful?
Most patients find the procedure comfortable. The sensation is often described as light tapping or tingling, and no anaesthesia is required. There may be mild soreness afterwards, but it typically resolves quickly.

How long do the effects of ESWT last?
The benefits of ESWT can last up to 2 years or longer, depending on individual health factors and lifestyle. Maintenance or top-up sessions may be recommended if the erectile function starts to decline again.

Will I still need to take ED medications after ESWT?
Some men may still benefit from taking oral ED medications after treatment, especially during the initial phase. However, many find that their response to medicines improves significantly, and some no longer need them altogether. Our doctor will advise based on your specific condition.

Who is a good candidate for ESWT?
ESWT is most effective for men with mild to moderate erectile dysfunction, particularly those with vascular-related causes. It is also suitable for men who prefer a drug-free, non-surgical option or who have not responded well to oral medications.

When is ESWT not recommended?
ESWT may not be suitable if your ED is caused by nerve damage, severe hormonal imbalances, or structural conditions like Peyronie’s disease. A thorough assessment with our doctor will determine the most appropriate treatment for you.

Are there any side effects or risks?
ESWT is generally well tolerated with minimal side effects. Some men may experience temporary soreness, mild bruising, or minor swelling. Serious complications are rare, and symptoms are usually resolved within a day or 2.

How many sessions will I need?
Most treatment plans involve 6 sessions over 3 weeks, followed by a short rest period. Some men may require up to 12 sessions, depending on the severity of their ED and their treatment response. Our doctor will customise the schedule to suit your needs.