Sexual dysfunction, or what we medically call Erectile Dysfunction (ED) , is a health problem that many people are reluctant to talk about, but it is a common problem in society. You may have heard of pills as a solution to this. But those pills may not work for everyone, or they may cause side effects. Today we are going to talk about a next-step treatment that doctors recommend in such cases. That is Alprostadil .
What is Alprostadil?
Simply put, this is a type of drug that widens our blood vessels and facilitates blood flow (Vasodilator) . This drug increases blood flow to the penis, creating and maintaining an erection. The special thing is that Alprostadil is similar to a substance that is naturally produced in our body and helps keep blood vessels open.
But this is very important. If you do not have Erectile Dysfunction (ED) , you should definitely not use this medicine. Also, using more than the amount recommended by your doctor can cause permanent damage to your penis and even risk never getting it back.
Is Alprostadil right for me? Things to tell your doctor
If oral medications for ED are not effective for you or cause side effects, your doctor may consider Alprostadil as a next-step treatment.
Before using this medicine, be sure to inform your doctor about the following:
- If you have had an allergic reaction to Alprostadil in the past.
- If you have allergies to other foods, medications, preservatives, or colorings.
- About any medications you are taking (including prescription, over-the-counter (OTC), herbal, or vitamin).
- If you have had any type of penile implant.
- If you have ever had painful, hours-long erections (priapism) before.
- If you have a congenital abnormality of the penis, excessive curvature of the penis during erection (Peyronie's disease), an infection of the penis, or a medical condition that affects blood flow (e.g. leukemia, multiple myeloma, sickle cell disease).
How do you use this medicine?
Alprostadil comes in two main forms. It is important to be aware of these two forms.
| Treatment method | Description |
|---|---|
| Injectable Alprostadil (injection) | It comes as a powder. It is mixed with a liquid and injected into the side of the penis using a very small needle. Sometimes it is also given as a mixture with other medications (Bimix, Trimix). Don't worry, your doctor will teach you how to do this exactly. The dose is different for each person, so it may take some time to find the right dose. |
| Transurethral Alprostadil (insertion of a pill) | This is like a very small pill (suppository). It needs to be inserted into the urethra. It then dissolves inside and is absorbed into the body. However, studies show that this method is not as effective as the injection, and there is a higher risk of pain and inflammation in the penis. |
Is there an Alprostadil cream?
Alprostadil is also available as a cream or gel. It is meant to be applied to the tip of the penis before sexual intercourse. However, this method is not yet approved or widely used in many countries, including Sri Lanka. Therefore, it is not a common option.
Important things to know when using
- How many times can it be used?
- Injection method: Do not use more than two or three times a week. After using once, wait at least 24 hours before using again.
- Transurethral method: Do not use more than twice within 24 hours.
- How long does it take to take effect?
- Injection method: Enthusiasm should occur within 5 to 20 minutes.
- Transurethral method: Starts working within 10 minutes.
- How long does it take to revive?
- Arousal usually lasts between 30 minutes and an hour. Even if arousal persists after orgasm, it should wear off within an hour.
When you need to see a doctor immediately
If you experience any of the following symptoms, see your doctor as soon as possible:
- If there is a painful bending of the penis during erection.
- If your awakening lasts more than 2 hours .
- If you experience swelling or pain in the testicles, feet, or surrounding area.
- If you develop symptoms of a flu-like illness such as fever, chills, nausea, and vomiting.
- If you feel dizzy or faint.
- If there are any scars or hard lumps on the penis.
- If the needle breaks while giving the injection.
If your erection lasts more than 4 hours, it is an emergency. Go to the nearest hospital emergency room (ETU) immediately. If this condition is not treated quickly, it can cause permanent damage to the tissues of the penis.
The most important warning: Do not use with other medications!
This is the most important thing you need to remember. Do not, under any circumstances, use it with other oral ED medications such as Alprostadil or Viagra®.
If you do, you run a very high risk of developing a painful erection that lasts more than 4 hours (priapism), a serious condition that requires treatment in an emergency room (ETU).
Take-Home Message
- Alprostadil is a second-line treatment for erectile dysfunction (ED), used when pills are not effective.
- This comes as an injection or as a tablet that is inserted into the urethra. Your doctor will decide which method is best for you and teach you how to use it.
- Always follow your doctor's instructions. Never use more than the prescribed dose and frequency.
- A seizure lasting more than 4 hours is a medical emergency and requires immediate referral to a hospital's Emergency Treatment Unit (ETU).
- Do not use with other ED medications such as Alprostadil or Viagra® for any reason.
- Erectile dysfunction is a common medical condition. Don't be ashamed or embarrassed about it. Talk openly with your doctor and choose the safest and most effective solution for you.
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