Men with erectile dysfunction face numerous treatment options, each with distinct advantages and limitations. Understanding how the P-Shot compares to traditional treatments—pills, injections, pumps, and surgery—helps you make an informed decision about which approach matches your needs, lifestyle, and expectations.
Understanding Your ED Treatment Options
Erectile dysfunction affects men differently, and treatment should match individual circumstances. Your age, overall health, ED severity, lifestyle, and preferences all influence which treatment is ideal.
Treatment Comparison Overview
| Feature | Oral Medications (Viagra) | Injections (Alprostadil) | Penis Pumps | P-Shot® | Surgery |
|---|---|---|---|---|---|
| Onset Time | 30-60 min | 5-20 min | Immediate | 2-4 weeks | N/A |
| Duration | 4-36 hours | 30-60 min | During use | 12-18+ months | Permanent |
| Side Effects | Common | Moderate | None | Minimal | Moderate-Severe |
| Success Rate | 70% | 75% | Varies | 75% | 80-90% |
| Cost (Annual) | $800-2000 | $2000-4000 | $300-1500 | $2000-3000 | $15,000-30,000 |
| Ongoing Medication | Yes | Yes | No | No | No |
| Treats Root Cause | No | No | No | Yes | Yes |
Oral Medications (Viagra, Cialis, Levitra)
How They Work
Oral ED medications are phosphodiesterase-5 (PDE-5) inhibitors that relax smooth muscle in blood vessels, increasing blood flow to the penis. They don't create erections directly—they enhance your body's natural response to sexual stimulation.
Pros
- Fast onset (30-60 minutes depending on medication)
- Non-invasive
- Well-studied with decades of use
- 70% efficacy rate for many men
- Discreet and convenient
Cons
- Temporary—effects last only 4-36 hours
- Requires planning 30-60 minutes before sex
- 25-30% of men don't respond adequately
- Potential side effects: headaches, facial flushing, nasal congestion, vision changes, indigestion
- Cardiovascular risks for some users
- Tolerance may develop over time
- Ongoing expense—requires medication each time
- Doesn't address underlying tissue damage or vascular disease
Best For
Men with mild to moderate ED who want quick onset and have no cardiovascular contraindications. Good for occasional use or as a bridge while pursuing other treatments.
Injectable Medications (Alprostadil, Papaverine)
How They Work
Injectable medications are vasodilators injected directly into the penis, causing blood vessels to dilate and increasing blood flow. Effects are more direct and faster than oral medications.
Pros
- Faster onset (5-20 minutes)
- Works even when oral medications don't
- Effective for most men (75% efficacy)
- Bypasses systemic circulation (fewer systemic side effects than pills)
Cons
- Requires injecting medication into penis—psychologically difficult for many
- Risk of fibrosis (scar tissue) with repeated use
- Pain or discomfort possible
- Effects last only 30-60 minutes
- Requires training on injection technique
- Ongoing medication required
- Expensive ($2000-4000 annually)
- Doesn't address underlying causes
Best For
Men who don't respond to oral medications and are comfortable with injection. Often used when pills have failed.
Penis Pumps (Vacuum Erection Devices)
How They Work
A cylindrical device creates a vacuum around the penis, drawing blood into erectile tissue. A constriction ring at the base maintains the erection by restricting blood outflow.
Pros
- Non-invasive, non-pharmacological
- No side effects
- No ongoing medication cost
- Works for most men regardless of cause of ED
- Inexpensive ($300-1500 one-time cost)
- Improves with practice
Cons
- Mechanical and cumbersome—requires device, time, and technique
- Interrupts spontaneity
- Risk of penile bruising or injury with improper use
- Limited duration (erection only while using ring)
- Doesn't improve underlying erectile capacity
- Less natural sensation
- Partner acceptance issues
Best For
Men seeking a mechanical solution without medication, or those with contraindications to other treatments. Often combined with medications for better results.
The P-Shot® (Priapus Shot)
How It Works
Growth factors from platelet-rich plasma (PRP) are injected into the penis, triggering tissue regeneration, new blood vessel formation, and nerve regrowth over 8-12 weeks.
Pros
- Addresses root causes (tissue quality, blood flow, nerve function)
- Long-lasting results (12-18+ months, often longer)
- Natural mechanism (uses your own growth factors)
- Minimal side effects
- No ongoing medication
- Results continue improving over 3-6 months
- Can combine with other treatments
- 75% success rate
- Regenerates tissue quality for lasting benefit
Cons
- Delayed onset (2-4 weeks for initial improvement)
- Requires patience for full results
- Most effective for partial ED (not complete non-responsiveness)
- Results eventually plateau (though often lasting 12-18+ months)
- Requires certification provider (not all physicians trained)
- Initial cost similar to injections but spread over much longer timeframe
Best For
Men with partial to moderate ED seeking lasting improvement, those who want to address underlying tissue damage, men tired of ongoing medication, and those seeking a more natural approach. Excellent for men 40-70+ looking for sustained benefit.
Surgical Options (Penile Implants)
How They Work
A prosthetic device is surgically implanted in the penis. Inflatable models use a pump to create erections; malleable models are mechanically bent into position.
Pros
- Permanent solution
- Highest success rate (80-90%)
- Works regardless of underlying cause
- No ongoing medication
- Allows spontaneity once implanted
Cons
- Major surgery with anesthesia
- Invasive—irreversible
- Very expensive ($15,000-30,000)
- Surgical risks (infection, mechanical failure, loss of tissue)
- Requires recovery period
- Potential device malfunction (1-5% need revision)
- Not suitable if you might want biological function later
- Limited to severe ED cases where other options have failed
Best For
Men with severe ED unresponsive to other treatments who have realistic expectations and understand surgical risks. Reserved for later intervention when other options have been exhausted.
Choosing Your ED Treatment: Decision Framework
If You Have Mild to Moderate ED and Want Quick Results
Start with oral medications (Viagra, Cialis). Effective, safe, and convenient for occasional use. If you develop tolerance or want long-term improvement, transition to the P-Shot.
If You Don't Respond to Oral Medications
Try injectable medications (if comfortable) or the P-Shot. The P-Shot addresses underlying tissue damage that may be why pills don't work, making it ideal for non-responders.
If You Want a Long-Term Solution Without Medication
The P-Shot is your best option. Results improve over months and last 12-18+ months. No ongoing side effects, no repeated doses, and it actually regenerates tissue rather than just masking symptoms.
If You Want to Avoid All Invasiveness and Medication
Penis pumps are your only option. Purely mechanical, no drug interactions, but requires technique and acceptance of limitations.
If Nothing Else Has Worked and You're Desperate
Consider penile implants only after exhausting all other options. It's a permanent solution but irreversible and comes with surgical risks.
Central New York's P-Shot Specialist
Dr. Fawole at Ivie Health is the only certified P-Shot provider in Central New York. Double board-certified with extensive regenerative medicine training, Dr. Fawole evaluates each patient individually to recommend the optimal treatment or combination of treatments for your specific situation and goals.
Find Your Optimal ED Treatment
Schedule a consultation with Dr. Fawole to discuss which treatment is right for you.
Learn More About P-Shot®Frequently Asked Questions About ED Treatments
Yes, combining treatments often produces better results. Many men use oral medications with the P-Shot, or use a pump as a backup while receiving P-Shot treatment. The ideal combination depends on your specific situation. Dr. Fawole can recommend a personalized treatment plan combining multiple approaches.
For new-onset ED or mild cases, oral medications are the standard first-line approach. For moderate ED or if you're tired of medication, the P-Shot is excellent. The choice depends on your severity, timeline expectations, and preferences. Dr. Fawole will help guide this decision.
Many men get annual P-Shot maintenance treatments to extend results beyond the typical 12-18 month window. Some transition to oral medications as a backup. Others do a second or third P-Shot series for renewed benefit. Options depend on your response and preferences.
For anxiety or stress-related ED, oral medications often work well because they provide confidence and reduce performance anxiety. The P-Shot can also help by improving baseline tissue function and sensitivity. Therapy or counseling combined with medical treatment is often most effective for psychological ED.
Coverage varies. Oral medications are often covered by insurance. Pumps may be covered with documentation of ED severity. The P-Shot and other regenerative treatments are typically not covered but may be eligible for health savings account (HSA) or flexible spending account (FSA) funds. Contact Dr. Fawole's office for insurance verification.