Erectile dysfunction is a total buzzkill that affects men everywhere. The longer you live, the higher your chances of dealing with it in your lifetime. There are many different treatment options, from penile injection to the infamous little blue pill. But what about treatment options for men who can’t (or don’t want to) take an ED medication?
Today we’re exploring alprostadil cream as an ED treatment. We’ll dive into what alprostadil cream is, if it helps ED, side effects and alternative treatment options.
The first-line of treatment for ED are oral PDE5 inhibitors. Four PDE5 inhibitors are currently approved by the FDA for the treatment of ED: sildenafil (Viagra®), tadalafil (Cialis®), avanafil (Stendra®) and vardenafil (Levitra®).
If these oral ED medications don’t work for you, penile injections with phentolamine, papaverine and alprostadil are considered the second-line treatment of erectile dysfunction, with alprostadil most commonly used.
Alprostadil can also be administered intraurethrally (into the urethra), by inserting a pellet into the urethral meatus and allowing the absorption of the drug into the corpora cavernosa.
Although less invasive than injections, this method results in less of an erectile response than intracavernosal injections, and is also associated with high rates of discontinuation due to urethral pain and bleeding.
That brings us to alprostadil cream. Alprostadil cream (Vitaros®) is a topical application of alprostadil used by patients with erectile dysfunction.
Alprostadil is a naturally occurring prostaglandin that’s used to dilate blood vessels and improve blood flow. When applied to the penis in topical cream form, alprostadil makes it easier to develop and maintain an erection.
Topical alprostadil cream may serve as an important second-line treatment for ED. It is less invasive than other second-line treatment options, has few side effects, and application is easy and painless.
Clinical trials have demonstrated that topical alprostadil cream is an effective alternative to the conventional treatment of ED.
Here’s the rub—at the present time, Vitaros topical cream has not been approved by the FDA for the treatment of ED, and is only available by prescription in the UK and certain other countries.
Yes, studies have shown that topical alprostadil cream does help men suffering from erectile dysfunction. In fact, using alprostadil cream has several advantages.
One advantage of Vitaros is the lack of drug interactions. Vitaros is a good option for men suffering from ED who cannot take first-line ED treatments, such as oral PDE5 inhibitors, due to drug interference. Oral medications, such as Viagra and Cialis, cannot be taken in combination with nitrates, and should be used cautiously and under the strict supervision of your healthcare providers with alpha-blockers and amlodipine.,
Vitaros doesn’t have any food and alcohol interactions, so another advantage is a higher degree of sexual spontaneity. You can still enjoy a meal and go out for drinks without worrying about an adverse reaction from your erectile dysfunction medication.
Vitaros also eliminates the need for the invasive nature and side effects of the intraurethral alprostadil pellets.
By eliminating many of these issues and roadblocks, many men may be more likely to use alprostadil cream in favor of other erectile dysfunction medications and treatments.
Vitaros has a few mild side effects, including genital pain, tenderness and erythema (skin redness) at the site of application.
In a 2016 study, over 97% of patients described the side effects of alprostadil cream as mild in intensity and short in duration (60 minutes or less).
Your female partner may also experience some mild side effects from the cream. The most common complaint of partners was vaginal burning or itching. Using a condom can be helpful in preventing vaginal burning or itching.
While we wait for alprostadil cream to become FDA-approved here in the U.S., sildenafil (Viagra) and tadalafil (Cialis) are two alternative options to treat ED.
Sildenafil, or generic Viagra, is a PDE5 inhibitor and is one of the most commonly known ED medications on the market today. Ever since FDA approved Viagra in 1998, sildenafil has been prescribed to patients across the U.S. for the last 20 years.
Sildenafil works by increasing blood flow to the penis, making it easier for you to get and maintain an erection when you’re sexually aroused.
However, like almost all medications, sildenafil does have the potential to cause side effects. Side effects can include headaches, muscle aches, nasal congestion, dizziness, facial flushing and more.
Tadalafil, or Cialis®, is another PDE5 inhibitor. Developed in the 1990s and approved by the FDA in 2003, tadalafil is a longer-lasting ED drug that provides similar effects to sildenafil.
With a 17.5 hour half life, tadalafil remains active for up to 36 hours after it's taken. This makes it the longest-acting of the erectile dysfunction drugs on the market today.
The side effects of tadalafil are similar to sildenafil, with headache, stuffy nose, heartburn and facial flushing the most common. Tadalafil can also cause muscle aches and back pain, which are usually a result of the drug’s vasodilation effect.
Topical alprostadil cream (Vitaros) may be a great option for the treatment of erectile dysfunction, with few side effects. The bad news is that alprostadil cream is not yet FDA-approved, and is only available by prescription in the UK and certain other countries.
While we wait for FDA-approval in the U.S., alternate treatment options include sildenafil, tadalafil and other oral ED medications. Talk to your healthcare provider about the ED treatment options that may be right for you.