Medically reviewed by Katelyn Hagerty, FNP
Written by Our Editorial Team
Last updated 12/9/2022
Erectile dysfunction, or ED, is a serious buzzkill that can affect men everywhere. An estimated 30 million men of all ages are affected in the US alone, and the longer you live, the higher your chances of dealing with this common form of sexual dysfunction become.
ED can vary in severity. For some men, it means never being able to develop an erection at all, even with significant sexual stimulation.
For others, it can mean difficulty with maintenance of erection — keeping a firm erection for long enough to have satisfying sex.
The good news is that ED is treatable, with options ranging from prescription medications such as sildenafil (the active ingredient in Viagra®) to vacuum erection devices, injection therapy and other options.
Recently, one medication that’s gained attention as a form of treatment for ED is alprostadil, a vasodilator that works by improving blood flow to your penis, resulting in improved erections.
Alprostadil comes in several forms, including an injectable solution, a suppository and a topical cream.
If you have erectile dysfunction and prefer not to take oral ED medication, alprostadil cream is one of several treatments for erectile dysfunction that’s worth considering.
Below, we’ve talked about what alprostadil cream is, as well as how it works as a treatment for erectile dysfunction.
We’ve also discussed the potential side effects of alprostadil cream, as well as alternatives to consider if you’re one of the tens of millions of men affected by ED.
Before we go into detail on what alprostadil is and how it works as a treatment for ED, let’s get one thing out of the way: research overwhelmingly shows that alprostadil cream works well for erectile dysfunction.
In a review published in the journal Research and Reports in Urology in 2016, researchers took a look at several clinical studies of alprostadil gels and creams for ED.
They concluded that alprostadil topical products worked well as treatments for ED, with the men who participated in studies showing improvements in erections and largely tolerable alprostadil side effects.
They also found that the safety of alprostadil creams was high when the products were used as prescribed.
Put simply, alprostadil appears to work well for ED, with high effectiveness and adverse effects that aren’t particularly common or severe.
With that out of the way, let’s get into more detail about what alprostadil is and how it works as a treatment for erectile dysfunction.
Alprostadil is a naturally occurring prostaglandin. It belongs to a class of medications referred to as vasodilators, which work by relaxing your blood vessels and improving blood flow throughout your body.
Healthy, rigid erections are all about healthy, consistent blood flow. When you feel aroused, your blood vessels dilate, allowing blood to flow into the corpora cavernosa — two cylindrical areas of erectile tissue inside your penis.
As blood pressure inside your penis increases, you’ll develop an erection that’s firm enough for penetrative sex.
So, how does alprostadil cream fit into this process? As a vasodilator, alprostadil cream dilates your blood vessels, making it easier for blood to flow into specific areas of your body.
When applied to your penis, alprostadil can improve blood flow, helping you to get and maintain an erection when you feel sexually aroused.
One popular brand of alprostadil cream is Vitaros®. Vitaros cream is applied to the end of your penis shortly before sexual activity. This stimulates local blood flow and makes it easier for you to get and stay hard when you’re sexually stimulated.
Currently, alprostadil cream for erectile dysfunction isn’t a first-line treatment, meaning it isn’t a medication your healthcare provider will typically prescribe if you have ED.
Instead, most men with ED are treated using phosphodiesterase-5 inhibitors (PDE5 inhibitors), which are also taken before sex.
One major reason for this is that Vitaros cream hasn’t been approved by the FDA for use in the United States.
However, alprostadil creams and other products are often prescribed in other parts of the world as second-line treatments for ED when PDE5 inhibitors are ineffective, inconvenient to use or cause unwanted side effects or safety risks.
Our guide to erectile dysfunction creams goes into more detail about how these products work, as well as their unique advantages and disadvantages.
Alprostadil has been extensively studied as a form of injectable medication for ED, marketed as Caverject®, Edex® and Muse®.
Over the last decade, researchers have also studied the effectiveness of alprostadil cream as a form of treatment for ED.
Studies have shown a clear link between the use of topical alprostadil cream and improvements in erectile function and general sexual performance in men. In fact, alprostadil cream appears to have several advantages over more conventional options for treating ED.
One advantage of Vitaros is the lack of drug interactions. Vitaros may be a good option for men suffering from ED who can’t take first-line ED treatments, such as oral PDE5 inhibitors, due to a risk of drug interference.
Oral PDE5 inhibitors can interact with certain medications, including nitrates and alpha-blockers, meaning they aren’t safe for all men.
If you currently take medication to treat chest pain, high blood pressure or other cardiovascular health conditions, your healthcare provider may suggest against using a PDE5 inhibitor.
Vitaros also doesn’t have any food and alcohol interactions, which can make it a good option for spontaneous sex after a night out.
As a topical cream, Vitaros is easier and more pleasant to apply than an intraurethral alprostadil ED suppository or injection. The process of applying it to your penis is quick and easy, meaning you can use Vitaros before sex without any significant inconvenience or discomfort.
By eliminating many of these issues and roadblocks, men might be more likely to use alprostadil cream in favor of other erectile dysfunction medications and treatments.
Alprostadil cream is generally a safe and effective medication for ED. Because it hasn’t received approval from the FDA, there isn’t a clearly defined list of side effects associated with alprostadil cream just yet.
However, studies of alprostadil cream have established several common side effects associated with this medication. These include:
Redness and skin rash
Mild pain or discomfort
Alprostadil cream may also cause a vaginal burning sensation or irritation in the vagina when it’s transferred to your partner during sex. Using a condom during sex can be helpful in preventing this side effect.
Your risk of developing side effects from alprostadil cream may vary based on the type of cream formulation you use.
Currently, alprostadil cream isn’t approved by the FDA, meaning it isn’t available as a treatment for erectile dysfunction in the United States.
However, there are several FDA-approved, evidence-based medications that you can use if you have ED and want to improve your sexual function.
The most popular treatments for ED are oral PDE-5 inhibitors, which are prescription drugs that you can take before having sex to increase blood flow and make getting an erection easier.
Widely-used PDE5 inhibitors include sildenafil (Viagra®), tadalafil (Cialis®), vardenafil (Levitra®) and avanafil (Stendra®).
We offer these ED treatments online, following a consultation with a healthcare provider who will determine if a prescription is appropriate.
When oral medications aren’t effective, erectile dysfunction is treated with injectable medication and penile suppositories for ED. Alprostadil is available as an injection and urethral suppository that’s inserted into your penis before sexual activity.
Other options for treating erectile dysfunction include:
Counseling to overcome mental health issues, such as depression or anxiety
Vacuum devices to pull blood into your penis and create an erection
Surgery to repair arteries or insert an implant into your penis
Often, treating underlying health issues, such as heart disease or diabetes, can help to improve your erections and sexual function.
Making changes to your habits and lifestyle could also help to make getting and maintaining an erection easier. Healthy habits for better sexual function include exercising frequently, reducing your alcohol consumption, eating a balanced diet and quitting smoking.
We’ve discussed these habits and lifestyle changes in more detail in our guide to maintaining a healthy erection naturally.
Topical alprostadil cream, sold under the brand name Vitaros, may be a solid treatment for erectile dysfunction, particularly with its limited side effects profile. However, it isn’t yet approved by the FDA, and as such, isn’t available in the United States at the moment.
This may change in the future. However, for now, if you would like to use alprostadil for erectile dysfunction, you’ll need to use alprostadil pellets or an alprostadil injection.
The good news is that several other options are available to help you successfully deal with ED, including oral medications that you can use before sex.
If you’d like to try these medications, you can participate in an online ED consultation to find out more about your options.
You can also learn more about successfully treating erectile dysfunction with our detailed guide to the most common ED treatments.