Hyperbaric Oxygen Therapy and Erectile Dysfunction: Reviewing the Research

Important: Hyperbaric oxygen therapy is not FDA-approved for erectile dysfunction, and it is not a UHMS-listed indication. This is an investigational use. The evidence is preliminary. Insurance will not cover HBOT for this condition. All costs are out-of-pocket.

A small Israeli study from 2018 reported that men with erectile dysfunction improved after a course of HBOT, and that their penile blood flow increased on imaging. The finding got picked up widely, and clinics that sell hyperbaric packages have used it ever since. The study is real and the result is interesting. It is also one early, uncontrolled trial, and that distinction matters before anyone spends thousands of dollars chasing it.

Where the Interest Came From

Erectile dysfunction is common, and a large share of cases are vascular in origin. When blood flow into the penis is reduced, often from the same arterial disease that affects the heart and the rest of the body, erections become harder to achieve and maintain. That is why first-line treatments target blood flow, and why a therapy that claims to improve circulation draws attention.

HBOT delivers oxygen at increased pressure. In wound-healing contexts, where it is FDA-approved, one of the effects researchers point to is angiogenesis, the formation of new blood vessels. The reasoning behind studying it for erectile dysfunction is straightforward on paper: if repeated oxygen sessions can encourage new vessel growth in damaged tissue, perhaps they could do the same in penile tissue with reduced perfusion.

That is a hypothesis. Plausible biology is the starting point for research, not the end of it, and a mechanism that works in a chronic diabetic wound does not automatically transfer to a different tissue and a different problem.

What the Study Actually Found

Hadanny et al. (2018), published in the International Journal of Impotence Research, studied 30 men with chronic erectile dysfunction attributed to vascular insufficiency. The men were not surgical cases, and they had lived with the problem for roughly four years on average. Each received 40 daily HBOT sessions. The researchers measured erectile function with the International Index of Erectile Function questionnaire and assessed penile blood flow with perfusion MRI before and after the protocol (PMID: 29773856).

The reported results were notable. Scores improved across all questionnaire domains, most patients described a positive outcome, and the MRI showed a substantial increase in penile blood perfusion. The imaging is the part that made the study stand out, because it pointed to a physical change rather than relying only on what men reported about their symptoms.

The design is where caution comes in. There was no control group, and the study was not sham-controlled. That is a serious limitation for any treatment evaluated on a subjective outcome like sexual function, where expectation alone can shift how people answer questionnaires. Without a comparison group receiving a convincing placebo, there is no way to separate a true treatment effect from the placebo response, the natural fluctuation of symptoms over time, or other changes the men made during three months of frequent clinic visits. The sample was also small, from a single center, and has not been replicated in a larger randomized trial. Independent replication has not happened to a degree that would change how this use should be described.

So the honest summary is narrow. One small, uncontrolled study found improvement and a measurable blood-flow change. That is hypothesis-generating research. It is not evidence that HBOT is an effective treatment for erectile dysfunction, and it does not justify the certainty some marketing attaches to it.

What Standard Care Looks Like

For context, erectile dysfunction has well-established treatments with far stronger evidence behind them. Oral PDE5 inhibitors, the drug class that includes sildenafil and tadalafil, are first-line for most men and work for a large share of them. Other options include vacuum erection devices, injectable medications, intraurethral therapy, and, for select cases, surgical implants. Because vascular erectile dysfunction often signals broader cardiovascular disease, a workup can also surface conditions that matter well beyond sexual function.

None of that is medical advice for your situation. The point is that men considering HBOT are usually weighing it against treatments that have decades of controlled-trial support, and that comparison belongs in the conversation. Your care team, ideally including a urologist, is the right place to have it.

Cost and the Marketing Around It

Because erectile dysfunction is not an FDA-approved or UHMS-listed indication, no insurer will cover HBOT for it. The cost falls entirely on the patient. At roughly $250-450 per session, a 40-session protocol like the one in the study runs in the range of $10,000-18,000 out-of-pocket. Rates change and vary by facility, so confirm any figure with the clinic’s billing team before committing.

This is a heavily marketed corner of the wellness world, and the 2018 study gets cited as if it settled the question. It did not. Be skeptical of any clinic that presents a single uncontrolled trial as proof, quotes the improvement percentages without mentioning the lack of a control group, or implies that results are typical or assured. The same caution applies here that applies to any off-label HBOT use worth considering carefully before paying out of pocket. If a provider is making confident outcome claims about erectile dysfunction, the evidence does not back that confidence.

Frequently Asked Questions

Is HBOT a proven treatment for erectile dysfunction? No. The available evidence is a single small study without a control group. That is preliminary research, not proof. It has not led to FDA approval, UHMS listing, or insurance coverage for this use.

How many sessions did the study use? The Hadanny et al. (2018) protocol involved 40 daily HBOT sessions. At typical clinic rates of $250-450 per session, that is roughly $10,000-18,000, paid out-of-pocket.

Does HBOT increase blood flow to the penis? The 2018 study reported increased penile perfusion on MRI after the protocol. Because the study had no control group, it cannot establish that HBOT caused the change rather than other factors. The angiogenesis hypothesis, that high-pressure oxygen may encourage new blood vessel growth, is discussed further in the how HBOT works guide, but its role in erectile function specifically is not established.

Should I try HBOT before standard erectile dysfunction treatments? That decision belongs to you and your care team, ideally including a urologist. The established treatments for erectile dysfunction have far more controlled-trial evidence behind them than HBOT does for this use.

References

Hadanny, A. et al. (2018). Hyperbaric oxygen can induce angiogenesis and recover erectile function. International Journal of Impotence Research. PMID: 29773856. https://pubmed.ncbi.nlm.nih.gov/29773856/

The Undersea and Hyperbaric Medical Society (UHMS) lists the accepted indications for hyperbaric oxygen therapy. Erectile dysfunction is not among them. https://www.uhms.org/

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Medical Disclaimer: This page is for informational purposes only. It does not constitute medical advice, diagnosis, or treatment. Always consult a qualified healthcare provider before pursuing any medical treatment.