Botox for ED: Does It Work?

Botox^® is well-known for smoothing out facial wrinkles and preventing migraine attacks, but could it also hold the secret to enhancing your erections?

Some proponents say Botox may improve erectile dysfunction (ED) by relaxing the smooth muscles in the penis and enhancing blood flow. But using Botox for ED is still relatively new and experimental.

Keep reading to learn how well Botox works as an ED treatment, the side effects you should know about, and other proven therapies to consider.

Botox (AKA botulinum toxin injection) is a popular cosmetic treatment that smooths and prevents wrinkle lines.

It’s made from a bacterium called Clostridium botulinum and works by blocking acetylcholine, a neurotransmitter involved in muscle contraction.

Of the seven types of botulinum neurotoxins, only botulinum toxin A and B are used in medical and cosmetic treatments.

Botox may help with erectile dysfunction by relaxing the smooth muscles in the blood vessels of the penis, improving blood flow — a crucial ingredient for getting and maintaining erections.

In addition to blocking acetylcholine, Botox also suppresses norepinephrine and stimulates cyclic adenosine monophosphate. Studies show norepinephrine levels increase during sexual arousal in men with ED. Other research suggests adenosine acts as a vasodilator to promote smooth muscle relaxation.

According to the American Urological Association, Botox’s effects are similar to those of phosphodiesterase type 5 inhibitors (PDE5 inhibitors), like Viagra^® or Cialis^®, rather than intracavernosal injection therapies like TriMix.

Research on the efficacy of Botox for ED is limited but promising. While some research has shown beneficial effects in some men, more research needs to be done. And Botox is currently not an FDA-approved treatment for erectile dysfunction.

Botox Outperforms Placebo

A six-month randomized controlled trial involving 176 patients compared Botox to a placebo for sexual performance. Participants were divided into three groups: one received 100 units of Botox, another 50 units, and the third a placebo.

Both Botox groups saw significant improvements in sexual performance and erection quality, with results peaking around the third month. By month six, the 100-unit dose proved more effective than 50 units, while the placebo group showed little change. Botox patients also experienced an increase in penile length.

Botox Can Work as an Add-On Therapy

A 2019 study examined botulinum toxin as an add-on therapy for people who don’t respond to standard ED treatments like PDE5 inhibitors or prostaglandin E1 injections.

Fifty-four percent of patients saw improved erectile function when Dysport^® — a product similar to Botox — was added to their treatment.

Researchers also found that Botox injections directly into the penis (intra-cavernous) worked best for milder cases of ED.

Botox Shows Promise As a Long-Term Treatment

Another study examined the long-term effects of Botox for ED, combined with either PDE5 inhibitors or prostaglandin E1 injections.

Of 216 men, around 43 percent requested at least a second injection. Researchers reported that 77.5 percent responded positively, with even better outcomes after repeat injections. This suggests Botox could provide lasting benefits over time.

Botox Treatment May Improve Other Penile Problems

Botox might also do more than help with ED — it could also improve sexual health in surprising ways.

A 2018 case study outlines its potential to treat priapism, a condition causing prolonged, painful erections due to trapped blood in the penis.

In this case, a 31-year-old man had been managing his priapism with cyproterone acetate, but the medication led to frustrating side effects like ED, low libido, and pelvic pain.

Switching to Botox injections helped prevent future episodes and eliminated those unwanted side effects.

Research is also ongoing into Botox for scrotal tightness and pain, penile enlargement, and penile retraction.

Botox isn’t FDA-approved for erectile dysfunction and may not be covered by your insurance.

Costs can go as high as $15,000, but pricing varies widely from clinic to clinic and depends on factors like dosage and provider expertise.

Similar to Botox injections in other parts of the body, an intra-cavernous injection of Botox can cause side effects. Side effects of Botox injections in general include:

• Bruising and pain at the injection site

• Redness

• Headaches

• Flu-like symptoms

• Nausea

If the toxin spreads beyond the treatment area, it can cause other symptoms.

While the research looks promising so far, there’s still a lot we don’t know about the safety and efficacy of Botox for ED. It simply hasn’t been studied and used as much as other ED treatments.

Until it is, consider these proven ED treatments:

• Oral medication. These medications include Viagra (sildenafil), Cialis (tadalafil), and chewable ED medication like Hims Hard Mints.

• Therapy. Sex therapy, couples therapy, or individual therapy can help with many cases of ED, especially in younger men.

• Vacuum erection devices. These devices pull blood into the tissues inside your penis to help you maintain an erection. You can often use them with a penis ring.

• Testosterone replacement therapy. If the root of your ED is low testosterone, testosterone replacement therapy (TRT) may help you have better erections again.

• Shockwave therapy. Shockwave therapy uses low-intensity shockwaves to target tissues near and in the penis to encourage better blood flow.

• Lifestyle changes. Healthy lifestyle habits like proper nutrition, adequate sleep, regular exercise, and lowered stress levels may help improve your erectile function.

Before you commit to Botox for ED, be sure to follow up with a healthcare provider specializing in urology or men’s health. They can give you the rundown on potential risks, benefits, and alternative therapies.

Here’s what we know about using Botox for erectile dysfunction:

• Botox shows potential, but it’s experimental. Research suggests Botox may improve erectile dysfunction by relaxing smooth muscles and enhancing blood flow, similar to PDE5 inhibitors. But it’s still an experimental treatment, with limited studies supporting its efficacy and safety.

• Studies so far show promising results. Clinical trials suggest Botox can improve erection quality, particularly as an add-on therapy for those unresponsive to standard treatments. Long-term studies show some patients benefit from repeat injections, and Botox may also help address other issues like priapism.

• Proven ED treatments first should be your go-to. Botox for ED doesn’t have FDA approval and can be costly, with potential side effects. Proven treatments like oral medications, therapy, and lifestyle changes are likely the best options to try first for addressing ED symptoms.

Have questions about treating ED? Reach out to a healthcare provider to get a recommendation.