Difficulty getting or keeping an erection
ED may involve blood vessels, medications, nerves, stress or several factors together.
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Men’s Sexual Wellness • Discreet Evaluation
When erections become less reliable, it can affect confidence and relationships. You deserve a respectful medical conversation that looks beyond the symptom. At Cleveland Health Center, we evaluate possible causes and discuss treatments—including emerging low-intensity shock wave approaches for selected men.
Care in The Villages and Wildwood, welcoming patients from across Florida, the U.S. and internationally. Treatment location confirmed when scheduling.
Understanding your options
Low-intensity extracorporeal shock wave therapy (Li-ESWT) uses acoustic pulses applied externally. It is being studied as a possible way to improve erectile function, particularly for men whose ED is related to blood-flow problems.
Evidence is mixed: some trials show modest improvements, while a 2025 Cochrane review found low-certainty evidence and uncertain clinical importance. The AUA still describes this treatment as investigational; European guidelines provide a weak recommendation for selected men with mild vasculogenic ED.
This is not a guaranteed cure, not a replacement for cardiac-risk evaluation and not the same as standard shock wave treatment for heel or tendon pain.
Concerns we evaluate
The right treatment starts with identifying the condition—not simply matching a symptom to a device or product.
ED may involve blood vessels, medications, nerves, stress or several factors together.
A focused history and evaluation can help determine whether vascular factors contribute.
Review dosage, timing, contraindications and other treatments before considering new technologies.
ED can be an early sign of vascular disease and deserves cardiovascular risk review.
Shock waves may help pain in selected cases but should not be promoted to straighten curvature or shrink plaque.
The treatment explained
During a treatment session, an applicator delivers low-intensity acoustic pulses to selected areas without an incision. The exact device and energy protocol matter. The proposed goal is to influence local vascular responses, but improvement is not assured.
Focused shock waves, radial pressure waves and other acoustic devices should not be described as clinically interchangeable. Patients should know exactly which technology is being used and what evidence applies to that device.
What to expect
Review onset, severity, morning erections, medications, chronic conditions and preferences.
Consider vascular, metabolic, hormonal and psychological factors and cardiovascular risk.
Discuss lifestyle measures, oral medications, vacuum devices, injection medicines or referral as appropriate.
If Li-ESWT is considered, discuss investigational status, costs, number of visits, side effects and how outcomes will be assessed.
Your health comes first
A good consultation includes the choice not to pursue a procedure. We review established options, medical care and referrals whenever appropriate.
Common first-line therapy for eligible men; review interactions and contraindications.
Address blood pressure, diabetes, weight, smoking and activity as appropriate.
A non-drug option for selected patients.
May be considered when other treatments are unsuitable or insufficient.
Why Cleveland Health Center
Sexual and pelvic health questions are personal. Our team takes the time to review your medical history, goals, treatment options and safety considerations.
Our practice is led by Florian Gegaj, MD, an ABIM board-certified internal medicine physician. We welcome patients from The Villages, Wildwood, across Florida and beyond.
Meet Florian Gegaj, MD, founder of Cleveland Health Center and an ABIM board-certified internal medicine physician.
Medical evaluation, thoughtful counseling, and coordinated care are central to our approach.
Your questions, answered
Do not assume that shock wave device clearance for another application constitutes FDA approval for ED. Li-ESWT for ED is considered investigational by the American Urological Association.
Some evidence suggests selected men with mild vascular-related ED may experience a modest benefit, but an individual outcome cannot be predicted.
Shock wave therapy should not be used with the expectation of reducing curvature or plaque size. It may be discussed for pain in selected cases.
There is no universally established protocol; the actual device, published research and individualized plan must be reviewed.
Sometimes clinicians discuss combination care, but the benefits of adding shock waves are not established for everyone.
Continue exploring
Educational information only. Individual treatments are based on a clinical assessment, and results vary. Do not change prescribed medication without professional advice.
These concerns may overlap with sexual wellness, but they deserve their own evaluation. Learn more about our separate Urinary Incontinence & Pelvic Floor Therapy service and BTL EMSELLA treatment.