Harvard Men's Health Watch

When drugs for erectile dysfunction don't work: What's next?

Here are the alternatives to oral erectile dysfunction drugs. Solutions are available for most men's needs.

Thanks to a lot of direct-to?consumer advertising, most American men of a certain age know to ask about the "little blue pill" or similar medications if they develop erectile dysfunction (ED). These drugs enhance blood flow to the spongy tissues in the penis, which creates an erection. However, the drugs don't work for about 30% of men. Then what?

Injections: The next best option to oral medication is injecting a drug called alprostadil (Caverject, Edex) directly into the body of the penis.
The relatively shallow injection creates an erection within five to 20 minutes that lasts for up to an hour. "Some men are not wild about sticking themselves with a needle, but it works," says Dr. Michael O'Leary, a professor of surgery at Harvard Medical School and a urologist at Brigham and Women's Hospital. Possible risks include pain at the injection site or an unusually prolonged erection requiring medical attention.

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