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MUSE For ED: Is It Safe?

Mary Lucas, RN

Medically reviewed by Mary Lucas, RN

Written by Our Editorial Team

Last updated 3/15/2022

From elastic and electric devices, to pills, topical creams and other therapies, there are plenty of erectile dysfunction (ED) treatments on the market making ED more manageable for the millions of men worldwide who have to deal with it. One of them is MUSE® for ED.

MUSE is a medication applied directly into the urethra and, despite what you may have heard, it’s actually fairly safe—assuming you use it as directed.

What Is MUSE and How Does It Affect Erectile Dysfunction?

MUSE is a ”transurethral system” for delivering an active ingredient called alprostadil directly to the area where it can work to increase your chance of erection. 

In other words, it’s a urethral suppository medication that you insert into your urethra with an applicator stem.

That sounds painful, perhaps, but it’s actually quite a simple way of taking the medication. 

MUSE delivers this medication in a suspension of polyethylene glycol, and when the medication (in pellet form) enters the urethra, it’s absorbed and broken down, where it begins working to increase the diameter of the blood vessels within your penis, helping the spongy tissue (your corpora cavernosa) to expand. 

This results in an erection

Side Effects of MUSE

Given the nature of how MUSE is used, you probably have some specific ideas in your mind about what side effects might arise from using it — and you’d be right in those assumptions.

With MUSE, the side effects included a variety of issues. 

In clinical trials, penile pain was the most reported side effect, with nearly a third of patients reporting pain in their penis, just over 10 percent reporting pain in the urethra, and a smaller number reporting testicular pain while using MUSE. 

However, most of these patients did report that the pain was mild and did not last for long.

Other unwanted effects included:

  • Minor bleeding in the urethra

  • Urethral Burning and Urethral Pain

  • Dizziness

  • Flu symptoms

  • Headache

  • Bodily Pain

Blood pressure and heart rate changes were recorded as lowered in some patients, and the drug instructions include warnings about low blood pressure and fainting—if you experience any of these, seek medical attention.

For these reasons, it is often recommended that you not perform tasks like operating heavy machinery or driving after using MUSE.

Oh, and it’s not particularly pleasant if it becomes an issue for your sexual partners, by the way—a female partner may also experience some vaginal burning and other issues if the medication is transferred to them. 

So, be sure to ask your healthcare provider for tips on how to prevent that if you decide to take MUSE.

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Is MUSE Safe?

It’s worth understanding that “safe” and “easy” are two different words when talking about prescription medications. MUSE comes with a risk of some stiff side effects that we mentioned above.

That said, it’s also been through a rigorous trial and testing phase from the Food and Drug Administration (FDA) and did gain their stamp of approval. So, it’s fair to say it’s safe enough

That said, the obvious point to make here is that unlike swallowing a pill, applications of MUSE could be considered hazardous tasks. Side effects of MUSE do on occasion include the possibility of urethral bleeding or permanent damage.

Additionally, several studies have delivered some information worth considering about the people who use MUSE.

A study of 100 patients from 2002 found that only 35 percent of patients were successfully treated, and less than half of those continued to use the medication after six months.

According to the study, those who stopped using MUSE did so either because it stopped being effective or because the side effects weren’t worth the benefits. 

Those common side effects we mentioned do sound pretty painful in some cases. But given that the study from 2002 only called the medication “moderately effective” in treating ED, it’s likely that patients simply wanted a higher return in exchange for their discomfort.

Actually, that’s how MUSE is described in several studies—an imperfect option, and not a first-line treatment. 

MUSE should generally be viewed as an alternative to consider for people who haven’t responded well to other treatments, or who cannot use other treatments due to things like preexisting conditions or drug interactions.

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Other Ways to Treat Erectile Dysfunction

So, you’re feeling a little put off by MUSE’s potential side effects, and you want to know what other options are out there. That’s totally okay.

There are more effective, well-known and better-researched medications on the market for ED treatment. Many of them fall into the category of phosphodiesterase type 5 inhibitors or PDE5 inhibitors. 

These erectile medications work in a roundabout way. They were originally designed for use in the cardiovascular disease world, but have found a home in erectile dysfunction treatment. PDE5 inhibitors stop the aforementioned enzyme (PDE5) from constricting the size of blood vessels, ensuring continued flow. 

When it comes to your penis, that means longer, more reliable erections. 

PDE5 Inhibitor Medications include:

A healthcare professional will typically start with sildenafil or tadalafil, though others may be prescribed based on your individual needs and side effects. Learn more in our Guide to PDE5 Inhibitors.

Sildenafil, which was the original “little blue pill,” is commonly prescribed for as-needed use. It’s the one you take at dinner time if dessert is going to be, well, something besides food. 

On the other hand, tadalafil can be prescribed as-needed, or as a daily medication according to the National Library of Medicine. In this format, taking it daily means that you can be ready to go without popping a pill in certain circumstances.

Both of these medications (as well as the other forms) are well-received by men and penises the world over: about 70 percent of men have been shown to benefit from PDE5 inhibitors. 

Of course, these medications and their effectiveness are also dependent on many variables. Your health, weight, lifestyle, alcohol and smoking are all important, as is the question of what’s causing your erectile dysfunction

Medications seem to be most effective for people who don’t have an obvious or specific cause of ED, though your healthcare provider can answer more questions about this if you’re unsure. 

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MUSE and ED: The Final Word

MUSE is one of quite a few FDA-approved medications for ED at this point. While safe enough, it does come with some potentially brutal side effects that may not make it right for you, and will likely only be recommended by your healthcare provider if other treatments aren’t proving effective. 

That said, before starting your search for treatment of erectile dysfunction, your first step should be talking with a healthcare professional.

Professional insight may help you address these problems through another method like diet and lifestyle changes, or weight loss or therapy.

Talking to a healthcare professional will also help you identify other, more serious conditions that might be causing ED as a side effect. 

6 Sources

Hims & Hers has strict sourcing guidelines to ensure our content is accurate and current. We rely on peer-reviewed studies, academic research institutions, and medical associations. We strive to use primary sources and refrain from using tertiary references.

  1. Erectile dysfunction: The Viagra revolution. (n.d.). Retrieved March 13, 2021, from https://www.health.harvard.edu/newsletter_article/Erectile_dysfunction_The_Viagra_revolution.
  2. Yafi, F. A., Jenkins, L., Albersen, M., Corona, G., Isidori, A. M., Goldfarb, S., Maggi, M., Nelson, C. J., Parish, S., Salonia, A., Tan, R., Mulhall, J. P., & Hellstrom, W. J. (2016). Erectile dysfunction. Nature reviews. Disease primers, 2, 16003. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5027992/.
  3. Padma-Nathan, H., Hellstrom, W. J., Kaiser, F. E., Labasky, R. F., Lue, T. F., Nolten, W. E., Norwood, P. C., Peterson, C. A., Shabsigh, R., Tam, P. Y., Place, V. A., & Gesundheit, N. (1997). Treatment of men with erectile dysfunction with transurethral alprostadil. Medicated Urethral System for Erection (MUSE) Study Group. The New England journal of medicine, 336(1), 1–7. https://pubmed.ncbi.nlm.nih.gov/8970933/.
  4. Khan, M. A., Raistrick, M., Mikhailidis, D. P., & Morgan, R. J. (2002). MUSE: clinical experience. Current medical research and opinion, 18(2), 64–67. https://pubmed.ncbi.nlm.nih.gov/12017211/.
  5. National Institutes of Health. (n.d.). DailyMed - MUSE- Alprostadil suppository. U.S. National Library of Medicine. Retrieved January 31, 2022, from https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=4c55f3f9-c4cf-11df-851a-0800200c9a66.
  6. Dhaliwal A, Gupta M. PDE5 Inhibitors. Updated 2021 Jun 25. In: StatPearls Internet. Treasure Island (FL): StatPearls Publishing; 2022 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK549843/

This article is for informational purposes only and does not constitute medical advice. The information contained herein is not a substitute for and should never be relied upon for professional medical advice. Always talk to your doctor about the risks and benefits of any treatment.