Erectile Dysfunction 101: Everything You Need To Know

Despite treatments such as Bi-Mix, Tri-Mix, Quad-Mix injections, Erectile Dysfunction can be an embarrassing topic, but it is one of the most common conditions for men in America. The condition can affect men of all ages, although the frequency of erectile dysfunction rises with age; research from the Journal of Sexual Medicine has found that it can affect 26% of men under the age of 40.

Most men will experience some trouble in getting or keeping an erection throughout their life. In fact, research has shown it can occur in up to 20% of sexual encounters. However, should issues arise more frequently, then it might be a sign of Erectile Dysfunction.

What is Erectile Dysfunction?

Often a difficult topic to discuss, Erectile Dysfunction is a common disorder that refers to the inability to get, or to maintain, an erection for sexual intercourse. This condition is caused by a lower flow of blood to the penis, which can be bought about for a wide range of reasons, such as side effects to drugs, high blood pressure, or stress.

Erectile Dysfunction can be displayed through a range of symptoms, but the most common include:

  • Difficulty getting and maintaining an erection
  • A reduced interest in sexual activity
  • A lower self-esteem and confidence

A doctor will be able to diagnose Erectile Dysfunction and to do this, they will typically conduct a physical examination as well as reviewing the patient’s medical history. Erectile Dysfunction can also be a sign of a more serious condition, so a doctor may conduct further examinations and tests to rule these problems out.

Causes of Erectile Dysfunction

Typically, when a man becomes aroused, the muscles in the penis relax, allowing an increase in blood flow that fills the tissue along the length of the penis. Erectile Dysfunction occurs when this does not quite happen correctly, and it can be caused by a wide range of symptoms.

Quite often, Erectile Dysfunction can be caused by a range of medical conditions, including:

  • Diabetes
  • Atherosclerosis
  • Hypertension
  • Brain or spinal cord injuries
  • Multiple Sclerosis
  • Hypogonadism
  • Parkinson’s
  • Stoke
  • Prostate or Bladder surgery

Lifestyle conditions

While Erectile Dysfunction can be caused by medical conditions, it can also be caused by lifestyle choices. Depression, stress, and anxiety are a common cause, as are heavy alcohol and tobacco use. Patients taking prescription medications for depression, pain, or high blood pressure can also notice Erectile Dysfunction as a side effect.

How to treat Erectile Dysfunction

While certain lifestyle conditions can cause Erectile Dysfunction, making small, simple changes can also help you to reduce the symptoms. Quitting smoking, exercising more regularly, and focusing on reducing stress can lower the regularity of experiencing Erectile Dysfunction.

Making these lifestyle changes can also benefit your life in a wide range of faculties. Quitting smoking and incorporating more exercise can help you to boost your cardiovascular strength, lower blood pressure, remove body fat, and improve self-esteem.

However, while these activities can help certain men, they are not a complete cure, and many will need medical treatment. According to the American Urologic Association, intracavernous injections are the most effective way to treat Erectile Dysfunction without surgery. An injection to the penis will typically cause an erection within a few minutes and will last for up to an hour.

Oral Medications

Erectile Dysfunction can also be treated through orally taken medicines. These medications enhance the chemicals such as nitric oxide that are typically released during stimulation. Unlike injections, these medications will not cause immediate arousal, and stimulation will still be needed to release the chemicals that are responsible for an erection. There is a wide range of oral treatments, but the most popular include Sildenafil, Vardenafil, Tadalafil, and Avanafil.

Erectile Dysfunction Injections

Injections are one of the most common and most effective methods of treating erectile dysfunction. There is a range of different strength injections, with the most common being:


Alprostadil is the only FDA-approve mono-therapy inject and works by stimulating Cyclic Adenosine Monophosphate production in the penis. This helps muscle relaxation, improving blood flow and helps maintain an erection. Alprostadil does not rely on Nitric Oxide enhancement, so is a popular alternative when oral medication does not work.


Bi-Mix injections are often prescribed to men who are sensitive to a low dose of medication. The Bi-Mix injection is composed of two core components, Papaverine and Phentolamine. Papaverine is a vasdodialating agent that helps to relax the muscles in the penis, widening the blood vessels and enhancing blood flow. Phentolamine is an alpha blocker that prevents the signals that typically constricts the flow of blood.

Bi-Mix is available in dosage strengths of either 5ml or 10ml, and comes in four key sizes:

  • Phentolamine 0.5mg/ Papaverine 30mg per ml
  • Phentolamine 1mg/ Papaverine 30mg per ml
  • Phentolamine 2mg/ Papaverine 30mg per ml
  • Phentolamine 3mg/ Papaverine 30mg per ml


Tri-Mix injections are typically prescribed to patients where Bi-Mix has not proven effective. Tri-Mix injections feature the same two chemicals but with the addition of Alprostadil. This additional ingredient helps to provide further relaxation of the muscles and increase the dilation of blood vessels. Research has shown that when combine with oral medication, Tri-Mix has a very high success rate.   

Tri-Mix is available in 5ml or 10ml dosage strengths and sizes include:

  • (5/0.5/15) PGE-1 5mcg/ Phentolamine 0.5mg/Papaverine 15mg per ml
  • (10/1/30) PGE-1 10mcg/ Phentolamine 1mg/Papaverine 30mg per ml

There is also a Tri-Mix Super injection available in:

  • (20/2/30) PGE-1 20mcg/ Phentolamine 2mg/ Papaverine 30mg per ml
  • (40/2/30) PGE-1 40mcg/ Phentolamine 2mg/ Papaverine 30mg per ml


Quad-Mix injections are the most powerful form of self-injection. Quad-Mix features the same three ingredients that are in Tri-Mix along with Prostaglandin E1, which helps to relax the blood vessels and dilate the cavernosal arteries even further. Quad-Mix also contains atropine sulfate, which helps to inhibit the receptors in your nervous system that are responsible for muscle control, proving greater relaxation.

Like Bi-Mix and Tri-Mix, Quad-Mix is available in dosage strengths of 5ml or 10ml and in three sizes:

  • PGE-1 10mcg/ Phentolamine 1mg/ Papaverine 30mg/ Atropine 0.15mg per ml
  • PGE-1 20mcg/ Phentolamine 2mg/ Papaverine 30mg/ Atropine 0.15mg per ml
  • PGE-1 60mcg/ Phentolamine 2mg/ Papaverine 30mg/ Atropine 0.15mg per ml

In cases where oral medications and injections do not work, then a doctor may decide that surgery is the best treatment option. This is a rare decision and will only be recommended when all other treatments have been exhausted. The surgery will involve an inflatable rod being placed in the middle of the penis, which can cause an erection when inflated.

How ACRX Pharmacy can help you

As a fully licensed pharmacy, ACRX specializes in non-sterile and sterile compounding. Our team focuses on providing the highest quality medications possible, and our dedicated team can help with any Erectile Dysfunction injections required. If you want to find out more, get in touch with us today!