Suppositories

For this treatment, known as "transurethral pharmacotherapy,"the man with erectile dysfunction places a suppository into the urinary tube (urethra) using a plastic applicator. The suppository contains the medicine alprostadil (Muse), which is absorbed into the nearby erection chambers (corpora cavernosa). Alprostadil belongs to a group of drugs called vasodilators—drugs that increase blood flow by relaxing and expanding blood vessels. It is identical to a naturally occurring substance found in the body that helps keep the blood vessels open, and it helps treat ED by increasing the blood flow to the penis.

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Though suppositories appear to be less effective than either injections or vacuum therapy, the drug can be used to treat erectile dysfunction due to a wide variety of causes.

Before inserting the suppository, you should urinate; the small amount of urine left in the urethra will help dissolve the suppository after you insert it. To help dissolve the suppository, roll your penis between your hands for 10 seconds. If you feel any stinging, continue this motion to help stop it. Sitting, standing, or walking for 10 minutes while an erection develops can help increase the blood flow to your penis to gain a proper erection. Alprostadil usually begins to work in about five to 10 minutes. Intercourse should be attempted within 10 to 30 minutes of using this medication. An erection may continue after ejaculation.

Do not insert more than two doses of alprostadil within a 24-hour period and do not use any more than the doctor-recommended dose. This could result in permanent damage to your penis.

When using a suppository form of alprostadil, it is advisable to use a condom if having sexual intercourse with a pregnant woman. While it is unlikely that a fetus will be harmed by the medication, the condom will protect it from exposure. The effects of alprostadil on early pregnancy are still unknown.

Possible side effects include mild bleeding or spotting from the urethra and stinging of the urethra. Contact your doctor if you experience curving of the penis with pain during an erection, an erection that lasts four to six hours with pain, swelling of or pain in the testes, dizziness, faintness, pelvic pain, or flulike symptoms.

Men who do not have erectile dysfunction should not use alprostadil as a sexual aid. If this medicine is not used properly, permanent damage to the penis and loss of the ability to have erections could result.