There are many potential causes of chronic erectile dysfunction (ED). (Learn More)
Perhaps the topical treatment that has the most promise in the treatment of erectile dysfunction is Vitaros, a cream that uses the vasodilator alprostadil. (Learn More) There are other creams on the market that use vasodilators like L-arginine and nitroglycerin. (Learn More)
There are potential advantages and disadvantages to using creams to treat ED. (Learn More)
Before using any over-the-counter product or product advertised online, you should take certain precautions. (Learn More) Discuss your situation with your physician before making a decision about what treatment to use. (Learn More)
Nearly all men will experience a bout of erectile dysfunction (ED) during their lifetime; however, the majority of cases of ED are transient and resolve on their own.
Chronic ED is a complex problem that may be the result of one or more different causes.
- A psychological or emotional problem
- Chronic drug or alcohol abuse
- Issues with the nervous system, circulation, or hormone production
- Some physical injury or neurological insult, such as a stroke
Many cases of chronic ED can be treated.
Approaches to Treating Erectile Dysfunction
There are several approaches to treating erectile dysfunction that include psychotherapy or other behavioral approaches like stress management if the problem is not physical.
Psychotherapy could address deep-rooted psychological issues that are resulting in the problem. It may also teach stress management techniques if it is deemed that stress and nervousness are contributing to your issue with ED.
If ED is related to a physical issue, the primary treatments are medications that are oral phosphodiesterase type 5 inhibitors like Viagra and Cialis. Injections of vasodilators like alprostadil (the only medication approved as an injectable) are the second-line approach.
Additional potential treatments include topical creams, penal implants, and other surgical procedures.
While medications like Viagra and injections containing alprostadil are approved by the Food and Drug Administration (FDA) for the treatment of ED, there are currently no creams that are approved by the FDA to treat erectile dysfunction.
The FDA has issued several warnings about possible risks of using certain types of products to treat ED. The FDA considers risks associated with some of the medications in these creams high enough to withhold formal approval of these products. Nonetheless, there are several creams on the market.
Vitaros for ED
There have been several topical creams that contain alprostadil that have been tested for the treatment of erectile dysfunction. Alprostadil is a vasodilator, meaning that it allows blood to flow more easily throughout the body. This helps you to achieve an erection if you have ED.
Vitaros has been approved in Europe and Canada, but it was recently turned down for approval again by the FDA.
Research studies have suggested that the gel led to an erection in two-thirds to three-quarters of research study participants who used it compared to less than 20 percent of comparison subjects using a placebo.
L-arginine and Nitroglycerin Creams for ED
Many of the other topical creams on the market that are sold as treatments for ED contain L-arginine, an amino acid. L-arginine is considered to be a natural vasodilator, although the research regarding the effectiveness of these creams is limited at best.
There are some other creams that utilize nitroglycerin, another vasodilator, such as Nitro-Bid (for angina). The research evidence for the effectiveness of these types of creams for the treatment of ED is also very limited despite claims of those attempting to market them.
Potential Advantages and Disadvantages
The makers of these topical creams list the following advantages for their use:
- Many are commercially available, and many do not require a prescription.
- They may produce fewer side effects than primary and secondary treatments for ED.
- They are easy to apply and need only be used 10 to 20 minutes before sexual activity compared to the need to use other interventions as long as 30 to 60 minutes before sex.
- They last for about one or two hours.
- There is no need to use a needle or take a medication that produces generalized effects throughout the body.
The following are disadvantages of these products:
- Their effectiveness is not documented by research studies (except for alprostadil), indicating that there is little objective evidence that they work.
- Some of the additives in these creams may lead to more serious side effects than the active medication.
- These products may have completely different side effects than standard treatments for ED, and some of these side effects may be potentially dangerous.
- None of them are formally approved to treat ED.
Before You Try
Herbal treatments for ED sold at your local health food store or online may contain dangerous additives that can affect your health. The manufacturers of these products are not regulated by the FDA. The creams may contain ingredients that are not listed on the label, and they may not contain the ingredients that are listed.
Never use ED treatments in combination, such as taking Viagra and using a cream or penile injectable drug. The combination of these drugs can lead to serious health effects, including increased risk of bleeding or the potential for a serious cardiovascular event.
Should I Use a Cream?
Because topical treatments for ED are not approved by the FDA, these creams are not recommended.
If you are suffering from problems with ED, discuss the situation with your physician to learn about potential treatment options that may be beneficial for you.
Erectile Dysfunction. (January 2013). The Lancet.
Erectile Dysfunction: AUA Guideline. (September 2018). American Urology Association.
FDA warns consumers not to use unapproved erectile dysfunction products advertised on the radio. (March 2018). Food and Drug Administration.
Vitaros 3 mg/g cream – Summary of Product Characteristics. (November 2017). Medicine.org UK.
L Argentine. Potential benefits, side effects, and risks. (June 2017). Medical News Today.
Medication guide: AndroGel. (May 2015). Food and Drug Administration.