Other types of medications

Nonoral medications for erectile dysfunction include:

• Self-injections. Several medications are commonly injected directly into the penis to achieve an erection. The most often used medications include alprostadil, papaverine, and phentolamine. With this method, you use a fine needle to inject the medications into the base or side of your penis.

  The goal of injection therapies is to produce an erection that lasts about 20 to 40 minutes. If an erection lasts longer than one hour, you will need to have the medication or dose adjusted to avoid potentially long-term complications. 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 (priapism) and formation of fibrous tissue within the penis or at the injection site.

• Alprostadil urethral suppository. Alprostadil intraurethral (Muse) therapy involves placing a tiny alprostadil suppository inside your penis in the penile urethra. You use a special applicator to insert the suppository into your penile urethra.

  The erection usually starts within 10 minutes and lasts between 30 and 60 minutes. Side effects can include pain, minor bleeding in the urethra and formation of fibrous tissue inside your penis.

• Testosterone replacement. Some men have erectile dysfunction that might be complicated by low levels of the hormone testosterone. In this case, testosterone replacement therapy might be recommended as the first step.

  Testosterone replacement therapy can be delivered via injection, patch, gel, gum and cheek (buccal cavity), intranasal, subcutaneous pellet, or oral medication. Talk to your doctor about your personal preference and the possible side effects.