There is a tremendous amount of misinformation regarding penile injection therapy for ED. The first falsehood is that it hurts. Normally one uses an injection device and the injectable goes right into the cavernosa or erection chambers. This does not go systemic and the effects remain localized so there are aspects that are actually safer than the orals. You do not risk hearing or vision. The penis actually has only limited ability to feel pain because the nerve structures are actually designed more for other purposes.
There are many formulae for injectable ED mixtures. Common caverject is little more than Prostaglandin E-1. The good with straight prostaglandin is that it works. The bad is that the patient forms a tolerance or resistance to the straight or singular formula more quickly. The other options are Bi-Mix, Tri-Mix and Quadmix. There is also the newest mixture which uses 5 ingredients.
The tolerance or resistance fades if one takes time off periodically and fades back to normal. This is not permanent. When I was first placed on injection therapy my Rx was for a given amount. My actual beginning injections were in fact about 1/3 that quantity. It took about 3-5 months for me to build enough resistance to where I actually needed the full amount. If I take a few months off or use it in alternating times with combination oral therapy this does not happen.
I have used this on and off for years, and if done correctly it is safe, effective and poses very little risk for other problems.
The greater the number of ingredients in the mix the more effective the mix and the more adjustable the mix becomes to the needs of the individual patient. Adjustments in the percentage of each ingredient in the injection changes the effect a great deal. One can extend duration in a patient and reduce the intensity or strength of the erection or the opposite can be done.
The strength of the erection changes sensation a great deal. The stronger the erection the more intense the stimulation of your penis. In time the best MD's dealing with ED make adjustments to tailor the erection to patient preferences.
The biggest problem to me with the injectable medications is that they must be refrigerated and they are anything but "portable" and you simply cannot travel and keep a supply with you. This is why you need a real expert when dealing with ED in this manner.
Most MD's are not qualified to handle injectable ED therapy and most are not aware of how many adjustments can be made to make this in fact the most effective and most pleasurable manner in which to proceed.
Cost of the injectables depends on sourcing. There are compounding pharmacies all over this country that ship via FedEx air. If this stuff is cold-packed it will keep for 24-hours from the time it leaves the Pharmacist. You need to really stay on top of pricing and remember that you need to price shop because an individual formula can vary between compounding pharmacies by a wide margin. Some of the less honest pharmacists will invent government rules and regulations that in fact are used to mark up their products. The more you buy in a single order the cheaper that this gets. If you were to buy your supply six months at a time it comes out far cheaper per injection than the cost of the oral medication. Again you MUST price shop your prescription. Avoid situations where there are MD kickbacks from certain pharmacies. Get your first Rx and then price shop after that requesting the pharmacy change as needed to save yourself a great deal of money.
Orals have great limitations and are most effective if the erectile dysfunction is mild to moderate. The effectiveness begins to drop off as the severity of the erectile dysfunction increases.
The orals have proven safe under physician supervision at dosages far higher than originally thought. Some treating ED are now using combination therapy. This means a combination of Viagra and Cialis. These are given at a lower dosage and the combination is effective in ED that is of higher severity.
If you need injection therapy and do not have severe side effects from the orals with the main problem being that the medication is not effective combination therapy can be tried. The only combination that works is the combination of Viagra and Cialis. Both use a slightly different method of operation even though they are both PDE-5 inhibitors. Viagra and Levitra operate in exactly the same way.
This really requires an expert and the best therapy is the Quad or new 5-mix specials. They are far more stable and it takes far longer to build resistance. This should be prescribed along with oral combination therapy to allow you the freedom to travel and still have fun with your partner.
I started this treatment quite a few years ago and I tailor what I do in medication to what I am going to do in bed. If I don't need anything for what is planned I don't take anything. If my other half simply wants to give me oral sex I require very little chemical aid for that. If I need to penetrate I need more.
The nicest thing I can say is that I wish I was not an expert at this one but unfortunately I am, and I am well versed in this one.