Do topical creams work for erectile dysfunction?

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Many scientifically proven treatments are available for ED. Among the newest remedies are topical creams, which are now available in some countries. However, these creams are not currently approved by the Food and Drug Administration (FDA) for use in the United States.

Read on to learn more about topical creams for ED, whether they work, and potential risks.

A quick look at the best erectile dysfunction topical cream alternatives

• Best online sex therapy: Talkspace
• Best penis pump: POS-T-VAC Vacuum Erection System
• Best for Viagra: Hims

ED is a condition in which a person cannot achieve or maintain an erection.

The National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) states that a person may experience ED due to psychological or physiological causes.

In some cases, ED could stem from a combination of both.

Psychological causes of ED include:

• anxiety
• depression
• guilt
• concerns relating to intimacy
• sexual trauma
• low self-esteem
• stress

Physiological causes of ED can include:

• increased age
• type 2 diabetes
• multiple sclerosis
• side effects of certain medications
• high blood pressure
• surgery for bladder cancer

Topical creams for erectile dysfunction aim to increase blood flow to the area by widening the blood vessels within the penis.

A person will apply these creams directly to the penis before sex.

The regulatory bodies of some countries have approved topical creams to treat ED. However, the FDA has not approved topical creams for ED treatment in the U.S.

There is limited up-to-date research on how effective topical creams for ED are.

An older 2016 review examines topical alprostadil cream, which enables the blood vessels to expand. The authors conclude that this drug may be a useful, safe alternative for people unable to take oral medication for ED.

Another 2016 review of alprostadil arrived at a similar conclusion, suggesting the drug is beneficial for people with ED.

Although topical alprostadil is available in some countries, the FDA does not currently approve the cream.

However, the drug is available in the U.S. in other forms, including a version that people can inject into the penis and a penile suppository.

According to safety information for alprostadil, some common side effects include:

• prolonged erection of more than 4 hours, known as priapism
• dizziness
• rash
• urethral pain
• burning, pain, and tingling in the penis
• numbness in the penis
• inflammation of the head of the penis (balanitis)
• genital itching

Some uncommon but serious side effects may also include:

• lightheadedness or dizziness
• fainting, known as syncope
• low blood pressure or rapid pulse
• narrowing of the urethra
• increase in sensitivity
• scrotal pain
• lack of sensation in the penis
• urinary tract inflammation

People should note that this cream may also have side effects for the partner or partners of the person who uses it. These may include burning or itching in the vagina or anus.

People apply topical ED creams onto the penis surface and surrounding areas. In some cases, a person may need to apply the cream into the urethra.

Exact application instructions may vary among products. However, most creams require people to apply them at least 30 minutes before sexual activity.

Although males can be uncomfortable speaking with a doctor about ED, they should work with a healthcare professional to determine the underlying cause of their ED.

Depending on what the trigger is, a doctor may suggest the following alternative treatments:

Sex therapy

If a person’s ED is due to guilt, negative sexual experiences, or concerns relating to intimacy, a sex therapist could help them overcome their issues.

Best online sex therapy: Talkspace

Talkspace is an online therapy service. It offers both individual and couples therapy.

Some Talkspace therapists specialize in sex problems, so a person can use its services to discuss ED.

Pricing will vary depending on location and the plan a person chooses. Prices start from $69–129 per month.

The potential advantages and disadvantages of this service include:

Pros

• provides unlimited access to communication with a therapist
• is entirely online
• has options for both individual and couples counseling

Cons

• may be costly
• may have longer wait times for specialist sex therapists
• live sessions are limited to 30 minutes
• does not accept all insurance plans

Cock ring and penis pump

A penis pump, such as a vacuum erectile device or VED, works by drawing blood into the penis to help achieve an erection.

Click here to learn more about ED pumps.

A person can use this alongside a cock ring, which can trap the blood in the penis to maintain the erection.

Click here to learn more about ED rings.

Best penis pump: POS-T-VAC Vacuum Erection System

The POS-T-VAC is a battery-powered pump for ED. The company claims it is easy to use with just one button, and there are a variety of ring sizes to choose from.

The product also comes with a 1-year warranty.

The system costs around $109.

A person can consider the following benefits and drawbacks:

Pros

• simple to operate
• comes with a range of ring sizes

Cons

• not rechargeable
• may cause bruising
• may not be effective if the underlying ED problem is psychological
• expensive

Viagra

Viagra is a drug that helps stimulate blood flow to the penis, which can help a person achieve an erection.

This is usually the first-line treatment for people with ED symptoms.

Best for Viagra: Hims

Hims sells Viagra and generic Viagra online.

When using Hims services, a person will speak with a doctor before getting a prescription for medication.

Brand-name Viagra is more expensive than the generic version of the drug. With Hims, brand-name Viagra costs $70 per pill.

The benefits and drawbacks to consider include:

Pros

• may help a person achieve and maintain an erection
• can be taken as needed rather than on a daily basis
• widely used and studied
• FDA approved

Cons

• may cause side effects
• can be expensive if using the brand-name version
• must be taken an hour before sexual intercourse
• may interact with other medications

Penis sleeve

A penis sleeve, or external penile prosthetic, is a sex toy that a person places over their penis.

According to a 2017 article, penis sleeves may be a suitable strategy to manage ED without drugs or surgery.

Click here to learn more about penis sleeves.

Weight loss

Older research suggests that obesity may cause ED.

Research from 2019 reinforces this, concluding that there is a link between ED and obesity.

Therefore, a person with obesity may wish to maintain a moderate weight.

The Centers for Disease Control and Prevention (CDC) recommend gradual weight loss, as rapid weight loss may be unsafe and lead to difficulty keeping the weight off.

The benefits and drawbacks of losing weight for ED include:

Pros

• may improve metabolism
• may promote a range of other health benefits, including improved cholesterol levels, blood pressure, blood sugar levels, energy levels, mobility, mood, and confidence

Cons

• may take time
• not all diets are safe
• requires ongoing support from a doctor, dietitian, or nutritionist

Change of medication

Sometimes, certain medications may trigger a person’s ED.

A person should consider discussing this with a doctor to see whether alternative medications are available.

The benefits and drawbacks of switching medications to improve ED include:

Pros

• may help improve or resolve erectile dysfunction

Cons

• may result in side effects
• is not an immediate fix, as a person will likely taper off existing medications
• is not an option in cases where no suitable replacement exists

Stopping smoking

Although there is limited recent research into the link between smoking and ED, an older review from 2014 shows that there is a large amount of evidence linking smoking with ED.

The authors write that smoking lowers nitric oxide levels and affects the function of vascular systems. As erections depend on vascular changes, problems with the vascular system can affect a person’s ability to get or maintain an erection.

People who wish to treat their ED could try techniques to limit or stop smoking.

These include:

• self-help guides
• counseling
• nicotine patches, lozenges, inhalers, or gum
• medication

There is a range of advantages and disadvantages to consider when thinking about quitting smoking, including:

Pros

• offers various health benefits, including reducing risks of 12 types of cancer, premature death, reproductive health problems, and heart and lung conditions
• benefits people of any age
• can reduce financial burden

Cons

• may take time
• may cause certain side effects
• not all quit methods are equally effective
• can require the support of doctors and friends and family

The table below compares each of the alternatives to topical treatments for ED.

A person should speak with a doctor about ED as soon as they experience symptoms.

A doctor will be able to find out if an underlying health condition is causing ED and suggest the most appropriate treatment.

A person may wish to involve their partner in discussions about ED. Research shows that 94% of males with ED felt that the support of their partner was important.

Below we answer some frequently asked questions about topical creams for ED.

Is there any ointment for erectile dysfunction?

There are no topical treatments for ED available in the U.S. This is because the FDA has not approved topical treatments for this condition.

However, certain creams, such as alprostadil, have been approved in other countries.

Where can I buy topical cream for erectile dysfunction?

Topical creams for ED are not available in the U.S.

Is there a Viagra gel?

There is currently no gel-based Viagra available for purchase within the U.S.

ED is a condition in which a person cannot achieve or maintain an erection.

Some evidence suggests that topical creams may be a useful treatment for ED. Although these creams are available in other parts of the world, such as Europe and Canada, the FDA does not currently approve the use of these products in the U.S.

People with ED can discuss their symptoms with a doctor, who may recommend appropriate treatment strategies.