What Researchers Did
Researchers conducted a network meta-analysis of 31 randomized controlled trials (1,874 participants) comparing five non-drug treatments for erectile dysfunction: electrical stimulation (ES), exercise, low-intensity shockwave therapy, acupuncture, and HBOT.
What They Found
Electrical stimulation combined with exercise produced the greatest improvement in erectile function scores (mean difference: 6.81 points on the IIEF-5 scale, 95% CI: 3.50–10.12), ranked first with 98.1% probability. Electrical stimulation alone also showed significant gains (mean difference: 2.86). HBOT ranked lower than ES-based therapies and shockwave treatment in overall efficacy for erectile dysfunction.
What This Means for Canadian Patients
Erectile dysfunction affects an estimated 3 million Canadian men, and many do not respond adequately to medications. This review suggests that for Canadians seeking non-drug options, electrical stimulation combined with exercise is currently the most evidence-supported approach. HBOT was included in the analysis but was not among the top-ranked treatments for this condition.
Canadian Relevance
No direct Canadian connection identified. Erectile dysfunction is not a currently approved OHIP-covered indication for HBOT in Ontario.
Study Limitations
Evidence quality ranged from low to high across studies, and most individual trials were small; the low-to-moderate evidence for HBOT specifically means its true ranking among non-drug ED therapies remains uncertain.