Tech millionaire Bryan Johnson’s anti-aging health regimen, “Project Blueprint,” has become the subject of countless media profiles for its severity. The venture capitalist takes more than a hundred supplements a day, eats only between 6 a.m. and 11 a.m., has experimented with receiving blood-plasma transfusions from his teenage son, and reportedly spends $2 million a year on efforts to optimize his body. He painstakingly documents these routines and their results on social media.

Understandably, people have questions about Johnson’s approach to longevity, from “Can any of this actually turn back the biological clock?” to “Even if it works, is it worth it?” But his latest therapeutic adventure has occasioned even more bewilderment. Johnson is now receiving shockwave treatments that are supposed to enhance his… johnson.

“Started penis rejuvenation protocol today,” Johnson tweeted on Aug. 3, joking, “Coming soon; just not too soon.” In a followup post two weeks later, he clarified that he was trying out focused shockwave therapy, which has shown promise for patients with erectile dysfunction, and “testing whether it improves total time nighttime erections, subjective sexual performance, sexual satisfaction, and medical imaging-based penile markers.” Responding to someone evidently curious about what this meant, he cautioned, “do not put your penis in an electric outlet.” A week ago, he hinted that his forthcoming monthly Blueprint progress report “may require a di[c]k pick.”

Have questions? We did too. So we went to the experts.

Is ‘penis shockwave therapy’ a real thing?

In the age of the biohacking Silicon Valley futurist, the line between “a known science” and “something a guy thinks he invented” is blurry at best. Johnson has already given up on the blood-plasma transfusions from younger people, noting that he derived “no benefits” from them — a sign that he would rather test new boundaries than stick with the established methods of physical renewal available to him.

However, shockwave therapy for your genital health is indeed an expanding practice, one accessible even to those of us who aren’t eccentric tech executives. Stephanie Wolff, a sexual wellness expert, clinician and CEO of the Novus Anti-Aging Center in Los Angeles, tells Rolling Stone that interest in such technology dates back to World War II, when doctors observed that sailors who had survived depth charge attacks on submarines had internal organ damage from explosive sound waves. Researchers studied the effects of gentler shockwaves on human tissue for decades to come, and by the 1980s, physicians were using something called extracorporeal shock wave lithotripsy (ESWL) to pulverize patients’ kidney stones.

Meanwhile, research also began to show that these shockwaves could accelerate healing or regeneration of bone, tendon and soft tissues. In 2010, low-energy shockwaves were used as an experimental treatment for erectile dysfunction and Peyronie’s disease, in which a buildup of scar tissue can deform the penis and lead to pain and erectile disfunction.

But how would that work?

In short, a medical practitioner uses a special wand to administer targeted energy pulses that stimulate a natural response to internal tissue damage. Dr. Rena Malik, a board-certified urologist and pelvic surgeon who offers such therapy at a clinic in Newport Beach, California, explains that this happens in two ways.

“Firstly, shockwaves create direct mechanical stress on the tissues, causing the body to then begin repairing those damaged tissues that also contribute to erectile dysfunction,” Malik says. “Secondly, shockwaves create turbulent flow in the blood vessels, which makes the body think there is trauma, and it triggers the body to produce growth factors such as vascular endothelial growth factor (VEGF). These growth factors promote angiogenesis, the growth of new blood vessels, and may enhance the production of nitric oxide — an essential factor for achieving and maintaining erections.”

Traumatizing your penis into getting stronger may sound weird, but Wolff has a convenient analogy. “This process is very similar to weightlifting,” she says. “As you create micro-tears in the muscle, the body’s response is to repair and regenerate the muscle tissue into a sturdier, healthier tissue with an increase in blood flow.” And, as with working out, a change in definition emerges over a period of training — and has to be maintained with regular exercise. Which is why, she says, the Novus Center sells a home-use medical device so men can continue to treat themselves with shockwaves.

What are the dangers or side effects?

Anyone encountering the words “shockwave penile therapy” for the first time would naturally express concern over potential drawbacks — and there are a few. A 2018 review of such treatment noted that adverse effects “may include penile skin bruising, hematoma, hematuria, infection of penile skin, painful erection, and difficulty having intercourse secondary to infection or pain.” The University of Utah Health reports that negative effects are “rare and generally mild,” but adds more to the list, including pain during the procedure, bleeding, blood in urine, and “penile curvature that worsens.” A 2022 study, meanwhile, found no reason to conclude that low-intensity waves harm your reproductive or hormonal testicular function, which is somewhat reassuring.

Aren’t there pills for erectile dysfunction?

In the late 1990s, Viagra was popularly viewed as a cure-all for erectile dysfunction. But according to Wolff and Malik, people today are seeking other options. “Patients who want to avoid prescription medications or can’t take them are generally interested in trying this treatment,” Malik says. Wolff has observed “a real movement in preventative and regenerative medicine over the past few years,” saying many of her patients, ranging from “A-list celebrities to truck drivers,” are interested in “alternative ways to deal with the issues of aging,” while some risk “adverse reactions from taking synthetic medications.” She says it’s also a good option for those who have built up a tolerance to such drugs and find they are no longer so effective. 

And this is getting more popular?

It would appear so. Wolff points out that vaginal rejuvenation is already a billion-dollar industry, with these ED treatments poised to follow suit. She says that Novus is the largest clinic in North America using shockwave therapy for this purpose, and claims a 90 percent success rate, but also believes a change in terminology — perhaps “erectile enhancement,” or Bryan Johnson’s phrase, “penile rejuvenation” — will help others overcome their embarrassment and try it out.

At the same time, there are unsettled questions and financial barriers. “We still don’t know exactly the optimal protocols and which types of patients may best benefit,” Malik says. “As of right now, it seems like patients with mild to moderate erectile dysfunction are good candidates. Also, because the research is still ongoing, it’s not covered by most insurances, and so it is cost prohibitive.” This, as in almost every area of life, is where it pays to be rich. Johnson can easily afford a series of shockwave sessions costing thousands of dollars to see whether it gives him a biologically “younger” penis.

Which doesn’t mean it’s just millionaires feeling those good vibrations, either. Wolff says her patients range in age from their twenties to their eighties, including not only biohackers but average middle-aged men “and even porn stars who are looking to be at their best.”

Can shockwaves produce all the positive results Johnson is hoping for?

I guess we’ll have to wait for the dick pic, right? But seriously, we’re still learning the extent of what shockwave therapy can do for your sex life (and for your body overall). As Malik observes, it may be more effective for those experiencing mild to moderate ED than those with severe ED. And research has indicated that it might produce better results in cases of vasculogenic ED, when the dysfunction is caused by narrowing or blockages of arteries and veins.

Of course, Johnson’s ambitions are far grander than a mild improvement in his erections: all his efforts are aimed at reattaining the organs equivalent to those of an 18-year-old. None of the shockwave clinics are promising that. Besides, the sample size of one individual in Johnson’s ongoing personal experiment won’t tell us much, whatever his findings. Not that this will stop him from sharing them in detail.