"I was reading a CNN article on 10 years of Viagra, and they said that prior to the drug, options for ED treatment included ‘penis injections.’ Is that as awful as it sounds? What’s in these things?"

It would be easy to say something blithe like "penis injections can’t possibly hurt as bad as (insert excruciating and unrelated thing women routinely go through), so buck up, soldiers, if you want that hard-on." But evidently the injections actually don’t hurt the majority of dudes who give them a try.

Not that it sounds like more fun, than say, shooting video game zombies, it’s just not THAT painful. Significant others, you don’t have to worry about penile injections becoming the next big distraction.

Kevin: "What’s wrong, Marc?"
Marc: "It’s our anniversary and he’s just up in his room, shooting Alprostadil into his corpus cavernosa again."
Kevin: "Ryan’s been doing the same thing all week. Those boys and their hobbies."

But getting back to your question. For men facing persistent difficulties getting or maintaining an erection, medications that get shot right into the wiener are one of the many treatment options.

I CAN’T GET IT UP. ASIDE FROM SUICIDE, WHAT ARE THE OPTIONS?

That depends on the cause. For a small but substantial portion of men (usually the younger ones), stress and other psychological factors can cause erectile dysfunction (ED). In this case, therapy and antidepressants can do the trick.

PILLS

Probably the most famous method of treatment, drugs like Viagra (Sildenafil), Levitra (Vardenafil) and Cialis (Tadalafil) revolutionized both sexual medicine and society in general when it was discovered that somewhere around three out of four men with ED could be helped by popping a pill an hour before sex. They work relatively quickly, can last up to a day (Cialis can anyway) and don’t interfere with the mood. Unfortunately, there are side effects (headache, flushing, stuffy nose, upset stomach, and vision problems), can’t be used if one is already on some other medications and it doesn’t work for everybody.

PUMPS/CONSTRICTORS

Nothing says "Baby, I’m so ready to do you" like a big vacuum pump on one’s penis. For many men, a pump and/or a cock ring (to keep the blood in once it has filled the penis) are the best option, since there are no medicinal side effects. Obviously though, it can kill the mood if your partner isn’t turned on by the sight of you using a suction contraption on your situation. And these devices are also known for creating artificial looking erections that can feel a little numb to the possessor, and for inhibiting ejaculation at orgasm.

SURGERY

Ironically the most effective method, the one most likely to be judged by patients and their partners as being satisfactory, is also the last resort. That’s because it’s surgery. Most of us spend our lives avoiding having some person cut us open and root around in our internal goodies. Unless you’re some kind of malfunctioning cyborg, in which case it’s in evitable albeit annoying fact of life.
There are two standard surgical options to treat ED: put a balloon in your doo-dad that you pump full of saline by squeezing your balls or have a perma-rection from implanted rigid rods. A doctor won’t describe the procedures quite so colorfully, but that is the hilarious reality. As unappealing as I gleefully made those sound, they work damn well.

WAIT, WHAT WAS THIS COLUMN ABOUT? OH YEAH, INJECTIONS

For those for whom pills are not successful, or for whom the side effects of other methods are intolerable, for those who want a much quicker and possibly longer-lasting erection, injections are a viable option. They work for 80-90% of users by widening the arteries and relaxing the muscles to increase blood flow, much like the pills do, but in a far more direct way. Usually the first dose is administered in the doctor’s office to monitor the patient’s reaction and ensure proper technique.

You’ve got a few options in johnson-injecting. Some men use suppositories: a little pellet that goes right into the urethra (the opening of the penis), which, like all drugs, comes with a bunch of wacky possible side effects. Others use the kind of needle that diabetics might use to shoot directly into the corpus cavernosa. For clarification and entertainment I have included the following images:

WHAT’S IN THERE ANYWAY?

A number of different drug options are available: Prostaglandin E1 ( also known as Alprostadil, with brand names like Caverject and Edex) Papaverine , and Phentolamine, although they’re usually given in mixtures. Only the Alprostadil is approved specifically for treating ED, the others are off-label uses of drugs originally intended for cardiac and vascular issues.

These are clearly not for everyone and the potential drawbacks, like scarring, are worth some thought. To find out more about the history, use, disadvantages, advantages and whatnot of injection ED treatments, check out this link.