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P-Shot vs Shockwave vs ED Pills: Which Option Fits You?

PRP (P-Shot), shockwave therapy and ED medications work in very different ways. Here's how they compare, and why many men combine them.
P-Shot vs shockwave: couple in trench coats at a New York crosswalk

Medically reviewed by Anand Thakkar, MD, MSCP. Last updated: September 29, 2026.

P-Shot vs shockwave vs pills: men often ask us which one is right. The honest answer depends on what is causing your erectile dysfunction (ED). Many men do well with a mix.

For details on PRP, see our P Shot Chicago page.

P-Shot vs Shockwave vs Pills: Quick Comparison

ED pills (PDE5 inhibitors) Shockwave therapy PRP (P-Shot)
How it works Improves blood flow when you’re aroused Low-intensity sound waves to penile tissue Growth factors from your own blood, injected
FDA status for ED FDA-approved Not FDA-approved for ED Not FDA-approved for ED
AUA view Recommended treatment option Investigational Experimental
When it works 30 to 60 minutes, on demand Builds over weeks to months Builds over weeks to months
Commitment Ongoing doses A series of sessions One treatment or a series

Source: American Urological Association ED guideline.1

ED Medications: The Evidence-Based First Step

Sildenafil (Viagra) and tadalafil (Cialis) have the strongest evidence of any ED treatment. The AUA lists them as a standard option.1

They don’t suit everyone. Some men get headaches or flushing. They can’t be taken with nitrate heart medicines.

When Pills Aren't Enough

Other options include compounded combinations, PT-141 and penile injections such as Trimix. See PT-141 and compounded ED medications and Trimix and Quad Mix injections.

Shockwave Therapy for ED

Low-intensity shockwave therapy sends sound waves into penile tissue. It’s sometimes sold under brand names such as GAINSWave®. The goal is new blood vessel growth and better blood flow. Evidence: A 2025 review of 12 sham-controlled trials (882 men with vascular ED) found better erectile function with shockwave than with sham treatment.2 Guidelines are more cautious. The AUA calls it investigational.1 European guidelines see weak evidence, mainly in mild vascular ED.3 Sessions are quick and need no needles.
P-Shot vs shockwave therapy for ED: smiling couple relaxing on a yacht

PRP (P-Shot)

A PRP penile injection, often called the P-Shot or Priapus Shot, uses platelet rich plasma from your own blood. At Bliss MD, Dr. Thakkar injects it with ultrasound guidance.

Evidence: Mixed. One trial found meaningful improvement in 69% of men on PRP versus 27% on placebo at six months.4 Another found no difference from placebo.5 The AUA considers PRP experimental.1 Many of our patients report firmer erections, but results vary. See P Shot benefits.

For some men, we also discuss exosomes and stem cells. See regenerative ED treatment.

Can You Combine Them?

Yes, and many men do. PRP and shockwave both aim at tissue and blood flow. A pill can work on demand while those changes build. Treating low testosterone or thyroid problems supports the whole plan.

At Bliss MD, the P Shot cost is typically $1,000 to $2,500 per treatment. Combination plans are priced separately. See P Shot cost near me: Chicago pricing.

P-Shot vs Shockwave or Both? What Combination Research Shows

Many Chicago clinics sell PRP and shockwave together. Only one placebo-controlled trial has tested the combination directly, so it’s worth knowing what it found.

The COCKTAIL trial at the University of Miami studied 59 men with ED. Half had five weekly shockwave sessions plus PRP at weeks 1 and 5. The rest had sham shockwave and saline injections.6 Neither group had serious side effects. At six months, erectile function scores improved by similar amounts in both groups. Early results presented to the American Urological Association also found no significant difference from placebo.7

That doesn’t mean combinations never help. It means the P-Shot vs shockwave decision, or a combination, should rest on your cause of ED, not a package deal. Learn how P Shot Chicago treatment works.

What a Shockwave Course Looks Like at Bliss MD

Shockwave therapy is offered at both Bliss MD clinics: Lincoln Park and our Schaumburg-area clinic in Hanover Park. A typical course is a series of short sessions over several weeks. See our shockwave therapy page. No needles or numbing are needed, and most men return to normal activities right away. We set your exact session plan at your first visit.

Don't Skip the Work-Up

ED can be an early sign of heart disease, diabetes or a hormone problem. We check:

  • Hormones: testosterone, DHEA, estrogen, cortisol, thyroid and growth hormone markers. See low testosterone and ED and low testosterone symptoms.
  • Metabolic health: blood sugar, lipids, weight and blood pressure
  • Lifestyle and mind: alcohol, sleep, exercise, stress and anxiety

Options include hormone replacement therapy and testosterone pellets.

How to Choose an ED Clinic in Chicago

Whether you’re weighing the P-Shot vs shockwave, or pills alone, ask any clinic these questions:

  • Who examines me? Look for a physician who reviews heart health, hormones and medications first.
  • Do you offer more than one treatment? A clinic with a single option may steer every man to it.
  • Do you use ultrasound? Imaging helps guide injections and assess blood flow. We offer penile Doppler ultrasound in-office at both clinics, especially when premature ejaculation or venous leak (“leaking”) is a concern.
  • What does the price include? Ask for a written quote covering the visit, labs and each session or injection. See our P Shot cost guide.
  • What does the evidence say? A good clinic tells you PRP and shockwave are not FDA-approved for ED, as the AUA guideline reflects.

At Bliss MD, you can compare all three options in one visit at our Lincoln Park clinic or our Schaumburg-area clinic in Hanover Park.

ED treatment options: confident man in a suit viewing the city

Why Bliss MD

  • One physician, many tools, including ultrasound-guided PRP
  • Board-certified internist since 2011, plus A4M/ABAARM board certified
  • Clinics in Lincoln Park and our Schaumburg-area clinic in Hanover Park

Frequently Asked Questions

Neither is right for everyone. Your cause of ED and your goals guide the choice.

Pills work within about an hour. PRP changes, if they happen, take weeks to months.

Yes. We check your heart health and medications first.

Some men need them less. Never stop a prescribed medicine without talking to your doctor.

If you’ve searched “P Shot near me” or “Priapus Shot near me,” you may have found clinics with only one option. Our Priapus Shot Chicago patients can compare all three in one visit, in Lincoln Park or at our Schaumburg-area clinic in Hanover Park.

It depends on the protocol and your response. When we compare P-Shot vs shockwave for you, we explain the plan and set the schedule at your first visit. Shockwave is available at both clinics.

Usually not, because neither is FDA-approved for ED. We provide itemized receipts. Ask your HSA or FSA administrator whether they qualify.

Begin Your Men's Health Journey Today

Find the Right Mix for You

Serving Chicago and the Northwest Suburbs

Bliss MD – Lincoln Park: 2707 N Halsted St, Chicago, IL 60614 Phone: (630) 289-0440 Get directions
Bliss MD – Hanover Park: 1802 Irving Park Rd, Hanover Park, IL 60133 Phone: (630) 289-0440 Get directions

References

  1. American Urological Association. Erectile Dysfunction Guideline. https://www.auanet.org/guidelines-and-quality/guidelines/erectile-dysfunction-(ed)-guideline
  2. Fatima K, et al. Shockwave therapy for ED: updated meta-analysis. 2025. https://www.tandfonline.com/doi/full/10.1080/20565623.2025.2511438
  3. European Association of Urology. Sexual and Reproductive Health Guidelines. 2024. https://uroweb.org/guidelines/sexual-and-reproductive-health
  4. Poulios E, et al. J Sex Med. 2021. https://pubmed.ncbi.nlm.nih.gov/33906807/
  5. Masterson TA, et al. J Urol. 2023. https://pubmed.ncbi.nlm.nih.gov/37120727/
  6. ClinicalTrials.gov. Shockwave Therapy and Platelet Rich Plasma for the Treatment of Erectile Dysfunction (COCKTAIL), NCT05048667. University of Miami. Results posted May 2026. https://clinicaltrials.gov/study/NCT05048667
  7. Interim results abstract, Journal of Urology (AUA Annual Meeting). https://www.auajournals.org/doi/10.1097/01.JU.0001015816.87470.c9.10

For educational purposes only. PRP and shockwave therapy are not FDA-approved for erectile dysfunction, and results vary. Please consult a licensed physician before starting treatment.

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