Penis Pumps for ED: How They Work and What to Expect

A penis pump is a mechanical device that can help treat erectile dysfunction (ED). Also known as a vacuum pump or vacuum erection device, it works by creating a vacuum that suctions blood into the penis to help achieve and maintain an erection needed for sex.

A penis pump may be used with or without ED drugs like Viagra and Cialis, depending on the severity of the condition. The pump is often used with an erectile dysfunction ring ("cock ring") that helps keep the blood in the penis once an erection has been achieved.

Although a penis pump cannot cure ED, it can help improve the quality of erections and the sex lives of people living with this all-too-common condition.

This article explains how a penis pump works, what to expect, and the risks and limitations of this potentially useful device.

What Does a Penis Pump Do?

When people hear the term "penis pump," the first thing that often comes to mind is penis enlargement. And, while it is true that people will often buy the device with the hope of enlarging their penises, it has a more practical use in people with ED.

For people with ED, the aim is not to enlarge the penis—which the device really can't do anyway—but to facilitate an erection when there are problems that impede the flow of blood into the penis.

While people will often buy novelty devices online or in sex shops, there are medically approved vacuum erection devices (VEDs) that have built-in safeguards to prevent injury to the penis. Some VEDs work with a hand pump, while others are battery-operated with a digital pressure readout to limit the amount of negative pressure a penis is subjected to.

ED and the Anatomy of the Penis

An erection involves a complex interaction of emotions, nerves, hormones, blood vessels, and smooth muscles that work together to engorge the penis with blood and prevent the backflow (venous leakage) of blood once it has been achieved.

Within the penis are two tube-like structures, called the corpora cavernosa, that run the length of the organ. During sexual arousal, these sponge-like bodies will relax, allowing blood to flood in and engorge the tissues.

As the penis swells, it presses against a band of fibrous tissues at the base of the penis, called the tunica albuginea, causing it to tighten and preventing blood from escaping.

In people with ED, there are many conditions that can interfere with these processes. Many are aging-related—which is why 40% of males over 40 and 70% of males over 70 have ED—while others are not.

Common causes and risk factors for ED include:

• Cardiovascular disease, including high blood pressure
  
• Prostate problems 
• Vascular surgery or prostate surgery
• Peyronie's disease
• Penile trauma
• Type 2 diabetes
• High cholesterol
• Antidepressants, antihypertensive drugs, and other medications
• Hypogonadism (low testosterone)
• Multiple sclerosis and other neurological disorders
• Spinal cord injury
• Relationship or emotional problems
  
• Alcohol abuse
• Smoking
  

Treatments for ED

A penis pump is one of several tools your doctor may recommend to help treat ED. It is often used in tandem with ED medications called phosphodiesterase type 5 inhibitors (PDE5 inhibitors).

PDE5 inhibitors are a group of drugs commonly used in the first-line treatment of ED. They work by dilating the corpora cavernosa and enabling an erection with sexual stimulation. There are five PDE5 inhibitors approved for use in treating ED:

• Cialis (tadalafil)
• Levitra (vardenafil)
  
• Staxyn (vardenafil) dissolvable tablets
• Stendra (avanafil)
  
• Viagra (sildenafil) 

There are also medications like Caverject (alprostadil) that are injected into the penis to dilate blood vessels within the corpora cavernosa. There is also a version of the drug called Muse (alprostadil urogenital) that is inserted into the urethra. These may be considered if PDE5 inhibitors are ineffective or cannot be used.

Lifestyle changes such as exercise, weight loss, and quitting cigarettes can greatly improve erections in some people, especially those who are young. In some cases, counseling and testosterone replacement therapy may be advised.

When all conservative treatments have failed, surgery may be explored. Options include arterial revascularization to increase blood flow into the penis, venous surgery to help trap blood during an erection, and an inflatable or solid penile implant that can be inflated or bent into shape on demand.

Do Penis Pumps Work?

Penis pumps can be extremely effective for many people with ED, but they are not for everyone. As with all medical treatments, there are benefits and drawbacks.

Benefits

The advantages of a penis pump are many, including ease of use and the relatively quick speed at which an erection can be achieved. Studies have shown that even individuals with nerve damage following prostate removal surgery are able to attain an erection with a pump, usually within two to three minutes.

Penis pumps are also reusable and cost-effective. They are a great option for people who cannot use PDE5 inhibitors, such as those with a history of stroke or heart attack or who are on nitrates or nitroglycerine.

Moreover, they can be incorporated into foreplay and are more "on-demand" than PDE5 inhibitors. Many people with ED may be able to sustain an erection for 30 minutes or longer. Those who can't may reapply the device to restore an erection.

Limitations

There are few contraindications to penis pumps other than having bleeding disorders like hemophilia or blood-clotting disorders like sickle cell disease. People with ischemic priapism, a recurrent form of priapism in which an erection is abnormally prolonged, may also be advised to avoid the device.

People on blood thinners like warfarin and anti-platelet drugs like Plavix (clopidogrel) should speak with their doctors before using a penis pump as the suctioning may cause bruising and bleeding.

Even those without these issues may encounter problems. One of the more common is petechiae, a type of red skin spot caused by the rupture of capillaries. This is often due to over-pumping the device or leaving it on for too long. Others complain of pain or having a cold or bluish penis.

Some people, particularly older adults, may find that the penis is unstable after pumping and experience twisting at the base when intercourse is attempted.

Speak with a doctor before using a penis pump to ensure that it is the right option for you and, moreover, that you are using it correctly.

How to Use a Penis Pump for ED

You can opt to buy a novelty penis pump if you have ED, but it may be safer to use a vacuum erection device (VED) prescribed by your urologist. Some doctors also refer to them as vacuum constrictive devices (VCDs) or external penile rigidity devices (EPRDs).

Choosing the Right Device

VEDs are classified as Class II devices by the Food and Drug Administration. Some are available over the counter, while others are only obtained through professional channels.

Another way that VEDs differ is that they tend to fit over the penis only, rather than over the penis and scrotum, as some novelty devices do.

Instructions

VEDs vary in design but consist of a closed-ended clear plastic cylinder and a vacuum pump this is either hand- or battery-operated.

There are several preparations you need to make in advance of pumping. If you intend to use condoms, buy a water-based lubricant that does not degrade or damage latex condoms. If you plan to use an ED ring—which almost invariably improves the quality of an erection—you should also keep it close at hand.

To operate a manual or battery-operated VED:

1. Lubricate: Coat the base of the penis with lubricant as well as the rim of the cylinder to ensure an airtight seal.
2. Insert: Place the cylinder over the penis until it rests flush against the skin. Move the scrotum into a comfortable position.
3. Suction: Using the hand- or battery-operated control, suction out the air to create a vacuum. Draw out enough air so that you feel significant pressure but no pain. The limiter will prevent over-suctioning.
4. Wait: Most people can achieve an erection within 30 seconds to seven minutes. If you feel any pain or discomfort, ease back by using the release valve.
5. Remove: Position one hand around the base of the penis, and remove the cylinder with the other.
6. Grip: Tighten your grip around the penis to keep blood from escaping. With your free hand, grab the ED ring and strap it around the base of your penis behind the scrotum.
   

What to Expect

If used correctly, a penis pump can increase the rigidity and duration of an erection. With that said, some people will have firmer and longer-lasting erections than others. If you start to lose an erection, you can remove the ED ring and start again.

If there is any instability in the penis, you can help stabilize it by holding it firmly at the base. Lubricate the penis and your partner's vagina or anus well. If you still have problems with insertion, switch positions until you find one that offers easier access.

Possible Risks

There are risks associated with penis pumps, particularly novelty pumps. If too much pressure is applied, the pump can cause pain, bruising, urethral bleeding, and hematomas (blood pooling due to ruptured vessels).

Some people also find it harder to ejaculate after using a penis pump as it can cause the tissues around the urethra to swell, pinching off the exit. If ejaculation does occur, it can be painful. The penis itself may also feel numb, and orgasm may be harder to achieve.

With the long-term overuse of a penis pump, scar tissues can begin to form in the skin and underlying tissues. While the penis may look larger due to the build-up of the tissue, it will often feel spongy rather than hard. There may also be permanent numbness.

The overuse of the ED ring can also cause nerve injury that worsens rather than improves ED. This is why you should never fall asleep with an ED ring on, particularly if you've taken a PDE5 inhibitor like Viagra.

Summary

A penis pump or vacuum erection device can be used to treat erectile dysfunction. The device is used to suction blood into the penis to help achieve and maintain an erection. While novelty devices are available over the counter, a vacuum erection device prescribed by a urologist is safer.

People with a blood clotting disorder or taking anticoagulants should not use a vacuum erection device.

A Word From Verywell

As stressful and embarrassing as erectile dysfunction may seem, it is a common condition for which there are several effective treatments. Don't assume that your ED is untreatable simply because Viagra or Cialis don't work for you. Sometimes, it takes more than one treatment to get your condition right.

A penis pump is one such option. But, rather than just buying one online and seeing if it works, speak with a doctor to identify the possible causes of your ED. By doing so, you may find the right combination of treatments for you as an individual.

If a penis pump is recommended, your doctor can point you in the direction of the safest options, whether over the counter or through professional channels. Some may even be covered in part by your insurance.