Injections for ED: Effectiveness, Risks & Costs
This article was reviewed by Kelly Brown MD, MBA.
The thought of injecting a needle into your privates might be enough to make you squirm. But ED injections can be an effective and safe way to treat ED.
If you see a healthcare professional about treatment for ED, they’ll likely first prescribe medications you can take orally. If these drugs are ineffective or if the side effects are too intolerable, your provider may recommend injections.
When done correctly, injections for ED can be a worthwhile solution. However, they do carry some risks — plus, you might not be overly excited by the idea of injecting yourself in the privates.
Let’s look at the effectiveness, side effects, and costs of injections for ED.
What Are Injections for ED?
Injections for ED (also called intracavernosal injections) are a treatment option that involves inserting a needle directly into the shaft of the privates to administer medication.
The first-line treatment for ED is usually phosphodiesterase type 5 inhibitors (PDE5 inhibitors). These oral ED medications are effective for many men and have good safety profiles, but they don’t work for everyone.
Injections of a medication like prostaglandin E1 (PGE1) might be a secondary treatment option healthcare providers recommend for ED.
Medicative shots for ED could be a good first option for men who:
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Experience too many or serious side effects of PDE5 inhibitors
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Don’t find that PDE5 inhibitors work well enough
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Have health conditions that make PDE5 inhibitors too dangerous to try
Common injectable medications for ED include
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Alprostadil (such as Caverject or Edex), which contains prostaglandin E1
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Papaverine, a vasodilator often used to treat heart problems
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Phentolamine, which causes blood vessels to expand and is often used to treat hypertension (high blood pressure)
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Aviptadil, a synthetic form of the hormone human vasoactive intestinal peptide (VIP)
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Bimix, which contains two of these medications
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Trimix, which contains phentolamine, alprostadil, and papaverine and is only available from compounding pharmacies
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Quad mix, which contains phentolamine, papaverine, alprostadil, and another drug called atropine
Injections work by relaxing the blood vessels in the smooth muscles of the privates. This effect allows more blood to flow into privates tissue, making it easier to achieve and keep an arousal long enough to have intimacy.
Alprostadil is the only PE currently FDA-approved for ED.
Another option is a platelet-rich plasma injection, also called the P-shot . This is a more experimental treatment that involves injecting platelet-rich plasma (PRP) — extracted from your own blood — directly into your privates.
Effectiveness of Injections for ED
Overall, ED injections seem to be quite effective. According to a 2019 review of studies published in the World Journal of Urology, the clinical efficiency rate is between 54 and 100 percent.
But evidence of P-shots effectively treating ED is still somewhat weak. For instance, in a 2023 study, researchers found no difference between the effectiveness of P-shots and a placebo among 61 men.
How to Use Injections
Your first injection will typically be administered for you in your healthcare provider’s office. Your provider will also give you a tutorial on how to do the injections yourself at home.
Here’s a general overview of how to administer a self-injection for ED.
Preparing the Injection
First, get your supplies together. You’ll need:
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A medication vial
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A single-use syringe
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Two alcohol swabs
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A sharps container
Follow these steps to get the injection ready:
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Wash your hands with soap and water.
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Wipe the rubber stopper at the top of the medication vial with an alcohol swab.
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Take the syringe out of its packaging, ensuring the needle doesn’t touch anything.
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Don’t put the needle into the vial yet. Holding the syringe upright with the needle at the top, pull back the plunger of the syringe, just past the dosage marker you’re using.
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Push the plunger up until it’s at the right dose.
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Turn the syringe downward. Carefully insert the needle into the vial of medication and push down the plunger to let the air into the vial.
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Hold both the syringe and the vial, ensuring the needle tip is in the medication so you don’t get air bubbles in your syringe.
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Draw the solution into the syringe by pulling on the plunger. Read the gradients on the side of the syringe to ensure you’re getting the correct dosage.
If you’re using a Trimix injection, don’t forget to put the medication vial back in the fridge. If you’re using Bimix or papaverine, you don’t need to store your medication in the fridge.
While this may seem like a complicated process, it’s easier the more you practice. Be sure to ask a healthcare professional for medical advice if you need further guidance.
Choosing an Injection Site
It’s important to select a proper injection site on your privates to avoid injecting the medication into a nerve or blood vessel. You’ll want to aim for the corpora cavernosa (the spongy tissue on the sides of the privates).
Don’t inject medication:
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Into any veins you can see or feel (which can create a large bruise)
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Straight into the head of the privates or urethra
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Into the bottom of your privates
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Into sores or scar tissue
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Directly on the top side or underside of your privates
Instead, inject the medication near the middle of the shaft. You’ll need to change injection sites frequently to prevent causing any damage to the tissue in your privates.
You can inject it at:
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The 10 o’clock position (left side of your privates, looking down)
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The two o’clock position (right side of your privates, looking down)
Remember to clean the injection site with an alcohol wipe before injecting.
Injecting the Solution
This part can be scary at first, but it’s relatively straightforward.
Take the following steps to administer injections:
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Use an alcohol wipe to clean the injection site.
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Pull your privates straight out in front of you so it’s stretched out.
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Insert the needle and slowly push down the plunger until all the solution is in your privates.
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Carefully pull out the needle.
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Using your thumb and forefinger, apply gentle pressure at the injection site for two to three minutes. This can reduce bruising.
Don’t forget to dispose of your needle safely — that is, in a sharps container.
To minimize pain at the injection site, you can use a local anesthetic like lidocaine jelly or cream. If you’re concerned about pain, mention this to your healthcare provider and ask if they can suggest any topicals or techniques to help.
Potential Privates Injection Drug Interactions
Potential drug interactions between alprostadil and other drugs haven’t formally been studied.
Some researchers have raised concerns that mixing injections with other medications, particularly PDE5 inhibitors, may raise the risk of complications like priapism. Priapism is a prolonged arousal lasting more than four hours — it’s considered a medical emergency.
In a 2023 study, researchers didn’t see an increased risk of priapism when combined with tadalafil or sildenafil (the active ingredients in Cialis and Viagra respectively), but ongoing research is looking at the possible link.
It’s always best to talk to your medical provider before combining injections or PDE5 inhibitors with other ED treatments — or any other medications
How Long Does It Take Injections to Work?
The amount of time that it takes for injections to work depends on factors such as the type and strength of injectable medication you use.
Some men can achieve an arousal within minutes of the injection.
Your privates might swell within five to 15 minutes of a Trimix injection. It might be aroused at that time, but you may not actually get an arousal until you’re stimulated.
Risks of ED Injections
While injecting your privates may sound dangerous, it’s often safe when done correctly. But there are still risks to be aware of.
Possible side effects of ED injections include:
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Bruising or bleeding at the injection site
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Temporary swelling, irritation, or mild pain
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Rash or discoloration on the privates
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Fast heartbeat
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Dizziness
More serious risks of ED injections include Peyronie’s disease, though this only tends to happen if you inject frequently. Peyronie’s disease is a condition where fibrous scar tissue forms and may lead to painful arousals or a curvature in the privates.
injections can also cause priapism, a prolonged arousal without any stimulation. Priapism has been reported in about four percent of people who receive Caverject.
If you experience pain with priapism or an arousal that lasts more than four hours, visit an emergency room as soon as possible.
Lastly, whenever you use an injection, pay attention to how you insert the needle. Be careful not to bend the needle, as there’s a risk of it breaking off in your privates. If this happens, seek immediate medical attention.
How Much Do Injections Cost?
Injections vary in cost, depending on factors like:
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What injectable medication you’re using
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The dosage
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Whether you opt for a brand-name drug or the generic version
Sometimes, your health insurance plan may cover injection therapy. For example, it might be covered if you develop ED after privates cancer treatment.
However, this depends on your insurance provider and the exact plan you have. It’s a good idea to call your insurance company to find out whether you’re covered.
If you’re paying for your injectable medicine out of pocket with coupons, the price can start from around $113 to $213. This means it could cost as little as $5 a dose, depending on your dosage, making it a fairly cheap treatment for ED.
Alternatives to Injections for ED
If you’re not keen on the idea of injecting medication into your privates, there are effective alternatives that don’t involve needles.
ED Medication
Oral ED medications will likely be the first treatment your healthcare provider recommends.
As noted, ED is most often treated with PDE5 inhibitors, which work by increasing blood flow to the privates.
These medications include:
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Sildenafil (the generic version of Viagra)
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Tadalafil (generic for Cialis)
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Stendra (avanafil)
Testosterone-Replacement Therapy
Testosterone-replacement therapy (TRT) isn’t primarily a treatment for ED. It’s meant to treat low testosterone levels, which are sometimes linked to ED.
If you have low testosterone (also known as low T), TRT might be necessary for your overall health — and it could improve intimate function. But you might still need additional treatments for ED, even if you’re getting testosterone therapy.
If you don’t have low T and your ED is caused by another issue, TRT won’t necessarily make a difference.
Vacuum Pumps
If oral ED medications aren’t suitable for you, but you can’t — or don’t want to — use an ED injection, you might consider vacuum pumps.
A vacuum device uses suction to improve blood flow to the privates, making it possible to get an arousal. There are a number of suction-based devices, including the Eddie by Giddy.
Though vacuum devices have lost popularity since the advent of Viagra, they still have their place — and they can be a useful alternative for those who want a drug-free ED remedy.
Other Options for ED
The list of ways to treat ED goes on. There are other options available, such as:
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Alprostadil creams and gels
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Alprostadil urethral suppositories
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Eroxon, a non-medicated topical gel to stimulate privates nerve ending that was FDA-authorized for ED in 2023
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Surgery
Talk to your healthcare provider about your symptoms and what’s worked or hasn’t worked for your dysfunction issues. They can help you figure out the right treatment.
ED Injections: The Verdict
ED is estimated to affect roughly half of men between ages 40 and 70 in the United States. Although not life-threatening, ED can be a sign of an underlying health problem or cause problems such as:
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Low self-esteem
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Mental health issues
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Lack of relationship satisfaction
ED can be frustrating to deal with. But there are quite a few ED treatment options that can be effective, including privates injections.
While they’re usually not a first-line treatment for ED, injections can be helpful for certain people. Here’s what to keep in mind about injections for ED:
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Injections are generally safe and effective. Overall, ED injections seem to have high success rates and a relatively low risk of side effects.
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But they’re not for everyone. Injections have their advantages, but some men might be wary of them because of the risks, inconvenience, and pain. Also, they might not be effective for everyone.
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Side effects are possible. Most side effects are mild and include bruising or swelling, but they can be serious in rare cases.
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Other treatment options for ED are available. You can talk to a healthcare professional, such as a urologist, about ED medications, testosterone treatment, vacuum pumps, and other ED solutions.
Beyond the treatments mentioned above, various healthy lifestyle changes can support intimate function — think healthy eating, exercise, and getting enough sleep.
Related: What Morning Arousals Reveal About Your Health
Related: Guys: Here’s Why You Get Nocturnal Arousals
This article originally appeared on Hims.com and was syndicated by MediaFeed.org
