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Penile Self Injection Therapy For Erectile Dysfunction (ED) - ED Treatment
Penile Self Injection Therapy For Erectile Dysfunction (ED)

Penile Self Injection Therapy For Erectile Dysfunction (ED)

Oral medication for the treatment of erectile dysfunction doesn’t always work, and is not suitable treatment in cases where other medications are being taken. Men unable to take oral medication to treat ED, or treatment was unsuccessful, are often prescribed a treatment that is introduced directly into the penis via injection. That is called Penile Self Injection.

Papaverine, a drug discovered in 1848 that produces vasodilatation, was found to produce erections when injected directly into the base of the penis. Vasodilatation is a medical term referring to widening of the blood vessels.

Soon after the discovery that Papaverine injected directly into the penis produced erections, researchers found that other vasodilators were effective treatments of erectile dysfunction as well, particularly Alprostadil.

Alprostadil is a type of Prostaglandin E1 (PGE1), and is the most commonly used and effective drug for injection directly into the penis. Alprostadil is administered on its own, or in combination with one or two other drugs, Papaverine and Phentolamine.

Caverject® and Edex® are the only pre-prepared, pre-packaged, FDA approved medications for use as an injection treatment for erectile dysfunction. However, Alprostadil treatment is also available as a generic, usually in combination with Papaverine and/or Phentolamine. A typical mix might be 30 mg of Papaverine, 2 mg of Phentolamine, and 20 mcg Alprostadil.

The generic drug combination must be mixed by a compounding pharmacy. Compounding pharmacies create differing combinations of Papaverine, Phentolamine and Alprostadil. No specific pharmaceutical company has the licensing rights to the combinations, so FDA studies have never been conducted to determine their exact safety and reliability. However, these combination treatments have been in use for longer than Caverject® and Edex® have been on the market, so are obviously just as safe and possibly more effective.

The combination injection therapies, called “Bi-Mix”, when two drugs are combined and “Tri-Mix” when the mixture contains three drugs, are generally mixtures of two or all three of the most commonly used drugs:

  • Papaverine
  • Phentolamine
  • Alprostadil

Both Bi-Mix and Tri-Mix injections have greater effectiveness than Alprostadil alone. However, Bi-Mix and Tri-Mix are often not covered by insurance, while Alprostadil alone is generally covered under most insurance plans.


Penile self-injection treatment of ED has proven effective…

Penile injection therapy represents the most effective means of achieve erection across a broad cross section of men who would otherwise not be able to obtain adequately rigid erections. In fact, if the vascular structure of the penis is healthy, the use of injection deliverable drugs is almost always effective. In one study of 683 men with erectile dysfunction, 94% reported having erections suitable for penetration after Alprostadil injections.

Men on anticoagulant medications, blood thinners, cannot use penile injection therapy.

Your doctor will determine an appropriate dose. The dose is regulated to achieve  erections that are adequately rigid for intercourse and last from thirty minutes to no more than ninety, with injections limited to three each week.


Side effects may include:

  • Pain caused by the medication, not pain from the actual injection.
  • Priapism, the symptom of which is a persistent or prolonged erection that lasts 4 hours or more, is a urologic emergency requiring consulting with an urologist or visiting the emergency ward of a hospital for immediate treatment.
  • Scarring or bleeding at the injection site.


Frequently Asked Questions About Direct Penile Injection Treatment


1. How do I learn to administer a penile injection?

Your doctor or a health clinic medical practitioner can instruct you on the proper technique to use when administering an injection directly into the base of the penis. It is a relatively simple procedure to learn.


2. What penile self-injections treat erectile dysfunction?

Alprostadil, a synthesized Prostaglandin E1 that is a vasoactive agent is used in all penile injection treatments. Alprostadil is injected directly into the penis alone or in combination with one or two other medicines, Papaverine and/or Phentolamine, which also belong to the group of medicines called vasodilators.


3. What does self injected treatment for ED do?

The injection of Alprostadil itself, or in combination with Papaverine and/or Phentolamine, relaxes the penises smooth muscle tissue, improving blood flow and aiding erection.


4. Is direct penile injection treatment effective?

Men not responding to oral treatments of ED find penile injections of Alprostadil alone, or in combination with Papaverine and/or Phentolamine, an effective alternative treatment. Self-injection treatment for ED is reportly as high as 94% of patients studied. Injections may also be helpful for men taking other medication, such as nitrates that should never be taken in conjunction with oral treatments for erectile dysfunction.


5. Are direct penile injection treatments for ED new?

Penile-injection treatment of erectile dysfunction is not new. It is a treatment introduced early in the 80s. Papavarine was the initial drug to be used as a treatment for ED, and was studied extensively during the remainder of the decade.


6. What’s involved in giving yourself penile injections?

Penile self-injections must be administed under the direction of a doctor or urologist. The patient administers their own injection, however the dosage to be using in the treatment is regulated by a medical professional.

The actual injection of drug into the base of the penis should be administed about 10 minutes before engaging in sex. The injection of the medication causes the blood vessels in the penis to dilate. This dilation increases blood flow to the penis, resulting in an erection. An erection resulting from an injection treatment will usually last for about 30 minutes.

The needles used to inject an ED treatment is a 29 gauge needle, similar to needles diabetics use to inject insulin. The injection using such a fine needle is no more painful than pulling a single hair out of your head.

Giving yourself the penile injection is a quick and easy procedure to learn. The penile injection method of treating ED is highly successful, with most patients experiencing erections rigid enough for sexual intercourse.

Penile injections for the treatment of erectile dysfunction shouldn’t be administed more than 3 times eacg week.


7. Are there side effects to a penile self injection teatment of erectile dysfunction?

Treating ED using penile injections poses a slight possibility of  prolonged erections, which are eretions lasting longer than 4 hours. Prolonged erection is a medical condition known as Priapism.

Priapism can cause irrepreial damage to the tissue of the penis that enables erections. Careful regulating of the dosage injected which your doctor or a urologist should perscribe, will avoid problems relating to Priapism.

Other possible side effects relating to penile injections are minor, and include:

  • Slight bruising around the injection site, which can be avoided by pressing on the injection spot for three minutes, or six minutes for anyone taking blood thinners.
  • Penile pain is uncommon, but if it does occur it’s more common among patients perscribed Alprostadil that also contains injection agents. Penile pain is also more common among diabetes sufferers, or men having recently undergone radical prostatectomy surgery. Radical prostatectomy is surgery to remove all of the prostate gland and some of the tissue around it to treat prostate cancer.
  • Swelling at the injection site can occur. This happens when some of the drug is injected under the skin, which is usually caused by poor injection technique.


8. Is penile self injection treatment costly or is it covered by health insurance? 

The cost of a single injection of Alprostadil (Caverject® and Edex®) is somewhat expensive. The injections that combine Alprostadil, Phentolamine and/or Papavarine, are usually less expensive.

Coverage for medical treatment and/or medication varies from one insurance provider to the another, and from one plan to another. It’s recommended you contact your healtcare insurance provider to determine what treatments for erectile dysfunction are covered by insurance.




Self-Injection of Alprostadil alone, or in combination with Phentolamine and/or Papavarine is a safe and reliable treatment for erectile dysfunction, or ED. Most men unable to realize satisfactory results using oral medication, or who are unable to use oral administered treatments because of possible reactions with other medications, report erections firm enough for penetration.

Self injection of ED treatment medication that is administered directly into the base penis is virtually painless, reported to be like pulling a hair from the back of your hand.

There are relatively few side effects to penile injection treatment of ED, and those are both rare and minor.

Penile injection therapy must be coordinated by a urologist, although the actual administration of the medication is be self-injection, and can be undergone as much as three times per week.

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