Medication for Erectile Dysfunction

After a spinal cord injury, getting and maintaining an erection can be frustrating. Fortunately, there are medications that can help.

Get help with erectile dysfunction (ED) after paralysis.

Your spinal cord injury (SCI) may affect your ability to achieve an erection. Or, you might have problems with the quality of your erection, such as lack of stiffness or duration. The good news is that there are several drug therapies that address these issues.

The type of medication that’s best for you depends on your specific situation. Below are a few options to consider discussing with your medical team.

Oral ED Medications 

You may have heard about erectile dysfunction (ED) medications, such as Viagra®, Cialis®, and Levitra®. It’s important to understand that these drugs are not designed to stimulate or create a feeling of desire. You’re not likely to get an erection solely by using them. If you are capable of getting an erection, however, they can be used to strengthen or extend it.

It’s important to be aware that these drugs can possibly have serious interactions with other medications, including those that treat blood pressure issues. In addition, alcohol consumption can involuntarily strengthen the effect of oral ED medications. Carefully follow your doctor's advice regarding the dosage and consult him or her if an erection lasts longer than three hours, as this can cause serious health problems.

ED Injection Therapy 

Another option for men with ED is injection therapy, where you use injectable medications such as alprostadil, phentolamine, and phentolamine/papaverine. Here's how it works:

• You (or your partner) inject the medication directly into your penis 15 minutes before sex
• A thin needle is used to inject the drug on the right or left side of your penis
• The erection may last up to an hour.
• Side effects can include mild bleeding from the injection, prolonged erection (priapism) and, rarely, formation of fibrous tissue at the injection site

Medical Urethral System for Erection 

A third option is a medical urethral system for erection (MUSE). This involves placing a tiny alprostadil suppository inside your penis. Here’s how it works:

• You use a special applicator to insert the suppository (a small pellet) through the tip of your penis into your urethra
• Blood flow to your penis increases and, after about 10 minutes, causes an erection
• When effective, the erection lasts between 30 and 60 minutes
• Side effects can include a burning feeling in the penis, minor bleeding in the urethra, and formation of fibrous tissue inside your penis

What’s right for you?

Consult with your healthcare team to see what medication or option will work best for you, given your unique situation. All drug therapies must be prescribed and monitored by your doctor. You may also want to ask about mechanical aids for ED, which some men with spinal cord injuries prefer.