P-Shot for Erectile Dysfunction: What the Evidence Says

The P-Shot is a brand name for injecting platelet-rich plasma (PRP), prepared from a man’s own blood, into the penis. It is marketed for erectile dysfunction (ED). The American Urological Association (AUA) says PRP for ED “should be considered experimental” and should not be offered outside an approved research study, because reliable evidence of its benefits and risks is not yet available.

This guide explains what the P-Shot is, what urology guidelines say, what the research shows so far, and which treatments for ED are established.

What is the P-Shot?

PRP is made by drawing a small amount of blood and spinning it to concentrate the platelets. In a P-Shot, that concentrate is injected into the erectile tissue of the penis. The theory is that growth factors released by platelets could help repair blood vessels and tissue.

Treatments of this kind are called restorative or regenerative therapies. The Sexual Medicine Society of North America describes them as aiming to reverse the underlying problem rather than only treat the symptoms.

What urology guidelines say about the P-Shot

Two professional bodies have published positions.

The American Urological Association. Its erectile dysfunction guideline states: “For men with ED, platelet-rich plasma (PRP) therapy should be considered experimental.” The panel adds that PRP “should not be offered to men with ED unless it is administered in the context of an IRB-approved experimental clinical research protocol,” and that, given the absence of evidence and the availability of other proven treatments, it is not appropriate outside a research trial. An IRB is an ethics board that oversees clinical studies.

The Sexual Medicine Society of North America (SMSNA). Its 2021 position statement on restorative therapies concludes that, until larger controlled trials are done, these therapies “should be reserved for clinical trials and not offered in routine clinical practice.”

What the research shows so far

The SMSNA statement reviewed the published studies of PRP for ED and found them limited. It notes that no double-blinded, prospective, randomised controlled trial had provided enough evidence to support widespread use, and that larger randomised trials are needed “before any claims about efficacy or safety can be made.”

The studies it describes are small. One treated five men and reported an average improvement of about four points on a standard erectile function questionnaire, with mild pain and bruising and no major side effects. The authors of that study acknowledged its small size and the lack of a placebo group.

In short, early reports are positive, but they are not strong enough to show whether the P-Shot works better than a placebo or how long any effect lasts.

What about size and “male enhancement”?

The P-Shot is also advertised for increasing size. The AUA guideline and the SMSNA statement discuss PRP as a treatment for erectile dysfunction. Neither document covers enlargement, so there is no guideline support for that use.

Established treatments for erectile dysfunction

The AUA guideline says men with ED should be told about these options, with their benefits and risks:

FDA-approved oral medicines known as PDE5 inhibitors;
vacuum erection devices;
alprostadil given into the urethra, or injections into the penis;
penile implant surgery.

It also recommends lifestyle changes, including diet and physical activity, for men whose other health conditions affect erections, and says referral to a mental health professional should be considered.

Why an assessment matters

The AUA says men should be counselled that ED “is a risk marker for underlying cardiovascular disease (CVD) and other health conditions that may warrant evaluation and treatment.” Its guideline calls for a medical, sexual and psychosocial history, a physical examination and selected blood tests, including a morning testosterone level.

That is a reason to see a clinician about ED whatever treatment you are considering.

Questions to ask before a P-Shot

Is this being offered as part of a research study?
Have I been assessed for the causes of my ED, including heart and hormone checks?
Which established treatments have I tried, and why would this be better?
What evidence can you show me, and was it compared with a placebo?
What are the risks, and what follow-up will I have?

Frequently asked questions

Does the P-Shot work for erectile dysfunction?

It has not been shown to. The AUA classes it as experimental, and the SMSNA says it should be reserved for clinical trials until better evidence exists.