External Penile Prostheses for Erectile Dysfunction (ED)

For people with erectile dysfunction, having a satisfying sex life can be a challenge. One potential solution is an external penile prosthesis, a device that can be used by individuals who want the option of penetrating a partner without having to undergo surgery or use medications. Options include penis sleeves and penile supports.

External penile prostheses are readily available and require no medical intervention (although a consultation with a doctor or sex therapist can be beneficial). It is important to understand how the devices work and which may be most appropriate for you before making a purchase.

Types of Prostheses

There are basically two types of external penile prostheses: one that slips over the penis and another that clamps onto the penis shaft. External penile prostheses are not medical devices per se. Some can be purchased online or from specialty sex stores. Others can be sourced through a sexual health professional or doctor.

Penis Sleeve

A penis sleeve, as per its name, is a hollow, penis-shaped device that is slipped over the penis. In the world of sex toys, these are commonly referred to as penis extensions.

Penis sleeves are typically pliable and come in a variety of shapes, sizes, and textures. Some are ridged or come equipped with a vibrator for added sexual stimulation.

There are several different penis sleeves to choose from:

• Complete sheathe: This is a sleeve that extends from the base of the shaft and completely covers the glans (head) of the penis. Some are constructed of hard plastic or silicone, while others are more rubbery. In some devices, there will be a ring or hole in the shaft through which the testicles are inserted to secure the sleeve and prevent slippage.
• Partial sheathe: This is similar to a complete sheath but leaves the glans exposed, increasing stimulation for the insertive partner. The sleeve is sometimes ribbed or pebbled to stimulate the insertive partner as well.
• Harness sleeve: Also known as a "strap-on," this device is most often made to resemble a penis and is worn with a thong-like harness. As with the other devices, the penis is slipped into a hollow core, after which the straps are firmly secured.

A 2017 study published in Translational Andrology and Urology reported that some cisgender men are able to reach an orgasm when using a penis sleeve despite having severe ED.

Penile Support Device

Marketed under brand names like Elator, Erektor, and others, this external penile device is less visible than a sleeve and may be ideal for men with mild to moderate ED.

The device employs two custom-fitted rings that are placed around the base and glans of the penis, which are then connected by a rigid rod. This creates a simulated erection that may be rigid enough for penetration. It also provides the insertive partner greater stimulation than with a sleeve and a better chance for an orgasm.

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Who Can Benefit

Erectile dysfunction can occur for a variety of reasons, from cardiovascular disease and age to radical prostatectomy. Cisgender men who fail to respond to other ED treatments may be helped by a penile prosthetic, as well as transgender men who have undergone phalloplasty.

Transfeminine people and trans women who have ED due to common reasons or from taking estrogen can also benefit from these products.

External penile prostheses may be ideal for people who are not candidates for other ED treatments (either for medical or psychologic reasons) or are unable to afford more costly medical interventions.

This can make purchasing a penile prosthetic a bit of a gamble. As such, you need to do your research and speak with a doctor or sex therapist if possible to ensure that your expectations are realistic. With that said, many couples find sex toys arousing and that alone may warrant a purchase.

If you do end up finding an external penile prosthesis that works for you, you may consider the cost a worthy investment for your sex life.

Penile Prostheses and Relationships

The most important factor in choosing an external penile prosthetic is how well it fits into your sex life. This requires not only a genuine acknowledgment of your own sexual desires (and limitations) but those of your partner as well. If using the device makes you or your partner embarrassed or uncomfortable, it is unlikely to work.

The only way to work through these issues is to talk about them. Being upfront about your needs and desires may encourage your partner to embrace an external prosthetic as a natural part of sexual play rather than as a "fetish."

Other ED Treatments

People sometimes think that Viagra is the only form for ED treatment, and that's simply not true. In addition to PDE inhibitors like Viagra (sildenafil), Levitra (vardenafil), Cialis (tadalafil), and Stendra (avanafil), there are other options to discuss with your urologist, including:

• Testosterone supplementation, an often-effective therapy for people diagnosed with hypogonadism (low testosterone) Although raising testosterone alone may not solve ED issues, there is a synergy or greater benefit to erectile function when testosterone medication is used with ED medications.
• Intracavernosal injections, in which a medication called Caverject (alprostadil) Trimix (papaverine, phentolamine, and prostaglandin) is injected into the shaft to increase blood flow to the penis.
• Internal penile prostheses, in which a flexible or inflatable device is surgically implanted into the shaft of the penis for an "on-demand" erection.

A Word From Verywell

Sex is about more than just the penis. Just as safe sex works best when couples find ways to eroticize it, so, too, does an erectile prosthesis.

In the end, erectile dysfunction doesn't have to be a limitation. It can be an invitation to explore new pathways of intimacy and pleasure if you keep an open mind and an open pathway of communication.