Although more research is needed, injections of onabotulinum toxin A – Botox – could be a viable therapy for men with erectile dysfunction (ED), according to a recent commentary in the Journal of Sexual Medicine.
The approach “represents a promising avenue for future experimental and clinical research for the treatment of ED,” the authors noted.
Botox, developed from a neurotoxin produced by the bacterium Clostridium botulinum, is sometimes used to treat excessive sweating, overactive bladder, and chronic migraine, among other conditions. It is also used cosmetically, to smooth wrinkles. The drug weakens targeted muscles and nerves.
So far, studies on Botox for ED include an animal study and a small pilot study involving twelve men. However, the encouraging results could make Botox a path to explore.
Other treatments for ED are available, but they are not appropriate for all men. For example, phosphodiesterase type 5 (PDE5) inhibitors are not safe for men who take nitrates because the interaction can cause a dangerous drop in blood pressure. Also, many men do not respond to the drugs.
Self-injections are another option, but the idea makes some men squeamish. And vacuum devices, activated by a special pump, can be cumbersome.
It is thought that Botox could help smooth muscle tissue relax and, in turn, allow more blood to flow into the penis, creating a rigid erection.
“The ability to decrease the tone of resistance vessels, increase resting blood flow, and inhibit the persistent cavernosal smooth muscle tone might allow many men currently with ED or in some men unresponsive to oral or injectable agents to respond to less invasive therapy or perhaps require no therapy at all,” the authors explained.
Botox injections could be effective for several months.
The drug does have side effects, however. Flu-like symptoms, nausea, and headaches are possible. Also, since Botox is made from the toxin that causes botulism, a type of food poisoning, it’s important that patients receive very small doses.
Experts caution that although this represents a promising area of treatment, until the safety and efficacy can be further studied, it should only be performed in clinical trials under the supervision of an institutional review board. Patients should be cautioned about seeking this treatment outside of a clinical trial, as it has the potential to result in a prolonged erection which may permanently damage the penis.
The Journal of Sexual Medicine
Giuliano, Francois, MD, PhD and Gerald Brock, MD, FRCSC
“Botox for Erectile Dysfunction”
(Full-text. Published online: February 2017)
H. Ghanem, A. Abdel Raheem, I. Fathy
“Safety and Effectiveness of Botulinum Toxin in the Treatment of Severe ED: A Pilot Study”
H. Ghanem, I. Fathy, A. Abdel Raheem, R. Shamloul, M. Abdel Hamid
“The Effect of Botulinum Toxin on Penile Vascular Parameters and Clinical Outcome in Patients With Severe Ed: A Pilot Study”
H. Ghanem, I. Soliman, M. AbdulHamid, R. Shamloul
“Can intracavernosal botulinum toxin injection salvage vascular erectile dysfunction patients not responding to oral and intracavernous therapy? A pilot study”
Medical News Today
“Botox: How Does Botox Work?”
(October 14, 2015)
(Page last updated: March 22, 2017)
“Botox could be ‘game changer’ for erectile dysfunction, Canadian urologists say”
(February 24, 2017)
Hussein Ghanem, Cairo University
“Botulinum Toxin for Erectile Dysfunction”