Somewhere in your research you will hit a page with a percentage on it. A big one, in a big font, usually next to the word proven. It will not say which study, how many men were in it, what device they used, what settings, or how long anyone was followed up for. It will just sit there being reassuring.
We do not have that page. Not because we are being coy, and not because there is no research. There is a reasonable amount of research. It is that the research does not support the sentence that page is trying to make.
Here is what it does and does not support.
What is actually being studied
Low-intensity shockwave is an energy device. A handheld applicator passes acoustic pressure waves through the skin into the tissue underneath. It is mechanical, not electrical, and nothing is injected or cut. In the context men care about, the studies look at erectile function: whether men who have a course score differently afterwards on standard questionnaires than men who do not.
That is the first thing worth understanding. Most of this literature measures a questionnaire score. Not an image, not a lab value. A man answering questions about his own experience, before the course and afterwards, which is both the most relevant thing to measure and one of the hardest to measure cleanly.
Why the studies do not add up to a promise
- The trials are smallMost are tens of men, not thousands. Small trials swing. A handful of unusually good or unusually poor responders moves the average in a way that would vanish in a larger group, and you cannot tell from the outside which way it moved.
- The devices are not the same deviceFocused, radial, linear, different manufacturers, different energy densities. These get bundled together under the single word shockwave in summaries and in marketing, and they are not interchangeable. A result from one machine is not automatically a result from another.
- The protocols are not the same protocolNumber of sessions, spacing, number of pulses, where on the anatomy, whether anything else was given alongside. Vary those and you have varied the treatment, which makes pooling the results across studies a much shakier exercise than a summary line suggests.
- The follow-up is usually shortA lot of the work reports at a few months. Where longer follow-up exists, differences have a tendency to narrow. Any claim about durability that goes beyond the length of the study is somebody’s opinion wearing a lab coat.
- The comparison is hard to run honestlyThe proper comparison is a sham: the same appointment, the same device, the same noise, no actual energy. It is difficult to do convincingly, expensive, and not every study does it. Without it, you are partly measuring the effect of being taken seriously for half an hour, which is real but is not the device.
- The good news travels furtherStudies that find something get published, cited and quoted in marketing. Studies that find nothing quietly do not. That skew exists across all of medicine and there is no reason to think this corner is exempt. It also means industry-funded work needs reading with an eye on who paid.
An average is a statement about a group. You are not a group.
The part nobody puts in an advert
Even in the studies that report a difference, the difference is not spread evenly. Some men in the treated group change a lot, some change a little, some do not change at all. The headline figure is the average of those men, and the average is a statement about the group. You are not a group. You are one man, and no trial published anywhere can tell you in advance which of those three you will turn out to be.
That is not us hedging. That is the honest limit of what this evidence base is capable of saying about an individual, and any clinic that talks past it is telling you something the research did not tell them.
So why do we offer it
Because non-invasive and reversible-by-doing-nothing is a genuinely reasonable place for a man to start, and because there is enough in the literature to make it a serious option rather than a gimmick. Nothing is cut. Nothing is injected. If it does nothing for you, you have not altered anything about yourself in the process.
What we will not do is dress that up as a certainty. Our shockwave page says in plain type that the evidence is not settled and that we hold no proof of outcome for you specifically. That sentence is on the page on purpose, and it stays there.
What we do instead of a number
We review as the course runs. If nothing is changing for you, we say so and we stop, rather than selling you another block of sessions on the strength of an average somebody else produced.
How to read the next page you land on
- If there is a percentage, look for the study behind it. If the study is not named, treat the percentage as decoration.
- Check whether the device in the study is the device in the room. Often it is not.
- Check the follow-up window, then notice whether the claim is bigger than the window.
- Look for the word sham. Its absence is not fatal, but its presence tells you somebody was trying.
- Ask who funded it. Not as an accusation. As basic reading.
- Ask the clinic directly what proportion of their own men get nothing out of it. Watch whether the number exists.
None of this is a reason not to look into it. It is a reason to be sceptical of anybody who has already made your mind up for you, ourselves included. Read our page, ask the awkward version of every question on it, and decide with your eyes open.