erectile dysfunction


Injections for Erectile Dysfunction: What You Should Know

Erectile dysfunction (ED) is a common ailment in men and can be the result of several different causes. (Learn More)

There are numerous potential treatments for ED (Learn More), but there is only one injectable medication that is approved by the Food and Drug Administration (FDA) for the treatment of erectile dysfunction. (Learn More)

This medication works quickly and can be used up to several times a week. (Learn More) It is also available via other administration methods. (Learn More)

Several other medications may be used via injection to treat people who have ED. (Learn More) There are also injection options that combine more than one medication. (Learn More)

If prescribed injections for ED, you will learn how to administer the medication yourself.  (Learn More)

There are side effects associated with the use of penile injections, and some can be serious. (Learn More)

Not everyone will benefit from an injectable for the treatment of ED. You should discuss whether or not the medication is right for you with your physician. (Learn More)

Erectile Dysfunction (ED) Causes

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Erectile dysfunction (ED) occurs when a man has difficulty getting or maintaining an erection. It is estimated that as many as 30 million men in the United States are affected with some level of ED.

The disorder appears to become prevalent as men get older, but it should not be considered a sign of normal aging. There are numerous conditions that can affect a man’s ability to get or maintain an erection.

Some of the more general causes of ED include:

  • An obstruction of blood flow in the penis or damage to the nerves in the penis.
  • A more serious condition like high blood pressure, complications from diabetes, heart disease, or arteriosclerosis (blockages or hardening of the arteries).
  • Psychological or emotional issues and stress.

Treatments for ED

The treatment of erectile dysfunction has become a lucrative business. There have been many approaches to treating the issue, including medical approaches, herbal approaches, and even behavioral approaches like therapy or hypnosis.

Medical approaches include medications, injections, and topical creams. Medical treatments typically require a prescription from a physician, and the prescription is most often given following an evaluation from the physician.

Medical treatments work best when the cause of the ED is due to a physical problem. Behavioral treatments like therapy are often very effective when the cause of erectile dysfunction is not due to a physical problem, but an emotional issue, stress, or a psychological problem.

Other approaches, such as herbs, vitamin supplements, and others, are available without a prescription. These remedies have significantly less success than standard medical treatments, especially in cases where ED is due to physical causes.

Some of the primary approaches to treating erectile dysfunction, particularly when medications like Viagra (sildenafil) are not effective, are penile injections.

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The Only Injectable Medication Approved by the FDA

The FDA has only approved one injectable medication for the treatment of ED: alprostadil.

This medication is a vasodilator, meaning that it helps to expand veins and arteries. The expansion of the blood vessels results in increased blood flow in the penis and assists in achieving an erection.

The medication goes by several brand names:

  • Caverject
  • Impulse
  • Edex
  • Prostin VR

Is Alprostadil Only Used Via Injection?

Alprostadil can be injected directly into your penis or used as a suppository (brand name MUSE [Medicated Urethral System for Erection]). It is also available as a cream, though this form is not approved by the FDA.

Clinical trials suggest that the medication is effective in 80 percent of people when it is injected, but the success rate is much lower when the medication is used as a suppository (30 to 40 percent).

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How Quickly Does It Work?

Alprostadil usually begins to work within 5 to 20 minutes, but you should wait 10 to 30 minutes after injecting it before you attempt to have sex. Your erection should last for about an hour, but it may continue after you have climaxed.

The medication should not be used more than three times a week. It is strongly recommended that you wait at least 24 hours after each use before using it again.

Other Medications Used as Injectables for ED

Alprostadil is not the only injectable medication available to treat ED; however, it is the only one approved by the FDA.

There are two other major medications used as injectables in the treatment of ED. Both are vasodilators used in the treatment of ED via injection use.

Again, these drugs are not approved by the FDA for the treatment of ED. Research studies suggest a much lower success rate than alprostadil (ranging from 35 to 65 percent).

Combined Injectables

The drug Bimix is an injectable that includes papaverine and phentolamine.

Trimix is an injectable that includes alprostadil, papaverine, and phentolamine.

These combined injectables may be used if you do not respond to alprostadil alone; however, there is not sufficient clinical evidence to suggest that they are more effective than alprostadil. There appears to be an increased risk for infections at the injection site with these combined formulations.

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Who Should Not Use Injectables?

Injectable medications for ED are not for everybody. Before you decide to use an injection medication, discuss your history with your physician. You should not use injectables if:

  • You had any allergic reactions to any of these medications in the past.
  • You have had a penile implant.
  • You are taking medications to treat ED, such as Viagra or other vasodilators.
  • You have curvature of the penis or priapism (a prolonged and painful erection).
  • You take a blood thinner.
  • You have a condition that obstructs your blood flow, leukemia, or sickle cell disease.

Do I Inject the Medication?

Your physician should demonstrate the safe way to inject yourself. They will also likely teach you how to prepare the mixture. Once you have been trained, you can inject the medication yourself.

Are There Side Effects?

There are potential side effects with every medication. The most common side effect associated with these injection drugs is pain or redness at the site of injection.

You should contact your physician if you experience:

  • A prolonged erection for four hours or more with pain in the penis.
  • Pain or swelling in your testicles.
  • Burning when urinating.
  • Bleeding from the urethra.

References

What Is Erectile dysfunction? (June 2018). Urology Care Foundation.

Caverject (alprostadil). (2019). Center Watch.

Erectile Dysfunction. (November 2016). American Family Physician.

Papaverine. (June 2016). RxList.

Oraverse.   (June 2016). RxList.