Having some trouble getting it up? Oral meds like Viagra and Cialis are usually the first-line treatment for erectile dysfunction, and in many cases, they’re pretty damn effective—only 9 percent of older guys said they still had erectile dysfunction after taking the drugs, a 2015 study from the U.K. found.
But they’re not magic pills: Some men can’t take them at all, like those who are on heart meds called nitrates, since the ED drugs can cause an unsafe drop in blood pressure. Other guys have tried the oral ED drugs, but they haven’t worked for them.
And even if they do work, you need to take the pill to get your erection going. That means spontaneous sex can be difficult—and all those refills can get pricey.
Still, the “holy grail” of erectile dysfunction treatment—a permanent or near-permanent therapy that restores your boners—remains elusive, researchers write in a commentary in the Journal of Sexual Medicine.
But there is one possibility that may come close: Botox. Yes, the same cosmetic procedure that smoothes out wrinkles on your face might provide a boost to your penis, too, the researchers believe. (But here are 10 bogus facts about erectile dysfunction that are just plain wrong.)
Botox—which is actually a bacterial toxin called botulinum—erases wrinkles by blocking the nerve impulses that cause muscles to contract.
The same mechanism may help give you an erection. Botox can thwart the release of the neurotransmitter norepinephrine, which prevents blood flow. But it doesn’t mess with the release of nitric oxide. Nitric oxide is vital to erections since it relaxes your smooth muscle and allows blood to rush into your penis.
Because of this, the researchers believe Botox can provide an erectile boost for several months—the duration of each injection. And it may work for guys with both physiological ED, which is caused by blood flow issues and those with psychogenic ED, which is triggered by physiological factors. (If you have this blood type, you may have stronger erections anyway.)
It may also help men whose ED hasn’t been helped by oral drugs or injectable therapy respond to less invasive therapies—or perhaps require no additional treatment at all, they say.
So what’s the evidence for this? Unfortunately, scientific experiments on Botox for erectile dysfunction have been limited. One human study of 12 men with ED nonresponsive to other treatments did show improved blood flow and reported better sexual functioning after two weeks, though.
While the treatment does seem promising, it’s not ready for showtime quite yet: Its safety and effectiveness need to be verified in larger clinical trials before it can be recommended, the International Society for Sexual Medicine warns. It also has the potential to result in a prolonged erection—which can permanently damage the penis—so you don’t want to seek out the treatment outside a clinical trial before it’s vetted.