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MUSE is short for "medicated urethral system for erection." It consists of a tiny medicated pellet that is inserted into the urethra, the opening at the end of the penis, to produce erections.
Administration of the drug alprostadil through the urethra using the MUSE system is an effective alternative treatment for many men, and provides a less invasive alternative to intrapenile injection. Alprostadil is a prostaglandin E preparation in a pellet form that is inserted with a plunger-like mechanism into the urethral opening. The plunger device is pre-filled to deliver a pellet about an inch deep into the urethra at the tip of the penis. Alprostadil is a form of a natural substance, prostaglandin E1, which serves to open blood vessels.
Prostaglandin E1 raises the intracellular concentration of the cyclic AMP, which leads to relaxation of the cavernosal smooth muscle, increase of arterial blood flow, dilation of sinusoids and veno-occlusion, thanks to the compression of sub-tunica albuginea venules against the tunica albuginea.
Men should be advised to urinate before insertion, because lubricants should not be used and a moist urethra will allow for easier insertion of the plunger device.
This illustration shows how the applicator is inserted into the opening at the end of the penis to leave the small pellet. Patients also find that it works better with a ring-type device to prevent the drug from getting absorbed into the systemic circulation.
The first application (usually a 500-µg dose) should be undertaken in the physician's office because of the potential complications of urethral bleeding, vasovagal reflex, hypotension, and priapism. The side effects of the drug itself are the same whether the drug is administered by injection or through the urethra, although each method has other side effects that are specific to it.
About 10% to 17% of MUSE administrations result in a burning sensation in the urethra that can last five to fifteen minutes, but this moderate pain does not appear to be a main reason for discontinuing treatment.
Men with or at risk for blood clots or who are using blood thinners, such as heparin or warfarin, should not use it. One of the more unusual side effects involved a case where the MUSE pellet became caught in a female partner's mouth during oral sex and created an allergic reaction which necessitated a trip to the emergency room. Contraindications include usage with a pregnant partner or a partner who is likely to get pregnant, hypersensitivity to prostaglandin, and sickle cell anemia, or a patient who is prone to developing priapism. In another study, the efficacy of intraurethral alprostadil was evaluated in a double-blind, placebo-controlled trial in 1511 men with chronic erectile dysfunction from a variety of organic causes.
In one study, 65% of men achieved erection using MUSE, and these men achieved intercourse in an average of 7 out of 10 administrations. Sertraline belong to a group of drugs called selective serotonin reuptake inhibitors or SSRIs. Improvements should be observed at the start of medication but a full reaction will become most apparent a month after treatment.

Taking this medication may not yield the same result for different individuals even though they have identical symptoms. When it comes to depression and obsessive-compulsive disorder this particular drug is recommended in amounts that range from 60 milligrams to 200 milligrams at least once a day. In terms of panic disorder, the particular drug is recommended in amounts that range from 25 milligrams to 200 milligrams at least once a day.
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Depending on the erectile response, you may then be instructed to increase or decrease the dose (up to 1000 µg or down to 250 µg).
Priapism (prolonged erection) is a potential side effect for both forms of administration although there is less chance for it using the MUSE system. Up to 50% of patients have a measurable drop in blood pressure, although only about 3% are aware of it. Two-third of these men responded to intraurethral alprostadil with an erection sufficient for intercourse in the clinic; these men were then randomly assigned to therapy with either alprostadil or placebo. A more recent study, however, reported disappointing results, with only 27% achieving erections and only 18% requesting additional refills. It is utilized to counteract panic disorder, depression, obsessive-compulsive disorder or OCD, and anxiety.
You will find that there are doctors who are not sure of your purpose in taking this treatment.

It could be harmful for folks to take prescription drugs if their doctor has not yet prescribed them.
Your doctor may suggest a reduced dose for you and gradually raise your dosage to one that’s suitable for you. Despite the existence of submucous veins that communicates the corpus spongiosum and the corpora cavernosa, therefore creating a possible absorption means, this procedure is considered erratic, meaning there is no constant correlation between given drug dose and absorbed dose.
After insertion, the pellet within the urethra should be dissolved by massaging or "kneading" the penis for about a minute. If this occurs, applying ice for ten-minute periods to the inner thigh may help reduce blood flow. Some patients have significant symptoms of hypotension Symptoms include dizziness, lightheadedness, and fainting. More recently, Porst reported that 43% of patients treated with 1000mcg of transurethral alprostadil were able to have a sexual intercourse, but only 10% mentioned rigid erection. Successful intercourse on at least one occasion was much more likely with alprostadil (65 versus 19 percent with placebo). Similarly, Werthmam and Rajfer obtained 30% of erections that enabled vaginal penetration, but only 7% of 100 patients using up to 1000mcg of alprostadil mentioned rigid erections. Among the men who responded to alprostadil, 7 of 10 applications were followed by successful intercourse. It also helps the brain in secreting serotonin which is a neurotransmitter that reduces panic attacks, improves mood and treats OCD. Several forms of prescription drugs may not be useful for several circumstances and conditions.
Scarring of the penis (Peyronie's disease) is also possible with both treatments, although the chances are far less with the MUSE system. The drug may have toxic effects if it reaches the fetus in pregnant women; men should not use alprostadil, then, for intercourse with pregnant women without the use of a condom or other barrier contraceptive device. If you lie on your back too soon after administration, blood flow to the penis may decrease and the erection may be lost. You should be upright, either sitting, standing or walking for about 10 minutes after administration.

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