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Liz Robertson

Evolan Pharma AB

Erectile dysfunction (ED) should be more openly discussed given its prevalence and relation to a number of other conditions including high cholesterol, smoking, obesity, and diabetes. Now there are multiple options for treating ED including injectables.


Self-administered penile injections became popularised in the 1980’s and had an instant appeal as an alternative to the only available treatment at the time, the penile prosthesis.

Although many men will be scared by the idea of placing a needle into their penis, most men who choose injection therapy quickly realise that the benefits of the injection far outweigh the actual injection, which is only a small pinprick.

Why injections are used

If oral ED medications become ineffective or are no longer tolerated, self-administered penile injections are considered an established and effective second line treatment for ED.

While the thought of injecting a needle into your penis may make you cringe, a review in World J Urol 2019 June;  found that penile injection therapy is generally an effective and well-tolerated treatment for ED.

Injectable therapies are often used in patients with severe erectile dysfunction. This may be caused by serval factors including, high blood pressure, high cholesterol, smoking, obesity, and diabetes.

Most men who choose injection therapy quickly realise that the benefits of the injection far outweigh the actual injection, which is only a small pinprick.

For men who have undergone radical prostatectomy and experience discomfort with injections of prostaglandin, there are effective injections which are pain free.

Men are finding success with self-injection therapy which is now considered a safe and effective treatment should oral therapy fail and there are several different injectable therapies available on prescription from your healthcare professional.

How to administer an injection

Penile injections can generally be self-administered at home. They help treat ED by improving blood flow to the penis, which leads to firmer erections.

Your first injections would usually be carried out in the outpatient clinic under the supervision of your healthcare professional. They will show you how to do the injections at home and provide you with the necessary information.

What to expect

In general, an erection should follow an injection within 5 to 15 minutes. However, some men may need sexual foreplay to achieve an erection. The erection should last about 30 to 60 minutes, though this will vary depending on your overall health and other factors.

What are the side effects?

Depending on the injection you have been prescribed, the most common side effect of injections is a dull aching pain during erection. This happens in about 1 out of 10 injections and the pain usually stops when the erection ends.

However not all injections have associated pain as a side effect. Ask your healthcare professional for advice on the most suitable option.

Another minor side effect is bruising at the injection site.

The most serious but rare side effect is priapism; this means that an erection lasts longer than  hours and is painful. Priapism may damage the smooth muscle cells in the penile vessels and can worsen ED.

It is very important to contact your doctor if you have an erection that lasts longer than 2 to 3 hours. Generally, priapism can be treated effectively with the injection of an antidote.

For more information on treating ED please consult your healthcare professional for further advice and support.

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