Of these formulations, alprostadil alone carries the highest reported rate (50 percent of users) of burning and pain; in bi-mix users the rate of burning is around 10 percent, and in tri-mix users it drops to less than 3 percent of users, says Nehra.
Nor is the injection itself — done with a very small, thin needle.
“Both [methods] are around a 1.5 to 2 on a zero-to-10 pain scale,” Kohler says, “where zero is no pain and 10 is getting run over by a truck.” The biggest complaint about these treatments is a burning sensation in the penis as the drug takes effect.
Urethral suppositories, the size of a grain of rice, are inserted via the head of the penis; injections are self-administered near the base of the penis.
The actual insertion of the suppository into the penis isn’t painful, say experts.
If you opt for a pump, experts say it’s important to get one through a doctor’s prescription.