Can Massage Help Erectile Dysfunction?

The 2025 European Association of Urology (EAU) Guidelines on Sexual and Reproductive Health do not recognize or recommend massage as an effective treatment option for erectile dysfunction (ED)¹. The guidelines provide a comprehensive overview of evidence-based treatments for ED, categorizing them into first-line, second-line, and third-line options based on invasiveness and efficacy, but massage therapy is not included among these recognized interventions². First-line treatments recommended by the EAU Guidelines include lifestyle modifications, addressing modifiable risk factors, and oral medications such as phosphodiesterase type 5 inhibitors (PDE5Is)³. These oral medications remain the standard first-line therapy for most men with ED due to their proven efficacy, ease of use, and favorable safety profile when properly prescribed⁴. For patients who do not respond to first-line treatments, the guidelines recommend second-line options including vacuum erection devices and various forms of intracavernosal injections⁵. These treatments have demonstrated efficacy in clinical trials and are supported by the guidelines for appropriate patients, particualarly those who cannot take or do not respond to oral medications⁶. Third-line treatments, recommended when other options have failed, include penile prosthesis implantation⁷. The EAU Guidelines recognize three types of penile implants: malleable (semi-rigid), two-piece inflatable, and three-piece inflatable prostheses⁸. These surgical interventions have high satisfaction rates (up to 90-95%) among properly selected patients and their partners⁹. Other emerging therapies mentioned in the guidelines include low-intensity shockwave therapy and platelet-rich plasma injections, though these are still considered investigational with varying levels of evidence supporting their use¹⁰. However, even among these experimental approaches, massage is not mentioned or supported by any evidence in the guidelines¹¹. It’s important for patients experiencing erectile dysfunction to consult with healthcare providers who can recommend appropriate, evidence-based treatments according to their specific situation rather than pursuing unproven interventions like massage that lack scientific support in the authoritative guidelines¹².