Low-intensity shockwave therapy for ED in Taichung: who it may suit

In short

• Who it may suit: mainly mild to moderate ED caused by blood vessel problems (vascular ED). The device used here is approved in Taiwan for vascular erectile dysfunction.
• First visit: history, a sexual function questionnaire, erection hardness grading, a physical examination and blood tests, on the same day. Allow 30–60 minutes. If there is no contraindication and conditions allow, the first session can be done that day.
• Sessions: done in person by a urologist, outside the body, with no anaesthesia, about 15–20 minutes each. Usually once a week, generally 6–12 sessions.
• Results: any effect builds up slowly. Men who respond usually notice it 1–3 months after the course. Not everyone responds, and the effect may become weaker over time.
• Costs: self-paid. Costs are explained at the consultation. You can also ask about costs on LINE before you come.

Is it right for me? First, find the cause

An erection needs blood vessels, nerves, hormones and the mind to work together. Each type of ED is treated differently:

• Vascular: the most common type, linked to high blood pressure, high blood fats, diabetes, smoking and metabolic syndrome. Most shockwave studies focus on this type.
• Hormonal: low testosterone, or thyroid or prolactin problems, often with low sex drive and tiredness. Only a blood test, usually in the morning, can confirm it. One low result is not enough: there should be symptoms and a second early-morning fasting test on another day. If low testosterone is confirmed, treating it first is usually more useful than going straight to shockwave therapy.
• Nerve-related: diabetic nerve damage, spine or pelvic surgery, or injury to the perineum (the area between the scrotum and the anus). This type usually responds less to shockwave therapy.
• Caused by medicines: for example finasteride and dutasteride (for hair loss and an enlarged prostate), antidepressants (especially SSRIs), some blood pressure medicines, some anti-androgen and antipsychotic medicines, and long-term heavy drinking. Talk to the prescribing doctor before changing any medicine. Do not stop it on your own.
• Psychological and relationship factors: anxiety, depression, poor sleep, relationship stress. This is more likely if morning erections are normal and problems happen only in certain situations.

Shockwave evidence comes mainly from vascular ED. There is no matching evidence for ED caused by medicines or psychological factors, so we do not advise going straight to shockwave therapy for these types.

Tablets “do not seem to work”? Often the dose is wrong, sex starts too soon, the meal was large or high in fat, or there was not enough sexual stimulation. The European Association of Urology (EAU) also says wrong use is an important reason. Untreated blood sugar, blood pressure or hormone problems can also be the cause. We check these first.

Shockwave therapy at this clinic

• Device: STORZ Medical (Switzerland) DUOLITH SD1 T-TOP, Ministry of Health and Welfare licence 衛部醫器輸字第 031091 號. For ED we use focused, electromagnetic shockwaves. Its approved indications are listed under risks below.
• Who: urologists in person, Dr. Chao-An Chen or Dr. Kai-Wu Yang. You can choose when you book. Non-medical staff do not operate the device.
• Where: a private treatment room on the third floor.
• How many: usually once a week, generally 6 to 12 sessions, adjusted to your response. You do not decide the number at the start, and more sessions do not mean a better effect. The energy and number of pulses are set after the assessment and explained before the course.

The process

1. Assessment: erections, morning erections, sex drive, ejaculation and orgasm, response to tablets. Questionnaires (IIEF-5 / SHIM) and the Erection Hardness Score (EHS) measure severity, as the EAU recommends. As needed: blood pressure, BMI and waist, blood sugar or HbA1c, blood fats, early-morning total testosterone, your medicines and heart risk.
2. Choosing treatment: lifestyle changes → oral medicine → shockwave therapy → medicine plus shockwave → other treatments.
3. Sessions: focused low-intensity shockwaves are applied to different areas of the penis through a coupling gel. Most people feel only light tapping; a few find it uncomfortable. Usually no recovery time is needed. The doctor tells you whether you can have sex that day.
4. Review: morning erections, firmness, keeping the erection, successful intercourse, and need for tablets, compared with your first-visit scores using the same questionnaire. If the effect is not enough, the doctor reviews the cause again or adds other treatment.

This clinic also offers a freeze-dried platelet product, given only with a shockwave course. Its evidence is at a different level from shockwave therapy.

No clear problem, but you want shockwave “maintenance”?

You are welcome to come and talk. “Maintenance” describes why you come. It is not an effect of shockwave therapy. Changes can be measured: the IIEF-5 maximum is 25; 22–25 is normal; 21 or lower meets the grading for ED (17–21 is mild). On the EHS, grade 4 is fully hard and grade 3 is hard enough for penetration but not fully hard. The score uses the last six months of sexual activity; without sex it does not apply. If you have ED that the doctor judges vascular, it is within the device’s approved indication.

If you still want it, the first visit measures a baseline and checks contraindications and medicines (especially anticoagulants). You can then arrange a single session or a weekly course.

What it is, and tablets or shockwave?

A shockwave is a focused acoustic pressure wave. It is not radiation and not an electric current. The energy is lower than the shockwaves used to break kidney stones, and the aim is to stimulate the erectile tissue and its blood vessels, not to destroy tissue. Changes in blood vessel growth factor (VEGF), nitric oxide pathways and small-vessel density were seen mostly in animal and laboratory studies.

Oral PDE5 inhibitors act within tens of minutes to a few hours, and remain the standard first-line medicine for ED (a strong EAU recommendation). Shockwave therapy is not “take it tonight, works tonight”: it is a course, judged gradually afterwards, and the right course and long-term effect are still debated.

• Need an effect tonight or on a trip: a doctor’s prescription.
• Tablets work, but you do not want to depend on them: shockwave therapy, or a daily low-dose tablet, can be discussed.
• Tablets work, but not reliably: check how you take them, then discuss combining.
• Tablets do not work at all: do not assume you need more shockwave. Reassess the cause. Injections into the penis and a vacuum erection device are other options. We also offer botulinum toxin injection, which is off-label; the doctor first explains that the evidence is not enough, and the risks.

The guideline: the EAU gives a weak recommendation for shockwave therapy, with or without PDE5 inhibitors, after the expected effects and limits are fully explained, in men with mild vascular ED, men who do not want or cannot use oral medicines, and men with vascular ED who respond poorly to PDE5 inhibitors. Improvement in studies is mild, and machines and courses differ a lot. The EAU also strongly recommends lifestyle and risk-factor changes before or with ED treatment.

Are all “shockwave machines” the same?

No. Focused shockwaves concentrate energy at a set depth; they are made electromagnetically, electrohydraulically or piezoelectrically, and settings cannot be converted between devices. Our device’s treatment head is electromagnetic with a parabolic reflector, and its energy density can be set from 0.01 to 0.55 mJ/mm² (approved product information). These are device settings, not results. Radial pressure waves spread from the surface and weaken with depth.

The Sexual Medicine Society of North America (SMSNA) warns that radial devices are often marketed for ED, but results for focused shockwaves cannot be applied to them. In one randomised, sham-controlled trial (Sandoval-Salinas et al., 2022), 80 men with moderate ED, all taking a daily low-dose PDE5 inhibitor, had a 6-week course. IIEF-EF scores changed by 3.4 with radial waves and 4.2 with sham treatment: no difference. One small, short trial does not prove they do not work, but their evidence is not yet as strong as for focused shockwaves.

How long until it works?

• Sessions 1–2: you may feel no change.
• During the course: some notice clearer morning erections and steadier firmness.
• About 1–3 months after: for some, the main improvement may appear.
• Longer term: results differ, and the effect may slowly weaken.

The EAU review says improvement may then decline, although some studies still saw part of the effect at 5 years. Most trials followed patients for 1 to 12 months; data beyond one year are very limited, so no one can say the effect lasts a set number of years. Results depend on age, ED severity, diabetes control, smoking, weight, blood fats, blood vessels and testosterone.

Can I stop tablets afterwards? Not necessarily. Some need less medicine, some do well with shockwave plus tablets, and some see no clear change and need reassessment.

Side effects, contraindications and risks

Short-term tolerance is generally good and serious problems are rare, but most studies are small and long-term follow-up is limited. You may feel tapping or vibration, brief local discomfort, or, in a few people, mild pain or a skin reaction. Discomfort usually settles within a few hours. You may also see no improvement.

Side effects in the approved product information: swelling, redness, haematoma (a collection of blood) or bruising, and pain at the treatment site; skin changes in people who used corticosteroids before. These usually settle within about 5 to 10 days.

Approved use: in Taiwan this device is approved in urology for vascular erectile dysfunction, chronic pelvic pain syndrome / chronic non-bacterial prostatitis, and Peyronie’s disease. ED not caused by blood vessels, and men without ED, are outside the approved indications. The EAU guideline (2026 edition) gives a weak recommendation for certain groups, with mild improvement in studies.

Coming from outside Taichung

The assessment and blood tests are done at the first visit, and the first session can be the same day if the doctor agrees and conditions allow. Follow-up blood tests are done at a treatment visit, so they add no trips. A review visit follows the course. The course must be completed here; another clinic cannot continue it. Book the whole course at the first visit and confirm times on LINE. You can usually leave on your own after each session.

The approved product information recommends, for vascular ED, 6 sessions in total, 2 a week, with a one-week interval. In practice we usually arrange 6 to 12 sessions, once a week. The doctor adjusts this for each person and explains it before the course starts.

Bring: a list of all your medicines (especially anticoagulants, antiplatelet and heart medicines) and recent reports for blood sugar, blood fats and blood pressure. When you book, tell us about any implanted electronic device, or a wound, infection or tumour history at the treatment area.

Frequently asked questions

Honest limits

• Not all ED comes from blood vessels.
• It does not replace checks for diabetes, blood pressure, blood fats, testosterone and heart risk.
• It should never be promised as a permanent cure, as permanent regrowth of blood vessels, or as something that always works.

The arteries of the penis are only about 1–2 mm wide, narrower than the heart’s coronary arteries, so weaker erections can be an early sign of blood vessel damage. This does not mean everyone with ED will have heart disease, but it is why we check blood pressure, blood sugar and blood fats.

Related pages

• Low testosterone (male menopause): blood tests and assessment
• Vacuum erection devices for ED
• Premature ejaculation: assessment and treatment
• Your first shockwave therapy visit
• Injections into the penis for ED: evidence and limits (Chinese)
• Shockwave therapy for chronic pelvic pain / chronic prostatitis

Appointments and access

Consultations are conducted in Mandarin, and can also be conducted in English.

On LINE, describe your situation, chronic diseases and current medicines. We reply with how the first visit works and available times.

昭安泌尿科診所 (Morning Urology Clinic)
No. 98, Boguan 2nd St., West District, Taichung City 403, Taiwan（403 臺中市西區博館二街98號）
Consulting hours: Monday to Saturday (closed Sunday). Online booking is open 24 hours.

This page was produced by 昭安泌尿科診所 (Morning Urology Clinic). Medical content last updated: October 2026 (same as the Traditional Chinese version). English version published: 5 November 2026. Medically reviewed by Dr. Chao-An Chen, urologist.

Sources: EAU Guidelines on Sexual and Reproductive Health: Management of Erectile Dysfunction, 2026 / You CH, et al. J Sex Med, 2026 / Liu JL, et al. SMSNA position statement, Sex Med, 2021 / Chung E, et al. Asia-Pacific Society for Sexual Medicine position statement, World J Mens Health, 2021 / Sandoval-Salinas C, et al. J Sex Med, 2022;19(5):738. Device content follows the Chinese product information approved by the Ministry of Health and Welfare.

This page provides general medical information and does not replace an individual diagnosis or treatment plan. Indications, contraindications, risks and costs are decided at a consultation with a doctor.