Erection problems: Should I try injection treatments?

Get the facts
Compare your options
What matters most to you?
Where are you leaning now?
What else do you need to make your decision?

1. Get the Facts

Your options

Try injection treatments.
Try counseling or sex therapy, or seek other ways to express intimacy.

Key points to remember

An erection problem is not a life-threatening condition. But 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. So the decision about whether to treat an erection problem is often based on what you and your partner prefer.
Before considering injection treatments, you should first consider taking pills for erection problems, like Viagra, Cialis, or Levitra. But talk to your doctor first.
Some men can't take pills for erection problems because of other medical problems. For those men, injection treatments may be a good choice.

FAQs

What is an erection problem?

A man has erection problems if he cannot get or keep an erection that is firm enough for him to have sex. Erection problems are also called erectile dysfunction or impotence.

What causes an erection problem?

Erection problems can be caused by:

Injury to nerves or loss of blood flow going to the penis.
Anxiety or depression.
Certain medicines.
Other problems, such as diabetes, high blood pressure, high cholesterol, atherosclerosis, multiple sclerosis, and Parkinson's disease.
Drinking too much alcohol, smoking, or using illegal drugs.

Erection problems can occur at any age but are more common in older men. Older men often have other health problems and take medicines that can cause erection problems. Treatment of erection problems in older men can work as well as it does for younger men.

Why treat an erection problem?

An erection problem is not life-threatening. But it can seriously affect your emotional health and sense of self-worth. It can also make it difficult to father a child. So the decision about whether to treat it is often based on what you and your partner prefer.

Very often, this decision is also based on how invasive the treatment is and its chance of succeeding. Injecting medicine directly into the penis often works well, but it is usually only considered after you have tried taking pills for erection problems.

Some men can't take pills for erection problems because of other medical problems. For those men, injection treatments may be a good choice.

What kinds of injections are used?

MUSE. MUSE stands for medicated urethral system for erections. A thin tube contains a small pellet of medicine. You insert the tube into the opening in the end of your penis. When you press a button on the applicator, the pellet is released into the penis. The erection that follows lasts at least 30 minutes.
Injected medicine. This involves injecting medicine, using a tiny needle, into the side of the penis. The erection that follows lasts 30 minutes or longer, depending on how much medicine you use.

Why might your doctor recommend injections?

Your doctor might recommend injections if you want to treat your erection problem but cannot take pills because:

You have a heart problem such as coronary artery disease, angina, or heart failure.
You have low blood pressure.
You take many different drugs for high blood pressure.

2. Compare Options

	Use an injection treatment	Don't use an injection treatment
What is usually involved?	MUSE: You insert a thin tube containing a pellet of medicine into the opening in the end of your penis . You press a button on the applicator, which releases the pellet into your penis. Injected medicine: You inject this medicine into the side of your penis with a tiny needle . If you cannot see well enough to do either treatment, your partner can be taught how to do it.	You seek other ways to express intimacy. You try counseling or sex therapy.
What are the benefits?	You will probably have erections that last 30 minutes or longer. You may have better self-esteem. You may be able to father children. MUSE works for 60 out of every 100 men who use it.¹ Injected medicine works for 90 out of every 100 men who use it.²	You avoid the side effects of using injections. You avoid the expense of this treatment if your insurance doesn't cover it.
What are the risks and side effects?	MUSE: May cause pain in the penis. May cause mild injury to the urethra. May cause pain and irritation in your partner's vagina when you ejaculate. Injected medicine: May cause bruising or scar tissue. May cause pain in the penis. May not work if you have low blood flow into or out of the penis.	You may have self-esteem problems if you cannot get an erection.

Personal stories

Are you interested in what others decided to do? Many people have faced this decision. These personal stories may help you decide.

For more information, see the topics:

Personal stories about using injections for an erection problem

These stories are based on information gathered from health professionals and consumers. They may be helpful as you make important health decisions.

"When my partner was having trouble getting an erection, we talked it over. We did want to have intercourse, so the first thing we did was try Viagra, but that didn't work. The doctor then suggested an injection. While we were trying Viagra, we discovered that we could have a healthy sexual relationship without intercourse, and that, together with the unpleasant idea of injecting something into his penis, made us choose not to use injections. "

— Fred and Darlene, mid-40s

"My erection problems had been making intercourse difficult for us. When we heard about Viagra, we were both thrilled! But Viagra did not work for us. The doctor told us about injections. We talked it over and decided to give them a try. We realized that it would be inconvenient, but at this point sex is still quite important to us. "

— Howard and Ginger, late 30s

"When Viagra didn't work, I was disappointed and asked my doctor what else could be done. He suggested injections. Stopping our lovemaking to give me a shot just didn't seem worth the effort. We turned down the injections and are exploring other ways to express our love to each other. "

— Trevor, age 55

"I was having trouble getting erections, and the other medications I take mean I cannot use Viagra. My partner and I still wanted to see if there was anything we could do. The doctor talked to us about injections. We looked at their advantages and disadvantages and decided to go ahead and give the injections a try. "

— B.J., age 62

3. Your Feelings

Your personal feelings are just as important as the medical facts. Think about what matters most to you in this decision, and show how you feel about the following statements.

Reasons to try injection treatments

Reasons not to try injection treatments

I'm willing to try anything in order to have erections again.

There is no way I could inject anything into my penis.

More important

Equally important

More important

I'm not at all worried about the cost of this treatment.

I cannot afford this treatment and don't have insurance that will cover it.

More important

Equally important

More important

My self-esteem is very low because I am unable to have an erection.

I don't think that my self-esteem has been affected by my erection problem.

More important

Equally important

More important

My relationship with my partner depends on our being able to have sexual intercourse.

I am sure that my partner and I can find ways to be intimate without sexual intercourse.

More important

Equally important

More important

Your other important reasons:

More important

Equally important

More important

4. Your Decision

Now that you've thought about the facts and your feelings, you may have a general idea of where you stand on this decision. Show which way you are leaning right now.

Injection treatment

NOT having injection treatment

Leaning toward

Undecided

Leaning toward

5. Quiz Yourself

Check the facts.

1. If I'm just too uncomfortable with the idea of injection treatment, that is a perfectly good reason not to have it.

True
False
I'm not sure

That's right! The decision is up to you and your partner. An erection problem is not a life-threatening condition. But for some men, it can seriously affect emotional health and sense of self-worth.

2. I should consider taking pills like Viagra, Cialis, or Levitra before I think about having injection treatments.

True
False
I'm not sure

That's right. Injecting medicine directly into the penis often works well, but it is usually only considered after you have tried taking pills for erection problems.

Decide what's next.

1. Do you understand the options available to you?

2. Are you clear about which benefits and side effects matter most to you?

3. Do you have enough support and advice from others to make a choice?

Certainty.

1. How sure do you feel right now about your decision?

Not sure at all

Somewhat sure

Very sure

2. Check what you need to do before you make this decision.

Nothing. I'm ready to take action.
I want to discuss the options with others.
I want to learn more about my options.

3. Use the following space to list questions, concerns, and next steps.

References

Citations

Tharyan P, Gopalakrishanan G (2006). Erectile dysfunction, search date August 2006. Online version of BMJ Clinical Evidence. Also available online: http://www.clinicalevidence.com.
Lue TF, Broderick GA (2007). Evaluation and nonsurgical management of erectile dysfunction and premature ejaculation. In AJ Wein, ed., Campbell-Walsh Urology, 9th ed., vol. 1, pp. 750–787. Philadelphia: Saunders Elsevier.