Treatment category · 2 treatments · Non-surgical · No injections
Energy-based treatments
for men’s sexual health
Non-surgical therapies using acoustic wave and radiofrequency energy to stimulate tissue response, improve blood flow, and support erectile function — without injections, surgery, or significant downtime.
Energy-based treatments are the only category on PhallusMD where no injections or foreign materials are involved. Shockwave therapy has the strongest clinical evidence of any non-surgical ED treatment on this site. Apex RF is an emerging option with more limited published data.
Overview
What are energy-based treatments?
Energy-based treatments use technologies — acoustic waves or radiofrequency energy — to stimulate a biological response in penile tissue below the surface. Unlike injections or medications, nothing is introduced into the body. The energy itself triggers the tissue response.
In the case of shockwave therapy, acoustic waves create controlled microtrauma in penile tissue — stimulating the body’s natural repair response, promoting new blood vessel formation, and improving vascular health over time.
These treatments are most often considered for men experiencing:
Mild to moderate erectile dysfunction
Reduced penile blood flow or vascular ED
Decreased erection firmness or quality
Poor or declining response to oral ED medications
Age-related changes in sexual performance
Men seeking non-invasive options before considering injections
Shockwave therapy (LiSWT) has the most clinical evidence of any non-surgical ED treatment on this site — including multiple randomized controlled trials and guideline-level recognition from the European Association of Urology for men with vasculogenic ED.
The EAU notes that low-intensity shockwave therapy may provide mild improvement in erectile function in men with blood flow–related ED. The key word is “mild” — results vary by patient and protocol.
Apex RF is less studied at guideline level. Most evidence supporting RF for sexual health comes from smaller studies and clinical experience rather than large randomized trials.
Current evidence does not support shockwave therapy for reducing penile curvature in Peyronie’s disease, despite some marketing claims. Energy-based treatments are also not effective for all causes of ED — proper diagnosis of the underlying cause is essential before choosing any therapy.
Treatments in this category
Two energy-based options
Click either card to read the full treatment page — mechanism, evidence, protocol, and what to expect.
Shockwave Therapy (LiSWT)
Low-intensity extracorporeal shockwave therapy uses acoustic waves to stimulate new blood vessel formation and improve vascular health in penile tissue. The most clinically studied non-surgical ED treatment available.
Apex RF™
Radiofrequency-based treatment using controlled thermal energy to support tissue remodeling, circulation, and penile tissue responsiveness. Less studied than shockwave at guideline level — emerging clinical interest.
How they compare
Shockwave vs. Apex RF vs. other approaches
Understanding where energy-based treatments fit relative to other options helps clarify when they are most appropriate.
| Feature | Shockwave (LiSWT) | Apex RF™ | PRP (P-Shot®) | ED Medications |
|---|---|---|---|---|
| Mechanism | Acoustic wave — vascular repair | Radiofrequency — thermal tissue remodeling | Growth factor delivery | Temporary blood flow increase |
| Invasiveness | Non-invasive — no injections | Non-invasive — no injections | Injection-based | Oral or injectable |
| Evidence in ED | Strongest non-surgical evidence | Emerging — less studied | Moderate — investigational | Established first-line treatment |
| Guideline recognition | EAU — mild improvement in vasculogenic ED | Not yet guideline-level | Investigational | First-line ED treatment |
| Addresses root cause? | Yes — vascular repair | Potentially — tissue remodeling | Partially — regenerative | No — symptom management |
| Downtime | None | None | Minimal | None |
| Sessions required | Typically 6–12 sessions | Protocol varies by provider | 1–2 injections, periodic maintenance | As needed |
Combination approaches
Energy-based treatments combined with other therapies
Some providers combine energy-based treatments with regenerative therapies as part of a comprehensive men’s sexual health plan. This is an emerging area — not yet standard care, but with growing clinical interest.
The most commonly combined approach
Shockwave therapy primes the vascular environment while PRP delivers growth factors to the same tissue — theoretically a synergistic combination. Early studies suggest potential improvement in erectile function scores beyond either treatment alone.
This combination is still considered emerging and requires more large-scale evidence before being considered standard protocol.
Common questions
Frequently asked questions
Are energy-based treatments FDA-approved for ED?
Most shockwave devices are FDA-cleared for musculoskeletal uses, but their use for erectile dysfunction is typically off-label in the US. Some devices have approvals outside the US specifically for ED. Apex RF devices may have separate FDA clearances. Use for ED is legal and common — but patients should understand it is off-label use in most cases.
How many shockwave sessions are needed?
Most shockwave protocols involve 6–12 sessions over several weeks, typically 2 sessions per week. Protocols vary between providers and devices. Some men see improvement after a full course; others require maintenance sessions. Your provider will recommend a protocol based on your response.
Can these treatments replace Viagra or Cialis?
Not necessarily — but for some men they may reduce reliance on medications or improve medication response. ED medications address symptoms temporarily. Shockwave therapy aims to address underlying vascular health. Some men use both — shockwave to work on root causes while continuing medication as needed during the treatment period.
Does shockwave therapy work for Peyronie’s disease?
Current evidence does not support shockwave therapy for reducing penile curvature in Peyronie’s disease, despite some marketing claims to the contrary. Shockwave may be used alongside other Peyronie’s treatments in some clinical settings, but patients should be cautious of providers claiming it specifically treats curvature. Discuss realistic options with a urologist.
What is GAINSWave® and how does it differ from shockwave therapy?
GAINSWave® is a branded marketing protocol for acoustic wave therapy — it uses shockwave technology. The brand name does not refer to a unique device or mechanism. Shockwave therapy performed under the GAINSWave® brand uses the same underlying acoustic wave technology as other shockwave treatments. Results depend more on device quality, protocol, and provider experience than the brand name.
Is there downtime after shockwave or Apex RF?
No significant downtime. Both treatments are performed in-office and most men return to normal daily activity immediately. Some mild temporary sensitivity in the treated area is possible. Neither treatment requires recovery time the way injection-based or surgical procedures do.
Find an energy-based treatment provider
Search our directory of vetted physicians offering shockwave therapy and Apex RF — or join the forum to hear from men who have been through these treatments.
PhallusMD is an informational resource and does not provide medical advice, diagnosis, or treatment recommendations. Content is prepared with clinical input but does not substitute for consultation with a licensed physician. Use of shockwave therapy and radiofrequency devices for ED is typically off-label in the US. Evidence assessments reflect published literature and guideline guidance as of 2026.