Should I use injections for erection problems?
Introduction
This information will help you understand your choices, whether you share in the decision-making process or rely on your doctor's recommendation.
Key points in making your decision
An erection problem is not a life-threatening condition, yet it can seriously affect your emotional health and sense of self-worth. It can also make it difficult to father a child, if that is your desire. Therefore, the decision about whether to treat an erection problem is often based on your and your partner's preferences. Consider the following when making your decision:
- If you are able to try phosphodiesterase-5 inhibitors (such as Viagra, Levitra, or Cialis) but have not, you should try one of these medications first.
- At this time, it is not known how effective injections are in those who have already tried phosphodiesterase-5 inhibitors.
Medical Information
What is an erection problem?
An erection problem (also called erectile dysfunction and sometimes impotence) refers to a man's consistent inability to get or maintain an erection sufficient to have satisfactory sex. It does not mean a lack of sexual interest or desire or the occasional difficulty achieving or maintaining an erection that affects all men at some time in their lives.
What causes an erection problem?
The cause of erection problems may be physical (such as injury to the nerves or loss of blood flow going to the penis) or psychological (such as anxiety or depression). Medications you take for other conditions, alcohol consumption, smoking, and illegal drug use can cause erection problems.
Certain conditions may affect blood flow or the nervous system, increasing the risk of having erection problems. These include diabetes, high blood pressure, high cholesterol levels, atherosclerosis, multiple sclerosis, and Parkinson's disease.
Erection problems can occur at any age but are more common in older men, who often have additional health problems or who may be taking medications that can interfere with normal erectile function. Treatment of erection problems in older men can be as effective as in younger men.
Why treat an erection problem?
The decision about whether to treat an erection problem may not be as straightforward as the decision about whether to treat many other medical conditions. An erection problem is not life-threatening, yet it can seriously affect your emotional health and sense of self-worth. It can also make it difficult to father a child, if that is your desire. Therefore, the decision about whether to treat an erection problem is often based on personal preference.
Very often, this decision is also based on how intensive or invasive the treatment is and its chance of succeeding. Injecting medication directly into the penis is often effective, but it is usually only considered after oral medications (such as Viagra, Levitra, or Cialis) have been tried.
Your Information
Your choices are:
- Try MUSE (medicated urethral system for erections), which calls for inserting a tiny pellet of alprostadil (prostaglandin E1) into the opening at the end of the penis (the urethra). A thin tube contains the pellet of medication. The tube is inserted into the opening in the end of the penis. By pressing a button on the applicator, the pellet is released into the penis.
- Inject medication into the side of the penis. This often involves using a mixture of medications that include alprostadil (Caverject), papaverine hydrochloride (Pavabid), and phentolamine mesylate (Regitine).
- Try counselling or sex therapy.
- Seek other ways to express intimacy.
The decision about whether to use injections or pellets takes into account your personal feelings and the medical facts.
Deciding about medications for erection problems Medication Reasons to use for an erection problem Reasons not to use for an erection problem MUSE
- 30% to 66% of men using MUSE achieve erections sufficient for intercourse.
- Erection develops in about 10 minutes and lasts 30 minutes to an hour or longer.
- MUSE does not usually cause bruising or scar tissue (as injections may).
Side effects include:
- Pain severe enough that the man stops using the medication.
- Mild injury to the urethra, such as a scrape that causes a small drop of blood at the tip of the urethra.
- Possible irritation to the partner's vagina when he ejaculates.
- Avoiding oral sex.
Injections into the side of the penis
- Up to 90% of men using this method achieve erections sufficient for sexual intercourse.
- Erection lasts 30 minutes to an hour or longer.
- Dose can be adjusted to create an erection that lasts the desired length of time
- Auto-injector is available if unable to give standard injections.
Side effects include:
- Risk of bruising and scar tissue.
- Mild to moderate pain in the penis.
- Formation of scar tissue in the penis (fibrosis).
Following are some general considerations about using injections or pellets for an erection problem.
Considerations about medications for erection problems Reasons to consider injections or pellets for an erection problem Reasons not to consider injections or pellets for an erection problem
- Enhanced self-esteem because of your ability to have intercourse
- Fulfills the need to show intimacy through sexual intercourse
- You want to have children.
Are there other reasons you might want to use injections?
- The idea of injecting a pellet into the opening of the penis or an injection into the side of the penis is not pleasant.
- You must stop lovemaking to insert or inject the medication into the penis.
- This treatment is usually not covered under provincial health plans, and it may be expensive if your private insurance does not pay for it. Ask if the treatment is covered under your plan.
- These methods are less likely to be effective in men whose blood flow into or out of the penis is severely impaired.
- Injecting medication into the penis may be difficult for men who have vision problems.
Are there other reasons you might not want to use injections?
These personal stories may be helpful in making your decision.
Wise Health Decision
Use this worksheet to help you make your decision. After completing it, you should have a better idea of how you feel about using injections or pellets for an erection problem. Discuss the worksheet with your doctor.
Circle the answer that best applies to you.
I have no vision problems that might make it difficult to use these medications. Yes No Unsure We have the finances and/or insurance to pay for the medication and supplies. Yes No Unsure Sexual intercourse is important to us. Yes No Unsure Being able to have sexual intercourse will help my or my partner's self-esteem. Yes No Unsure We don't mind stopping our lovemaking to give an injection. Yes No Unsure We don't expect sex to solve a relationship problem. Yes No Unsure We feel capable of giving an injection in the penis. Yes No Unsure We don't worry about the side effects of medication. Yes No Unsure Use the following space to list any other important concerns you have about this decision.
What is your overall impression?
Your answers in the above worksheet are meant to give you a general idea of where you stand on this decision. You may have one overriding reason to use or not use injections or pellets.
Check the box below that represents your overall impression about your decision.
Leaning toward using injections or pellets
Leaning toward NOT using injections or pellets
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| Author: | Douglas Dana Ralph Poore | Last Updated: August 24, 2006 |
| Medical Review: | Adam Husney, MD - Family Medicine Tom Bailey, MD - Family Medicine Christopher G. Wood, MD, FACS - Urology/Oncology | |
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