Erectile dysfunction: Nonoral treatments

Oral medications aren't the only way to treat erectile dysfunction. Know the full range of treatment options and how they work. By Mayo Clinic Staff

If you have erectile dysfunction and can't take certain oral medications, you have other treatment options, including medications that are injected into or placed in the penis, penis pumps, and surgically placed penis implants.

Understand why you might choose a nonoral treatment for erectile dysfunction and how these different treatments work.

When oral medications might not be safe

Not all men can safely take erectile dysfunction oral medications, such as sildenafil (Viagra), vardenafil (Levitra, Staxyn) and tadalafil (Cialis). Medications for erectile dysfunction might not work or might be dangerous if you:

  • Take nitrate drugs — commonly prescribed for chest pain (angina) — such as nitroglycerin (Nitro-Dur, Nitrostat, others), isosorbide mononitrate (Monoket) or isosorbide dinitrate (Dilatrate-SR, Isordil)
  • Take blood-thinning (anticoagulant) medications, alpha blockers, antibiotics, anti-seizure medications or anti-arrhythmic heart medications
  • Have heart disease or heart failure
  • Have had a stroke
  • Have uncontrolled low blood pressure (hypotension) or uncontrolled high blood pressure (hypertension)
  • Have eye problems, such as retinitis pigmentosa, or a family history of certain eye problems
  • Have severe liver disease
  • Have kidney disease that requires dialysis

Some men might also choose another treatment option to avoid the side effects caused by certain oral medications.

Other types of medications

Nonoral medications for erectile dysfunction include:

  • Alprostadil self-injection. With this method, you use a fine needle to inject alprostadil (Caverject, Edex) or a combination of medications that includes alprostadil into the side of your penis. Each injection generally produces an erection that lasts about an hour. Because the needle used is very fine, pain from the injection site is usually minor. Side effects can include bleeding from the injection, prolonged erection and formation of scar-like (fibrous) tissue at the injection site.
  • Alprostadil penis suppository. Alprostadil intraurethral (Muse) therapy involves placing a tiny alprostadil suppository in your penis. You use a special applicator to insert the suppository into the tube that carries urine from your bladder (the urethra). An erection usually starts within 10 minutes and lasts between 30 and 60 minutes. Side effects can include pain and minor bleeding in the urethra.
  • Testosterone replacement preparations. Some men have erectile dysfunction caused by low levels of the hormone testosterone. In this case, testosterone replacement therapy might be recommended. Testosterone replacement therapy can be delivered via injection, patch, gel, gum and cheek (buccal cavity), or oral medication. Talk to your doctor about your personal preference and the possible side effects.
May 23, 2013 See more In-depth