Erectile dysfunction, or ED, affects nearly 20 million men in the United States. ED is a man’s inability to attain or sustain an erection hard enough for sexual activity.
Oral medications, including PDE5-inhibitors like Viagra, Cialis, Levitra, among others, have been found effective at treating ED. Other ED treatments include penile pumps, vacuum devices, and even vascular surgery.
However, a 2018 study published in the Journal of Sexual Medicine has looked at the use of topical nitroglycerin as a potential ED treatment. The results of the study looked promising, but it is imperative to note that the U.S. Food and Drug Administration (FDA) has not approved nitroglycerin gel or cream for ED.
Nitroglycerin is a vasodilator, meaning it widens the blood vessels and improves blood flow across the body. The medication comes in various forms, such as sublingual pills, topical creams or gels, and transdermal patches. It is often used in patients with heart failure and high blood pressure.
Urologist Dr. Joseph Brito of Yale New Haven Health says, “The idea of treating ED with topical nitroglycerin is not new and was first described in the 1980s.”
Dr. Brito, who is also a member of Healthline’s clinical review network, says the drug works by dilating the blood vessels; therefore, it is traditionally used for patients with chest pain (angina) due to poor blood flow in cardiac blood vessels.
So, the concept is the same for ED, although Dr. Brito says it may have a dual mechanism of action; “it widens blood vessels helps blood flow and it relaxes penile smooth muscle, which in turn compresses penile veins and impedes blood flow out of the penis, which causes rigidity.”
Explaining how nitroglycerin could help treat ED, Dr. Brito says, “[Topical nitroglycerin] acts as a nitrogen donor to increase local levels of nitric oxide, which works through molecular signaling (cGMP pathway) to cause this response,” according to Healthline.
However, there is no enough research to claim that nitroglycerin corrects ED. Dr. Brito points out that the FDA does not approve topical nitroglycerin gel for the treatment of ED.
He also points out that the American Urological Association guideline on ED published in 2018 did not include topical nitroglycerin for ED treatment.
Dr. Brito explains, “Though this therapy was not specifically mentioned, the authors did state ‘the use of these treatments may preclude the use of other treatments known to be effective,’ and felt more research was needed.”
Nevertheless, he says, “Nitroglycerin may have some benefits over standard oral ED medications.” For instance, Viagra takes 30 to 60 minutes to shows its action, while topical nitroglycerin could take 10 to 20 minutes.
In fact, the study published in the Journal of Sexual Medicine found that 44% of patients experienced an erection within 5 minutes of application and 70% of the men had an erection within 10 minutes.
“This may help with spontaneity, which can be an issue for couples using oral agents,” Dr. Brito explains.
He also says that nitroglycerine does not need to enter your gastrointestinal system, unlike drugs like Viagra and Cialis that may cause gastric irritation.
“Since absorption of oral agents like sildenafil is strongly affected by food intake, the medications are much more effective when taken on an empty stomach,” Dr. Brito says. This requires more planning and doesn’t always allow for spontaneity.
Remember, the FDA does not approve nitroglycerin gel or cream for ED treatment so do not use it without checking with your doctor. If you think you have ED, talk with your doctor about treatment options that are suitable for you rather than self-medicating. Visit Healthline for more information on the efficacy of nitroglycerine gel or cream in treating ED.
