How Long Does Shockwave Therapy for Erectile Dysfunction Last?

How Long Can the Effects of Shockwave Therapy for ED Last?

A shockwave therapy session for erectile dysfunction usually takes around 15–20 minutes, while a treatment course involves multiple sessions. If you mean how long the benefits last, there is no fixed answer. Some men who respond to low-intensity shockwave therapy maintain improvement for months and, in some studies, one to two years. However, response varies and may reduce over time. Shockwave therapy should not be described as a permanent cure for erectile dysfunction.

This is one of the most common questions men ask before starting shockwave therapy:

“If it works, how long will it last?”

The answer depends on the individual.

Low-intensity extracorporeal shockwave therapy – often abbreviated to Li-ESWT or LiSWT – has been studied as a treatment for erectile dysfunction, particularly where vascular factors contribute to the problem.

Research suggests that improvement can persist after the treatment course has finished.

A systematic review examining longer-term outcomes found improvements at six months across several studies. Among studies that followed patients to 12 months, erectile function generally remained above baseline, although some showed deterioration after the six-month point.

A separate long-term study followed men who had initially responded successfully to shockwave therapy. At two years, approximately half of those initial responders still maintained the defined treatment benefit. Men with milder ED without diabetes appeared more likely to maintain their response than men with more severe disease.

Another longer-term study found improvements at one and two years, with the treatment effect declining between years two and three. That study was relatively small, however, so its results should not be interpreted as a guarantee of how long treatment will work for an individual patient.

The practical answer is therefore:

For some responders, improvement may continue for months or longer, but the effect can diminish and not every patient responds in the first place.

Is Shockwave Therapy a Permanent Cure for Erectile Dysfunction?

The aim of Li-ESWT is different from simply producing an erection at a particular moment. It has been investigated as a treatment intended to influence erectile function, particularly in men with vascular-related ED.

But erectile dysfunction can be influenced by ongoing factors including:

• diabetes;
• cardiovascular disease;
• high cholesterol;
• smoking;
• obesity and metabolic health;
• hormonal abnormalities;
• medication;
• neurological conditions;
• psychological factors; and
• progression of vascular disease.

If the underlying factors affecting erectile function continue or worsen, improvement following treatment may also change over time.

This is one reason MDC believes ED treatment should be considered as part of a wider men’s health and andrology assessment, rather than treating the penis in isolation.

When Do You Start Seeing Results from Shockwave Therapy?

Shockwave therapy is not designed to work like Viagra or Cialis.

Sildenafil (Viagra) and tadalafil (Cialis) are PDE5 inhibitors that support erectile response when used appropriately. Shockwave therapy is delivered as a course of treatment, and any improvement may develop during or following that course.

Studies assess response at different time points, including one, three, six and 12 months, which makes it difficult to give every patient a universal timetable.

The 2025 Cochrane review included 21 randomised controlled trials involving 1,357 men. It found that LiSWT may have a small effect on erectile function in the short term and may improve erectile function over longer follow-up. However, the certainty of the evidence was rated low because of limitations and substantial differences between studies.

So, a patient should not assume: “I had one session yesterday, so I should know today whether it worked.” Response needs to be assessed over an appropriate period.

How Many Shockwave Therapy Sessions Do You Need for ED?

Shockwave therapy for ED is generally delivered as a course rather than as a single treatment.

However, there is no universally established treatment protocol that can be applied to every man.

Research studies have used different:

• numbers of sessions;
• treatment frequencies;
• numbers of shockwave pulses;
• energy settings;
• devices; and
• treatment schedules.

This variability is important.

A 2026 systematic review of randomised controlled trials found that treatment frequency and the number of pulses across a course were associated with treatment response, but the authors concluded that the available evidence does not establish the superiority of one specific treatment regimen.

At Marylebone Diagnostic Centre, the appropriate treatment pathway should therefore be determined according to the patient’s assessment and clinical circumstances rather than promising that one fixed number of sessions works for everybody.

What Determines How Long the Results Last?

There probably isn’t one factor. Research suggests that severity of erectile dysfunction, age, diabetes, response to PDE5 inhibitors and other health factors may influence outcomes, although findings between studies are not completely consistent. In practice, several areas are worth considering.

Severity of Erectile Dysfunction

A man with mild vasculogenic ED is clinically different from someone with severe, longstanding erectile dysfunction. Long-term research has suggested that men with milder ED may maintain improvement for longer than those with severe disease.

Diabetes and Metabolic Health

Diabetes can affect blood vessels and nerves involved in erectile function.

In one long-term study, men with severe ED and diabetes were less likely to maintain the initial benefit of shockwave therapy over two years.

Cardiovascular Health

Erections depend heavily on vascular function.

Blood pressure, cholesterol, smoking, weight and cardiovascular disease can therefore be relevant when assessing ED.

Hormonal Health

Low testosterone and other hormonal abnormalities may contribute to sexual symptoms in selected patients.

That does not mean every man with ED has a testosterone problem, but appropriate hormonal investigation can sometimes be useful.

The Cause of the ED

Shockwave therapy has primarily been investigated for vasculogenic erectile dysfunction.

If the erection problem is predominantly caused by another factor, simply continuing shockwave sessions may not address the main problem.

Should I Keep Having Shockwave Sessions to Maintain the Result?

Yes, most of our patients are advised to maintain regular sessions over the years.

The better question is:

Has your erectile function actually improved, and what is happening now?

If treatment has worked but erectile function later deteriorates, it may be appropriate to reassess the patient rather than automatically selling another course.

Is There Any Downside to Shockwave Therapy?

No

The 2025 Cochrane review found little to no difference in treatment-related adverse events between LiSWT and sham treatment, but the certainty of the evidence was low.

A newer 2026 meta-analysis found improvements in certain erectile-function scores but no significant improvement across several other functional and penile vascular outcomes. The authors concluded that the clinical relevance may be limited for many patients.

This is why patients should be cautious about claims such as:

“Guaranteed results”

“Permanent cure”

or

“Works for every type of ED.”

Those claims go beyond what current evidence can support.

What Is the Strongest Treatment for Erectile Dysfunction?

There is no single strongest treatment for every man with erectile dysfunction.

Treatment depends on the underlying cause, severity of symptoms, other health conditions, medication, previous treatment response and patient preference.

Options can include:

• management of lifestyle and cardiovascular risk factors;
• PDE5 inhibitors such as sildenafil (Viagra) or tadalafil (Cialis);
• psychological or psychosexual intervention where appropriate;
• vacuum erection devices;
• Intracavernosal injections;
• low-intensity shockwave therapy for selected patients; and
• penile prosthesis surgery for appropriately selected men with more severe or treatment-resistant ED.

What is causing my erection problem and which treatment is most appropriate for me?

That is the question an appropriate ED assessment should help answer.

Is Shockwave Therapy Better Than Viagra or Cialis?

They are different treatments and should not be compared simply as stronger versus weaker.

Viagra and Cialis are brand names for sildenafil and tadalafil. Both belong to a group of medicines known as PDE5 inhibitors. Our urologist advises patients to take these medications alongside Shockwave Therapy. They help support the erectile response when used appropriately.

Shockwave therapy is different. Li-ESWT is delivered over a treatment course and has been investigated as an approach to improving erectile function rather than producing an immediate medication-assisted erection. Some men receiving shockwave therapy may still use PDE5 inhibitors.

Patients should not stop or change prescribed medication simply because they are undergoing shockwave therapy. Medication decisions should be discussed with the prescribing clinician.

Can Shockwave Therapy Work If Viagra or Cialis Doesn’t?

It may be considered in selected men who respond poorly to PDE5 inhibitors, but poor response to Viagra or Cialis does not automatically mean shockwave therapy will work.

There are several reasons ED medication may appear ineffective.

These can include how the medication is taken, dose and timing, the severity or cause of ED, hormonal factors and other health conditions.

Research has investigated Li-ESWT in PDE5 inhibitor non-responders. One study found that some responders-maintained improvement at 12 months, but this should not be interpreted as evidence that the treatment works for every medication non-responder. A proper assessment remains important.

How Much Does Shockwave Therapy for Erectile Dysfunction Cost in the UK?

The cost of shockwave therapy for ED varies between UK clinics and depends partly on the number of sessions and treatment pathway offered.

Price alone is not necessarily the best way to compare providers.

Before paying for treatment, patients should understand:

• who is assessing their erectile dysfunction;
• whether the treatment is clinically appropriate for them;
• what type of shockwave therapy is being offered;
• what treatment protocol is being used;
• how response will be assessed;
• whether further investigation is available;
• whether specialist urology/andrology review is accessible; and
• what happens if treatment does not work.

At Marylebone Diagnostic Centre, patients can start with a £50 erectile dysfunction assessment to discuss their symptoms and determine the appropriate next step. This cost will be removed from the treatment. Where appropriate, MDC can coordinate blood testing, specialist urology/andrology assessment and shockwave therapy.

What If Shockwave Therapy Doesn’t Work?

This is an important question – and one that should be discussed before treatment begins.

If there has been little or no improvement, simply repeating sessions indefinitely may not be the most useful approach.

The patient may benefit from reassessment of:

the original diagnosis

vascular and cardiovascular risk

diabetes and metabolic health

testosterone or other hormones where indicated

current ED medication

psychological or relationship factors

other urological conditions

alternative ED treatments

Specialist urology or andrology assessment may also be appropriate.

Should I See a Urologist or Andrologist for Erectile Dysfunction?

Yes, specialist urology or andrology assessment can be appropriate when ED is persistent, complex, associated with other symptoms, or not responding as expected to treatment.

You do not necessarily need to decide for yourself whether you need a specialist before contacting MDC. We will guide you and if need be, we will connect you with our Urologist.

Our pathway is designed to help determine the appropriate next step.

The MDC Approach to Shockwave Therapy

At Marylebone Diagnostic Centre, we do not want shockwave therapy to become:

Session 1 → Session 2 → Session 3 → keep paying for more sessions

without considering whether the patient is actually improving.

Instead, our approach is:

1. Understand the erection problem

Patients can start with a £50 erectile dysfunction assessment at MDC in Baker Street.

2. Investigate where appropriate

Depending on symptoms and medical history, this may include relevant hormonal, cardiovascular or metabolic blood testing.

3. Specialist assessment when required

MDC can coordinate referral through our urology and andrology pathway.

4. Shockwave therapy when appropriate

If Li-ESWT is considered suitable, treatment can be arranged through MDC.

5. Review the response

We want to understand whether erectile function is actually changing rather than simply counting completed sessions.

6. Decide what happens next

That may mean follow-up, further investigation, specialist review or another treatment strategy.

Assessment → Investigation → Specialist input → Appropriate treatment → Review → Next step

How Do We Know Whether Shockwave Therapy Is Working?

A patient saying “I think it’s a little better” is useful, but treatment response can also be assessed more systematically.

Clinical research commonly uses validated measures such as the International Index of Erectile Function (IIEF) and Erection Hardness Score (EHS) to assess changes in erectile function.

This matters because a statistically measurable change does not always mean that a patient experiences a meaningful improvement in everyday sexual function.

Indeed, recent evidence reviews have highlighted exactly this distinction.

Common Questions About Shockwave Therapy for ED

How long does each shockwave therapy session take?

An ED shockwave session is generally a relatively short outpatient treatment, often around 15–35 minutes, although the exact appointment duration can depend on the protocol and provider.

How long do the results last?

There is no guaranteed duration. Some responders maintain improvement for months or longer, while the effect can diminish with time. Studies have reported persistent benefit in some men at one and two years, but results vary substantially.

Does shockwave therapy permanently cure ED?

No. Current evidence does not justify describing Li-ESWT as a guaranteed permanent cure.

How many sessions will I need?

Li-ESWT is generally delivered as a treatment course, but research uses different schedules and there is no single universally superior regimen established by current evidence.

Is there any downside to shockwave therapy?

Trials suggest a low rate of treatment-related adverse events, but response varies and some men may experience little or no clinically meaningful improvement.

What is the strongest treatment for ED?

There isn’t one treatment that is strongest for everybody. Treatment should reflect the cause and severity of ED, overall health, previous response and patient preference.

Can I take Cialis or Viagra while having shockwave therapy?

Some clinical pathways combine Li-ESWT with PDE5 inhibitors. Do not start, stop or alter prescribed ED medication without discussing it with the appropriate clinician.

How much does shockwave therapy for ED cost in the UK?

Prices vary between providers and according to the treatment course. Patients should also compare the clinical assessment, technology, protocol, medical oversight and follow-up included rather than comparing only the price per session.

Considering Shockwave Therapy in London?

If you have erectile dysfunction and are unsure whether shockwave therapy is appropriate — or you previously received treatment and want to understand what should happen next — MDC can help you start with an assessment.

£50 Erectile Dysfunction Assessment

At Marylebone Diagnostic Centre in Baker Street, we can discuss your symptoms, previous treatment, medication and relevant health factors.

Where appropriate, the pathway can then include:

Blood testing

Urology/andrology referral

Shockwave therapy

Follow-up assessment

Further investigation or treatment

The objective is not simply to provide shockwave sessions.

It is to determine an appropriate pathway for your erectile dysfunction.

Book a £50 ED Assessment – Book Now

Learn About Shockwave Therapy for ED in London

Visit the MDC Urology & Andrology Service

MDC Clinical Insight

At MDC, we believe the response to shockwave therapy should be reviewed rather than simply continuing sessions indefinitely. Erectile dysfunction can have vascular, metabolic, hormonal, psychological and other contributors. If improvement is limited or later declines, reassessment, appropriate blood testing or specialist urology/andrology review may be more useful than automatically repeating treatment.

Common questions

How long do the effects of shockwave therapy for erectile dysfunction last?

There is no fixed duration. Some men who respond to low-intensity shockwave therapy maintain improvement for months, and in some studies, one to two years. However, response varies considerably between individuals and may reduce over time. Shockwave therapy should not be described as a permanent cure for erectile dysfunction.

Is shockwave therapy a permanent cure for erectile dysfunction?

No. Current evidence does not justify describing shockwave therapy as a guaranteed permanent cure. Erectile dysfunction can be influenced by ongoing factors including diabetes, cardiovascular disease, smoking, obesity, hormonal abnormalities, medication, and psychological factors. If underlying factors continue or worsen, improvement following treatment may also change over time.

When do you start seeing results from shockwave therapy for ED?

Shockwave therapy is not designed to work immediately like Viagra or Cialis. It is delivered as a course of treatment, and any improvement may develop during or following that course. Studies assess response at different time points, including one, three, six and 12 months. Response needs to be assessed over an appropriate period.

How many shockwave therapy sessions do you need for erectile dysfunction?

Shockwave therapy is generally delivered as a course rather than a single treatment. However, there is no universally established protocol. Research studies have used different numbers of sessions, treatment frequencies, pulse numbers, energy settings and schedules. The appropriate treatment pathway should be determined according to individual assessment and clinical circumstances.

Can shockwave therapy work if Viagra or Cialis doesn’t work?

It may be considered in selected men who respond poorly to PDE5 inhibitors, but poor response does not automatically mean shockwave therapy will work. Research has investigated shockwave therapy in PDE5 inhibitor non-responders, with some maintaining improvement at 12 months, but this should not be interpreted as evidence the treatment works for every medication non-responder.

Are there any side effects or downsides to shockwave therapy for ED?

The 2025 Cochrane review found little to no difference in treatment-related adverse events between shockwave therapy and sham treatment, although the certainty of evidence was low. However, response varies and some men may experience little or no clinically meaningful improvement. Not every patient responds to treatment.

Is shockwave therapy better than Viagra or Cialis for erectile dysfunction?

They are different treatments and should not be compared simply as stronger versus weaker. Viagra and Cialis are PDE5 inhibitors that help support erectile response when used appropriately. Shockwave therapy is delivered over a treatment course and has been investigated as an approach to improving erectile function rather than producing an immediate medication-assisted erection.

What factors affect how long shockwave therapy results last?

Research suggests several factors may influence outcomes, including severity of erectile dysfunction, age, diabetes, response to PDE5 inhibitors and other health factors. Studies suggest men with milder ED may maintain improvement for longer than those with severe disease. Men with severe ED and diabetes were less likely to maintain initial benefit over two years in one study.

How long does a shockwave therapy session take?

A shockwave therapy session for erectile dysfunction is generally a relatively short outpatient treatment, often around 15–35 minutes, although the exact appointment duration can depend on the protocol and provider used.

Can I take Viagra or Cialis while having shockwave therapy?

Some clinical pathways combine shockwave therapy with PDE5 inhibitors. The article advises patients not to stop or change prescribed medication simply because they are undergoing shockwave therapy. Medication decisions should be discussed with the prescribing clinician.

Written by Mr Tharb Faisl
Writer / Scientist

Medically reviewed by Mr Giulio Garaffa
Consultant Urological Surgeon

Last medically reviewed: 12 September 2026