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Erectile dysfunction

What is it?

Erectile dysfunction (ED) is a common problem affecting men of all ages. It means difficulty getting or keeping erection that is firm enough for satisfying sexual activity.

Research suggests that up to 50% men will experience ED at some point of their lives. It becomes more common with age, but it can affect men at any stage of adulthood.

What causes ED?

ED can be linked to both physical and psychological factors, including:

Physical causes- cardio-vascular problems, diabetes, high blood pressure, high chlesterol, obesity, smoking, vaping, alcohol and drugs use, hormonal changes, nerve damage, side effects from illnesses or treatment

Psychological causes- stress, anxiety, depression, relationship diffculties, performance worries

When should I start seeking treatment for ED?

You should consider seeking treatment if:

It happens regularly (more than just a one-off due to stress, fatigue, or alcohol).
It affects your relationship, self-confidence, or quality of life.
It lasts longer than 2 months.
You notice other symptoms such as low libido, fatigue, chest pain, or difficulty exercising (which could signal heart or hormone issues).

Why timing matters

ED can sometimes be an early warning sign of conditions like high blood pressure, diabetes, heart disease, or low testosterone.
The sooner you check it, the sooner underlying causes (if any) can be managed.
Treatments (lifestyle, medication, shockwave therapy, devices) are more effective when started early rather than waiting until the condition worsens.

First step

See a GP or urologist. They’ll do a health check, blood tests if needed, and discuss options (lifestyle changes, shockwave therapy, medication , counseling if stress/psychological).

Shockwave therapy for erectile dysfunction

How does it work?

The principle

Focused shockwave therapy uses targeted acoustic waves delivered to the penile tissue. These waves are not painful or destructive- instead, they create tiny mechanical stresses in the tissue that stimulate the body’s natural repair and growth mechanisms.

What it does inside the body

Improves blood vessel health
- The waves trigger neovascularisation (growth of new small blood vessels).
- This improves blood flow into the penis, which is essential for achieving and maintaining erections.
Stimulates cell activity
- Encourages release of growth factors and stem cell recruitment in the treated area.
- Supports tissue regeneration in erectile tissue (corpora cavernosa).
Breaks down micro-plaque
- Shockwaves may help reduce micro-plaque build-up in penile blood vessels, improving circulation.
Nerve and sensitivity effects
- Some studies suggest enhanced nerve regeneration, which may improve penile sensitivity.

Expected outcomes

Best suited for: Men with vasculogenic ED (erections affected by reduced penile blood flow).
Not a quick fix: Usually delivered in a course of sessions (e.g., 6–12 over several weeks).
Goal: Restore natural erections, sometimes reducing or removing the need for medication.
Durability: Some studies show benefits lasting 1–2 years, though maintenance may be required.

Limitations

Less effective if ED is due to severe nerve damage, advanced diabetes, prostate surgery, or primarily psychological causes.

What to expect from your first shockwave ED treatment?

At your first appointment, your therapist will begin by reviewing your medical history and discussing your symptoms, lifestyle, and treatment goals. This helps ensure that shockwave therapy is safe and suitable for you. You’ll also have the opportunity to ask any questions before giving your consent.

During the treatment itself, a special gel is applied to the treatment area to help conduct the shockwaves. The handheld Piezowave 2 device is then placed against the penis to deliver focused acoustic waves. The procedure is non-invasive, does not require anaesthetic, and typically takes around 5-10 minutes.

Most men describe the sensation as a series of tapping or pulsing feelings. You may experience some mild discomfort, but it should not be painful. There is no downtime, so you can return to your normal activities straight after your appointment.

Your therapist will also discuss the recommended treatment plan with you- usually a course of several sessions over a few weeks for the best results. As this is a natural, regenerative therapy, improvements may take time and results can vary between individuals.