Botulinum toxin for ED — the careful version
An investigational add-on option for selected men whose erections don’t respond adequately to tablets — offered with a full, honest explanation before anything is scheduled.
George W. Carroll, MD Florida license ME48111NPI 1073644985 Men’s sexual medicine since 1992
What it is
The treatment is a single injection of botulinum toxin into the erectile tissue, performed by Dr. Carroll in the office. The medication is ordered for you individually, and the injection visit is scheduled about a week later.
Its use for ED is investigational and not FDA-approved for this purpose — Dr. Carroll explains exactly what that means, and what the published studies show, before anything is scheduled.
When tablets aren’t enough
Botulinum toxin has been studied specifically in men whose erections don’t respond adequately to tablets like sildenafil or tadalafil. In the published series it is used as an add-on rather than a replacement — men continue their usual medication and receive the injection alongside it. About half the men in these series had a clinically meaningful improvement. The published studies are small and most are uncontrolled, which is exactly why candidacy here is decided at a physician evaluation, not by an ad.
How long it lasts
In published studies, the benefit of a single injection has been formally measured out to six months. In the largest real-world series, men went a median of roughly eight to nine months before requesting another injection. Dr. Carroll sees a similar pattern — most men who return for re-treatment do so around the nine- to ten-month mark. Duration varies considerably between individuals, no trial has yet followed patients past six months, and no specific duration can be promised.
Safety and candidacy
- Candidacy is screened at consultation — bladder and urologic history matter, and Dr. Carroll declines patients for whom the treatment isn’t appropriate.
- The standard emergency rule applies to every erectile treatment: seek emergency care for any erection lasting longer than 4 hours.
- Where it fits is a diagnosis question: the diagnostic evaluation comes first, and alternatives like injection therapy are always on the table.
Common questions
- Is this the same Botox used for wrinkles?
- It is the same class of medication, used off-label at a different site for a different purpose. Its use for ED is investigational, and we say so plainly.
- Will it replace my tablets?
- No — in the published series it is used alongside existing ED medication, not instead of it. Whether that combination makes sense for you is an evaluation question.
- Why offer an investigational treatment at all?
- Because for some men whom tablets have failed, the published early evidence and Dr. Carroll’s clinical experience justify discussing it — honestly labeled, with the alternatives on the table. Offering it and overselling it are different things. What we bill and what we don’t →
Care provided by George Carroll, M.D.
Medically reviewed by George W. Carroll, MD (Florida license ME48111) · Reviewed August 2026
Ask whether you’re a candidate
Even if you choose to do nothing, it’s worth knowing what’s going on. Dr. Carroll will tell you, and the decision stays yours. One call to our office starts it — no obligation, no pressure, and no one pushing you toward a decision.
Office hours: Mon–Fri 9:00 AM – 5:00 PM.