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For men who do not respond to oral medications, second-line treatments include vacuum erection devices, intracavernosal injections (alprostadil), intraurethral therapy, or penile prosthesis surgery

Injection location strategies Local injection (near pain site): Inject within 2-3 inches of painful area Example: Knee pain = inject into thigh or near knee Shoulder pain = inject into shoulder/deltoid area May provide faster local relief Systemic injection (away from pain): Inject into abdomen or thighs Works throughout body Better for multiple pain sites Still effective, just less targeted Which is better: Local: Faster relief for single pain site Systemic: Better for multiple areas Both work - choose based on situation Oral vs injectable for pain Injectable (more common): Higher bioavailability Works for all pain types Faster results typically Oral (specific uses): Good for gut-related pain (IBD, ulcers) Easier for needle-phobic people BPC-157 and KPV available oral Lower absorption but still works See our injectable vs oral peptides , how to inject peptides , and how to take BPC-157

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Journal of Endocrinology and Metabolism