As far as engineering erections is concerned, alprostadil gel could become a competitor of Viagra.
Previous formulations of alprostadil were awkward to apply, as they were for injections or intraurethral pellets.
Most men do not want to inject medications into their penises, and definitely not on a day-to-day basis.
The alprostadil that now has become available through compounding pharmacies can be applied as an ointment to the male genitals. It will reliably cause an erection within minutes.
Viagra usually needs 60 to 90 minutes to take effect (and on a full stomach, even longer). This means that with Viagra, it is difficult to bridge the waiting period with foreplay.
Of course, the opportunity for great sex often occurs rather spontaneously.
For men who need erectile support, the use of Viagra is sometimes difficult to plan.
"Oops, all of a sudden, she wants; but I'm not yet on Viagra!"
Alprostadil cream, which becomes effective within minutes, can offer the advantage that when the opportunity actually arises, one just needs a short trip to the toilet where the cream can be applied to the penis.
But mind you: good erections are not a guarantee for good sex, regardless of whether they are engineered via Viagra or alprostadil. For good sex instead of good erections, better try tongkat ali.
Andrew P. Lea, Harriet M. Bryson, Julia A. Balfour
Drugs & Aging January 1996, Volume 8, Issue 1, pp 56-74
Clitoral Hemodynamic Changes after a Topical Application of Alprostadil
Edgardo F. Becher, Amado Bechara & Adolfo Casabe
Journal of Sex & Marital Therapy Volume 27, Issue 5, 2001 pages 405-410
A double-blind, placebo-controlled, efficacy and safety study of topical gel formulation of 1% alprostadil (Topiglan) for the in-office treatment of erectile dysfunction ?
Irwin Goldstein, Terry R Payton, Paul J Schechter
Urology Volume 57, Issue 2, February 2001, Pages 301-305
Intracavernosal alprostadil is effective for the treatment of erectile dysfunction in diabetic men.
Heaton JP, Lording D, Liu SN, Litonjua AD, Guangwei L, Kim SC, Kim JJ, Zhi-Zhou S, Israr D, Niazi D, Rajatanavin R, Suyono S, Benard F, Casey R, Brock G, Belanger A
International Journal of Impotence Research [2001, 13(6):317-321]
Quality of life effects of alprostadil therapy for erectile dysfunction: results of a trial in Europe and South Africa.
Willke RJ, Yen W, Parkerson GR Jr, Linet OI, Erder MH, Glick HA
International Journal of Impotence Research [1998, 10(4):239-246]
Treatment of Men with Erectile Dysfunction with Transurethral Alprostadil
Harin Padma-Nathan, M.D., Wayne J.G. Hellstrom, M.D., Fran E. Kaiser, M.D., Richard F. Labasky, M.D., Tom F. Lue, M.D., Wolfram E. Nolten, M.D., Paul C. Norwood, M.D., Craig A. Peterson, M.S., Ridwan Shabsigh, M.D., Peter Y. Tam, B.S., Virgil A. Place, M.D., Neil Gesundheit, M.D., M.P.H., Christy Cowley, B.S, Kerry J. Nemo, Alfred P. Spivack, M.D., Darby E. Stephens, B.S., and Leslie K. Todd, B.A.
N Engl J Med 1997; 336:1-7January 2, 1997