What is natural Viagra? Does herbal Viagra work
There are many unproven herbals, dietary supplements, and natural remedies for ED. These include panax, propionyl-L-carnitine, L-citrulline, pomegranate, rhodiola rosea, golden root, Indian ginseng, zinc supplements, and ashwagandha.
Natural Viagra: Herbal & Other Alternatives to Treat ED
No one wants to experience erectile dysfunction. As a matter of fact, it can feel pretty damned embarrassing — even depressing.
But it isn’t uncommon, and you don’t have to suffer through it.
There are numerous possible solutions and treatments available to help men regain their sexual health.
Medications likeViagra® are just one option. For men interested in non-prescription solutions, there are other natural alternatives for the treatment of erectile dysfunction.
Though, it’s worth noting that the jury is largely out on just how effective these might be.
What Are Natural Viagra Alternatives?
When it comes to treating a medical condition, the word “natural” can mean many things.
It’s become a buzzword regarding food, skin care products, treating illnesses and everything in between.
Defining “natural” is important. For the sake of our analysis, we have included natural and home remedies for ED that do not require surgery or taking a prescription medication.
Vacuum Therapy
Vacuum devices are a mechanical treatment for sexual dysfunction. Used since the early 1980s, vacuum therapy involves using a pump to create a vacuum on the penis, leading to engorgement by engaging your blood vessels and increasing blood flow.
Once the vacuum has enlarged and stiffened the penis, a ring is placed at the base to keep the tissue engorged for sexual activity.
Satisfaction with the results of a penis pump or vacuum vary.
One smaller study published in the Journal of Urology of 100 men with ED problems found the overall satisfaction rate with the penis pump was 68 percent, and those who were unsatisfied cited pain, inconvenience and fleeting effects as their reasons.
genuine Viagra® makes it possible
Sex Therapy
For men whose ED is caused or worsened by psychological factors, counseling or sex therapy for ED may provide some relief.
Things like anxiety, relationship conflicts, trauma, cultural taboos and unresolved relationship attachments can all be addressed with the help of a mental health professional.
It’s obvious that erectile dysfunction can be frustrating. Talking to a licensed therapist or mental health caretaker can help you work through any mental health issues that could be causing your ED and may lead to an enhancement of your sex life.
Herbal Remedies and Dietary Supplements
There are currently many over-the-counter herbal supplements marketed as natural remedies for erectile dysfunction. However, it’s extremely important to note the scientific efficacy, because many of these herbs and homeopathic remedies haven’t been thoroughly tested or approved by the Food and Drug Administration, and should be taken lightly at best.
Epimedium or horny goat weed, for example, has been shown to have small improvements on erectile dysfunction and aphrodisiac effects (increases in sexual desire) in animal testing. Still, no high-quality human studies have confirmed these and they could act as placebos.
Red ginseng (an antioxidant) and L-arginine (a type of amino acid) are two other products frequently marketed as herbal viagra alternatives but lack much scientific evidence for natural ED remedies.
Finally, a small study published in the journal, Pharmacognosy Review, (involving 29 men) of yohimbine was shown to be a useful treatment option in orgasmic dysfunction.
What is natural Viagra? Does herbal Viagra work?
If you have any medical questions or concerns, please talk to your healthcare provider. The articles on Health Guide are underpinned by peer-reviewed research and information drawn from medical societies and governmental agencies. However, they are not a substitute for professional medical advice, diagnosis, or treatment.
Whether at your local corner store or some not-so-far corner of the internet, you’ve likely seen a product or two claiming to be natural or herbal Viagra. They may be marketed as treating erectile dysfunction (ED) naturally, all without the need for a prescription.
And if you have ED, it’s tempting to look for over-the-counter options or other alternatives to prescription drugs. But do these natural remedies for ED work? The science is scarce, but there may be some natural alternatives, like red ginseng, that could potentially increase your libido or help improve erectile function.
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What is natural Viagra?
When someone uses the term “natural Viagra,” they’re referring to a supplement or ingredient that treats ED similarly to how medications like Viagra (generic name sildenafil; see Important Safety Information) would.
In order to understand what natural Viagra does (or what it’s supposed to do), let’s look at how the prescription medication works. To keep it brief: Viagra works by stopping the chemical reaction that causes blood to leave an erect penis. In other words, it helps you stay hard.
Natural Viagra supplements make similar claims. But, like all supplements, those claiming to be a form of herbal Viagra aren’t regulated by the U.S. Food and Drug Administration (FDA). That means you can’t be sure of their purity or strength. Not only could these products be ineffective, but they can also even be dangerous for some people.
However, some natural remedies for ED have shown promise in early scientific studies.
Natural alternatives to Viagra
If you’re looking to try a drug-free ED remedy, there are some supplements and herbs that may mimic the effects of their prescription counterpart Viagra.
Horny goat weed
Horny goat weed is a medicinal herb that has been used in traditional Chinese medicine for thousands of years to treat fatigue and low libido.
Some anecdotal reports and animal experiments suggest horny goat weed might help address ED by improving erections. How so? Horny goat weed contains icariin, a substance that is a mild inhibitor of PDE5, which is exactly how Viagra works (Dell’Agli, 2008).
But studies on the effects of icariin have only been conducted on animals and petri dishes, meaning it might not work the same way in the human body. No clinical trials on horny goat weed’s effect on ED in humans has been conducted yet.
Korean red ginseng
Korean ginseng has been touted as an ED treatment for years, and unlike some other natural products, studies have found it may actually be effective at alleviating symptoms of ED.
In a meta-analysis involving over 2,000 men with ED, researchers found that red ginseng improved erectile function in participants. While results are promising, they did caution that more studies are needed before red ginseng is touted as the next herbal Viagra (Borrelli, 2018).
Erectile dysfunction (ED): causes, symptoms, and treatment
Yohimbe
Yohimbe is a dietary supplement made from the bark of an African evergreen tree. Yohimbine, the active ingredient in yohimbe bark, is a common ingredient in supplements sold as aphrodisiacs and male sexual enhancers.
A 2015 review of studies determined that yohimbine was superior to placebo for treatment of ED, but it has yet to be compared to PDE5 inhibitors like Viagra (Cui, 2015).
DHEA
One of the causes of ED is low testosterone. Dehydroepiandrosterone, or DHEA for short, is a hormone produced in the adrenal glands, which sit atop the kidneys. In our bodies, DHEA boosts certain hormones, like testosterone.
Studies on the use of DHEA supplements to boost testosterone have been mixed though. While some research shows that testosterone levels go up, others found the supplement had no effect (Liu, 2013). And either way, there’s no clear evidence that DHEA will boost testosterone in a way that has any meaningful effect on symptoms of ED (Morales, 2009).
L-citrulline and L-arginine
Some researchers believe that L-citrulline, an amino acid, can cause blood vessels to relax similarly to how Viagra works. It’s the precursor of L-arginine, another amino acid that has been shown to improve blood flow (Cormio, 2011).
A large study that looked at ten different studies including 540 participants found that there was potential for L-arginine to help with ED. The researchers found that dosages between 1500 mg and 5000 mg offered significant improvements in ED over placebo and participants had higher self-reported scores of sexual satisfaction and erectile function (Rhim, 2019).
Other Viagra alternatives
If herbal Viagra alternatives aren’t of interest to you, there are other options here that have been shown to help ED (Sooriyamoorthy, 2021):
Medical devices
Several medical devices can be helpful for ED, including penis pumps and cock rings. A penis pump works by drawing blood into the penis, giving you harder erections.
A cock ring is placed around the base of penis (or around the penis and testicles), keeping blood from flowing out once it has entered. This can help your erection last longer.
Penis implants—which include a rod, semi-rigid implant, or one that can be inflated before sex—are also an option. These devices are typically reserved for extreme cases of ED.
8 natural remedies and treatments for erectile dysfunction
Lifestyle changes
Lifestyle changes like exercising regularly, eating a heart-healthy diet, and avoiding alcohol and smoking (both of which can damage blood vessels and nerves that produce a healthy erection) can also help. Regardless of whether you’re taking Viagra or a natural supplement, these lifestyle changes can have a significant effect on your ability to get and maintain an erection.
Other alternatives to Viagra
Aside from the herbal and natural alternatives to Viagra, there are other medications you can take. These include other PDE5 inhibitors––like Cialis (generic name tadalafil; see Important Safety Information) and Levitra (generic name vardenafil)––as well as non-oral ED medications like alprostadil, which is injected into the penis or placed in the urethra as a suppository (Sooriyamoorthy, 2021).
If low testosterone is the cause of your ED, testosterone replacement therapy may be used. This treatment comes as a patch, gel, or injection (Sooriyamoorthy, 2021).
Natural Viagra: the bottom line
As you can see, when it comes to natural alternatives to Viagra you do have options. But, before taking any supplements that claim to be a natural form of Viagra, it’s best to speak with a healthcare provider.
If you’ve just started experiencing symptoms of ED, reach out to a medical professional. This is important not only to improve your sex life, but make sure nothing else is going on behind the scenes. ED can be an early warning sign of serious health conditions like heart disease, high blood pressure, diabetes, depression, and low testosterone. You owe it to yourself to get to the core of the issue and receive effective treatment as soon as possible.
References
- Borrelli, F., Colalto, C., Delfino, D. V., Iriti, M., & Izzo, A. A. (2018). Herbal Dietary Supplements for Erectile Dysfunction: A Systematic Review and Meta-Analysis. Drugs, 78(6), 643–673. doi: 10.1007/s40265-018-0897-3. Retrieved from https://pubmed.ncbi.nlm.nih.gov/29633089/
- Cormio, L., De Siati, M., Lorusso, F., Selvaggio, O., Mirabella, L., Sanguedolce, F., et al. (2011). Oral L-citrulline supplementation improves erection hardness in men with mild erectile dysfunction. Urology, 77(1), 119–122. doi: 10.1016/j.urology.2010.08.028. Retrieved from https://pubmed.ncbi.nlm.nih.gov/21195829/
- Cui, T., Kovell, R. C., Brooks, D. C., & Terlecki, R. P. (2015). A Urologists Guide to Ingredients Found in Top-Selling Nutraceuticals for Mens Sexual Health. The Journal of Sexual Medicine, 12(11), 2105–2117. doi: 10.1111/jsm.13013. Retrieved from https://pubmed.ncbi.nlm.nih.gov/26531010/
- Dell’Agli, M., Galli, G. V., Dal Cero, E., Belluti, F., Matera, R., Zironi, E., et al. (2008). Potent inhibition of human phosphodiesterase-5 by icariin derivatives. Journal of Natural Products, 71(9), 1513–1517. doi: 10.1021/np800049y. Retrieved from https://pubmed.ncbi.nlm.nih.gov/18778098/
- Liu, T.-C., Lin, C.-H., Huang, C.-Y., Ivy, J. L., & Kuo, C.-H. (2013). Effect of acute DHEA administration on free testosterone in middle-aged and young men following high-intensity interval training. European Journal of Applied Physiology, 113(7), 1783–1792. doi: 10.1007/s00421-013-2607-x. Retrieved from https://pubmed.ncbi.nlm.nih.gov/23417481/
- Morales, A., Black, A., Emerson, L., Barkin, J., Kuzmarov, I., & Day, A. (2009). Androgens and sexual function: a placebo-controlled, randomized, double-blind study of testosterone vs. dehydroepiandrosterone in men with sexual dysfunction and androgen deficiency. The Aging Male : The Official Journal of the International Society for the Study of the Aging Male, 12(4), 104–112. doi: 10.3109/13685530903294388. Retrieved from https://pubmed.ncbi.nlm.nih.gov/19883295/
- Smith, B. P. & Babos, M. (2021). Sildenafil. [Updated June 29, 2021]. In: StatPearls [Internet]. Retrieved from https://pubmed.ncbi.nlm.nih.gov/32644404/
- Sooriyamoorthy, T., & Leslie, S. (2021). Erectile Dysfunction. [Updated Aug. 12, 2021]. In: StatPearls [Internet]. Retrieved from https://pubmed.ncbi.nlm.nih.gov/32965924/
- Rhim, H. C., Kim, M. S., Park, Y., Choi, W. S., Park, H. K., Kim, H. G., et al. (2019). The Potential Role of Arginine Supplements on Erectile Dysfunction: A Systemic Review and Meta-Analysis. The Journal of Sexual Medicine, 16(2), 223-234. doi:10.1016/j.jsxm.2018.12.002. Retrieved from https://www.jsm.jsexmed.org/article/S1743-6095(18)31362-6/pdf
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Daily Viagra: how often can you take it?
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Important Safety Information for Sildenafil (Viagra)
What are the most important things I need to know about VIAGRA® (sildenafil citrate) 25 mg, 50 mg, and 100 mg tablets and generic VIAGRA®?
Discuss your health with your doctor to ensure that you are healthy enough for sex. If you experience chest pain, dizziness, or nausea during sex, seek immediate emergency medical attention.
- VIAGRA® and generic VIAGRA® can cause serious side effects. Serious, but rare, side effects include:
- an erection that will not go away (priapism). If you have an erection that lasts more than 4 hours, seek emergency medical attention right away. If it is not treated right away, priapism can permanently damage your penis.
- sudden vision loss in one or both eyes. Sudden vision loss in one or both eyes can be a sign of a serious eye problem called non-arteritic anterior ischemic optic neuropathy (NAION). Stop taking VIAGRA and call your healthcare provider right away if you have any sudden vision loss
- sudden hearing decrease or hearing loss. Some people may also have ringing in their ears (tinnitus) or dizziness. If you have these symptoms, stop taking VIAGRA and contact a doctor right away
Who should not take VIAGRA® or generic VIAGRA®?
Do not take VIAGRA® or generic VIAGRA® if you:
- Take any medicines called nitrates, often prescribed for chest pain, or guanylate cyclase stimulators like Adempas (riociguat) for pulmonary hypertension. Your blood pressure could drop to an unsafe level
- Are allergic to sildenafil, as contained in VIAGRA® and REVATIO®, or any of the ingredients in VIAGRA® or generic VIAGRA® tablets.
- Are a women or a child
When should I call my primary provider?
Call your primary provider right away if you:
- Have an erection that lasts longer than 4 hours
- Experience a sudden loss of vision in one or both eyes
- Experience a sudden decrease in or loss of hearing
- Experience chest pain, dizziness, or nausea during sex
- Take too much Viagra or sildenafil citrate
If you are experiencing a medical emergency, call 911 or seek immediate medical attention.
What are the most common side effects of VIAGRA® and generic VIAGRA®?
- headache
- flushing
- upset stomach
- abnormal vision, such as changes in color vision (such as having a blue color tinge) and blurred vision
- stuffy or runny nose
- back pain
- muscle pain
- nausea
- dizziness
- rash
What should I tell my Roman-affiliated provider before taking VIAGRA® and generic VIAGRA®?
Before you take VIAGRA® or generic VIAGRA® , tell your healthcare provider if you:
- Have or have had heart problems such as a heart attack,irregular heartbeat, angina, chest pain, narrowing of the aortic valve, or heart failure
- Have had heart surgery within the last 6 months
- Have pulmonary hypertension
- Have had a stroke
- Have low blood pressure, or high blood pressure that is not controlled
- Have a deformed penis shape
- Have had an erection that lasted for more than 4 hours
- Have problems with your blood cells such as sickle cell anemia, multiple myeloma, or leukemia
- Have retinitis pigmentosa, a rare genetic (runs in families) eye disease
- Have ever had severe vision loss, including an eye problem called NAION
- Have bleeding problems
- Have or have had stomach or intestinal ulcers
- Have liver problems
- Have kidney problems or are having kidney dialysis
- Have any other medical conditions
Tell your healthcare provider about all the medicines you take, including prescription and over-the-counter medicines, vitamins, and herbal supplements.
VIAGRA may affect the way other medicines work, and other medicines may affect the way VIAGRA works, causing side effects.
Especially tell your healthcare provider if you take any of the following:
- Medicines called nitrates
- Medicines called guanylate cyclase stimulators such as Adempas® (riociguat)
- Medicines called alpha-blockers such as Hytrin® (terazosin HCl), Flomax® (tamsulosin HCl), Cardura® (doxazosin mesylate), Minipress® (prazosin HCl), Uroxatral® (alfuzosin HCl), Jalyn® (dutasteride and tamsulosin HCl), or Rapaflo® (silodosin). Alpha-blockers are sometimes prescribed for prostate problems or high blood pressure. In some patients, the use of VIAGRA® with alpha-blockers can lead to a drop in blood pressure or to fainting
- Medicines called HIV protease inhibitors, such as ritonavir (Norvir®), indinavir sulfate (Crixivan®), saquinavir (Fortovase® or Invirase®), or atazanavir sulfate (Reyataz®)
- Oral antifungal medicines, such as ketoconazole (Nizoral®) and itraconazole (Sporanox®)
- Antibiotics, such as clarithromycin (Biaxin®), telithromycin (Ketek®), or erythromycin
- Other medicines that treat high blood pressure
- Other medicines or treatments for ED
- VIAGRA® contains sildenafil, which is the same medicine found in another drug called REVATIO®. REVATIO® is used to treat a rare disease called pulmonary arterial hypertension (PAH). VIAGRA® should not be used with REVATIO® or with other PAH treatments containing sildenafil or any other PDE5 inhibitors (such as Adcirca [tadalafil])
Withholding or providing inaccurate information about your health and medical history in order to obtain treatment may result in harm, including, in some cases, death.
What is the FDA-approved use of VIAGRA® and generic VIAGRA®?
VIAGRA® (sildenafil citrate) is prescription medicine used to treat erectile dysfunction (ED).
Roman-affiliated doctors may prescribe VIAGRA® or generic VIAGRA® for the treatment of premature ejaculation (PE), if they believe in their medical judgment that it is an appropriate course of treatment. While this is not an FDA-approved use of the drug, the American Urological Association has included the use of sildenafil citrate in the treatment of PE in its Guideline on the Pharmacologic Management of Premature Ejaculation.
You are encouraged to report negative side effects of prescription products to the FDA. Visit www.fda.gov/medwatch or call 1-800-FDA-1088.
Please see the full Prescribing Information for complete safety information.
Product names referenced herein are trademarks of their respective owners.
Important Safety Information for Tadalafil (Cialis)
What Is The Most Important Information I Should Know About CIALIS® (tadalafil) and generic CIALIS®?
- CIALIS® and generic CIALIS® can cause serious side effects. Serious, but rare, side effects include:
- An erection that won’t go away (priapism). If you get an erection that lasts more than 4 hours, get medical help right away. Priapism must be treated as soon as possible or lasting damage can happen to your penis, including the inability to have erections.
- Changes in vision. Color vision changes, such as seeing a blue tinge (shade) to objects or having difficulty telling the difference between the colors blue and green.
- Sudden decrease or loss of vision. In rare instances, men taking PDE5 inhibitors (oral erectile dysfunction medicines, including CIALIS® and generic CIALIS®) reported a sudden decrease or loss of vision in one or both eyes. It is uncertain whether PDE5 inhibitors directly cause the vision loss. If you experience sudden decrease or loss of vision, stop taking PDE5 inhibitors, including CIALIS® and generic CIALIS®, and call a healthcare provider right away.
- Sudden loss or decrease in hearing. Sudden loss or decrease in hearing, sometimes with ringing in the ears and dizziness, has been rarely reported in people taking PDE5 inhibitors, including CIALIS® and generic CIALIS®. It is not possible to determine whether these events are related directly to the PDE5 inhibitors, to other diseases or medications, to other factors, or to a combination of factors. If you experience these symptoms, stop taking CIALIS® and generic CIALIS® and contact a healthcare provider right away.
- ED is a condition where the penis does not fill with enough blood to harden and expand when a man is sexually excited, or when he cannot keep an erection. A man who has trouble getting or keeping an erection should see his healthcare provider for help if the condition bothers him.
- CIALIS® and generic CIALIS® help increase blood flow to the penis and may help men with ED get and keep an erection satisfactory for sexual activity. Once a man has completed sexual activity, blood flow to his penis decreases, and his erection goes away. Some form of sexual stimulation is needed for an erection to happen with CIALIS® or generic CIALIS®.
- CIALIS® and generic CIALIS® do not:
- Cure ED
- Increase a man’s sexual desire
- Protect a man or his partner from sexually transmitted diseases, including HIV. Speak to your healthcare provider about ways to guard against sexually transmitted diseases.
- Serve as a male form of birth control
- Take CIALIS® or generic CIALIS® exactly as your healthcare provider prescribes it. Your healthcare provider will prescribe the dose that is right for you. Do not change your dose or the way you take CIALIS® or generic CIALIS® without talking to your healthcare provider.
Who Should Not Take CIALIS® or generic CIALIS®?
Do not take CIALIS® or generic CIALIS® if you:
- Have severe liver disease. Tell your doctor if you have mild to moderate liver disease as you may need dosage reductions.
- Have severe kidney disease. Tell your doctor if you have mild to moderate kidney disease as you may need dosage reductions
- Take any medicines called “nitrates”
- Use recreational drugs called “poppers” like amyl nitrite and butyl nitrite
- Take any medicines called guanylate cyclase stimulators, such as riociguat
- Are allergic to CIALIS®, tadalafil or ADCIRCA®, or any of its ingredients
When should I call my primary provider?
Call your primary provider right away if you:
- Have an erection that lasts longer than 4 hours
- Experience a sudden loss of vision in one or both of your eyes
- Experience a sudden decrease or loss hearing
- Take too much CIALIS® or generic CIALIS®
- Have an allergic reaction to CIALIS® or generic CIALIS®
- Symptoms of an allergic reaction may include:
- Rash
- Hives
- Swelling of the lips, tongue, or throat
- Difficulty breathing or swallowing
Call your healthcare provider or get help right away if you have any of the symptoms of an allergic reaction listed above.
If you are experiencing a medical emergency, call 911 or seek immediate medical attention.
What Should I Tell My Roman-affiliated Provider Before Taking CIALIS® and generic CIALIS®?
Tell your Roman-affiliated provider about all your medical problems, including if you:
- Have heart problems such as angina, heart failure, irregular heartbeats, or have had a heart attack. Ask your healthcare provider if it is safe for you to have sexual activity. You should not take CIALIS® and generic CIALIS® if your healthcare provider has told you not to have sexual activity because of your health problems.
- Have pulmonary hypertension
- Have low blood pressure or have high blood pressure that is not controlled
- Have had a stroke
- Have liver problems
- Have kidney problems or require dialysis
- Have retinitis pigmentosa, a rare genetic (runs in families) eye disease
- Have ever had severe vision loss, including a condition called NAION
- Have stomach or intestinal ulcers
- Have a bleeding problem
- Have a deformed penis shape or Peyronie’s disease
- Have had an erection that lasted more than 4 hours
- Have blood cell problems such as sickle cell anemia, multiple myeloma, or leukemia
Tell your healthcare provider about all the medicines you take including prescription and non-prescription medicines, vitamins, and herbal supplements.
Especially tell your healthcare provider if you take any of the following:
- Medicines called nitrates
- Medicines called guanylate cyclase stimulators, such as riociguat (Adempas®), used to treat pulmonary hypertension
- Medicines called alpha blockers. These include Hytrin® (terazosin HCl), Flomax® (tamsulosin HCl), Cardura® (doxazosin mesylate), Minipress® (prazosin HCl), Uroxatral® (alfuzosin HCl), 4 Jalyn® (dutasteride and tamsulosin HCl) or Rapaflo® (silodosin). Alpha-blockers are sometimes prescribed for prostate problems or high blood pressure. If CIALIS® or generic CIALIS® is taken with certain alpha blockers, your blood pressure could suddenly drop. You could get dizzy or faint.
- Other medicines to treat high blood pressure (hypertension)
- Medicines called HIV protease inhibitors, such as ritonavir (Norvir® , Kaletra® )
- Oral antifungals such as ketoconazole (Nizoral® ), itraconazole (Sporanox® )
- Antibiotics such as clarithromycin (Biaxin® ), telithromycin (Ketek® ), erythromycin (several brand names exist. Please consult your healthcare provider to determine if you are taking this medicine).
- Other medicines or treatments for ED.
- Tadalafil is also marketed as ADCIRCA® for the treatment of pulmonary arterial hypertension. Do not take both CIALIS® or generic CIALIS® and ADCIRCA®. Do not take sildenafil citrate (Revatio®, Viagra®) with CIALIS® or generic CIALIS®.
Withholding or providing inaccurate information about your health and medical history in order to obtain treatment may result in harm, including, in some cases, death.
What are the most common side effects of CIALIS® or generic CIALIS®?
The most common side effects with CIALIS® and generic CIALIS® are:
What is the FDA-approved Use of CIALIS® and generic CIALIS®?
CIALIS® and generic CIALIS® are prescription medicines used to treat erectile dysfunction (ED), symptoms of benign prostatic hyperplasia (BPH), or both.
Roman-affiliated doctors may prescribe CIALIS® for the treatment of premature ejaculation (PE), if they believe in their medical judgment that it is an appropriate course of treatment.
You are encouraged to report negative side effects of prescription products to the FDA. Visit www.fda.gov/medwatch or call 1-800-FDA-1088.
Please see the full Prescribing Information for complete safety information.
Over-The-Counter Viagra Alternatives? Are There Natural Forms of Viagra?
There are many reasons why you might not see a doctor to get a prescription for Viagra. You might think it’s not necessary, or you could be worried about the cost. Perhaps you’re just shy or embarrassed. If you’ve been having erectile dysfunction but aren’t willing to speak to a doctor, then you might want to consider some over-the-counter substitutions.
While some great over-the-counter options are available, you also need to be aware of the limitations, so make sure you find out everything you need to know before buying.
What is Viagra?
Viagra is a prescription drug. It is used to treat erectile dysfunction in men. It works by increasing blood flow to the penis, which allows for an erection. Viagra is made by Pfizer’s pharmaceutical company and has been one of the most prescribed medications on the market. It has been around for a long time, and it continues to be as popular as it always has been.
Is OTC Viagra Safe?
One of the most significant drawbacks to over-the-counter Viagra alternatives is that they don’t have the same security that real Viagra has when prescribed by a doctor that knows you and your medical history.
Because these aren’t prescription drugs, they don’t have to be tested for potential side effects or interactions with other medications. They may not be as safe to use, so you will need to be careful and pay attention to how your body reacts to them.
However, most herbal and natural supplements are safe for you to take, so long as you don’t have any allergies to the ingredients. You should also speak to your doctor about any medications you are taking to make sure that you don’t have any interactions that could be dangerous.
The truth is that, just like Viagra, you need to be careful when taking over-the-counter Viagra alternatives.
Are OTC Viagra Replacements Just as Effective?
The short answer is not really, there are some limitations and concerns. Each brand is formulated slightly differently, so they are not all the same. However, the ingredients are similar across the board. Herbal supplements and OTC Viagra replacements can affect each man differently, so it’s hard to say if one is more effective than the other. The best you can do is try out a few and see which works best for you.
Top OTC Viagra Alternatives
Horny Goat Weed is a traditional Chinese herb that has been used for thousands of years for male sexual health. It contains Icariin, which is a chemical compound that has been proven to inhibit the PDE-5 enzyme. The PDE-5 enzyme is the same enzyme that is affected by Viagra. The effects of Horny Goat Weed can be felt within 30 minutes and may last for several hours. However, the results of Horny Goat Weed are not as strong as Viagra, and many people report that Horny Goat Weed doesn’t work for them.
Horny Goat Weed is a natural and safe alternative to Viagra. It is effective in both men and women, although men most commonly use it. People can purchase horny Goat Weed from most health stores and many online retailers.
Yohimbe Bark Extract is a natural tree bark used to increase blood flow to the penis. Yohimbe Bark Extract is often used in combination with other herbs to create a herbal Viagra alternative.
Yohimbe Bark Extract is one of the best OTC alternatives to Viagra, as it is reported to be very effective at increasing the flow of blood to the penis. However, Yohimbe Bark Extract has several side effects, including nervousness, headaches, and insomnia. Before taking Yohimbe Bark Extract, always speak to a doctor, especially if you have any existing medical conditions.
Damiana is a natural herb that is commonly used as an aphrodisiac. It contains chemicals that have been shown to increase blood flow to the penis. Men and women can take damiana. It is often used in combination with other OTC herbs to create a herbal Viagra alternative.
Damiana is effective at increasing blood flow to the penis. However, it’s also not as strong as Viagra. Damina can be found online and in some health stores.
4. Red Ginseng or Korean Ginseng
Ginseng is a common herbal supplement that has been used in Asia for thousands of years. It is often used to treat fatigue and improve general well-being. Red Ginseng contains a chemical compound called ginsenosides. The ginsenosides in Red Ginseng can inhibit the PDE-5 enzyme. The effects of Red Ginseng are similar to Viagra, but it is not as strong. Korean Ginseng was found to work better for ED than a placebo in a study featuring 2,080 men.
Side effects of Red Ginseng are mild and include nausea, headache, restlessness, and diarrhea. Red Ginseng is a popular natural alternative to Viagra. It is available online and in health stores.
5. DHEA (Dehydroepiandrosterone)
DHEA is a hormone produced by the human body by the adrenal gland. DHEA levels naturally decrease with age but taking it as a supplement can help. Taking DHEA can increase testosterone levels in both men and women, and in turn, increase libido and help with ED. DHEA also affects the brain and can increase sexual desire, which is a perk.
Side effects of DHEA include acne, increased facial hair, and a deepening voice among women. Women should not take DHEA, unless under the guidance of a doctor. DHEA can be purchased online and in health stores. DHEA is a serious hormone that people should not take casually and only under the guidance of a doctor.
L-arginine is an amino acid that is naturally produced by the body. It is essential for the production of nitric oxide that allows blood vessels to relax and widen. L-arginine is used to treat erectile dysfunction, as it is a precursor to nitric oxide. L-arginine can be taken as an oral supplement and is also available as a topical cream.
Many users have reported that the effects of L-arginine can be felt within an hour of taking it. However, the results of the supplement are not as strong as Viagra. L-arginine is safe and natural and does not have any known severe side effects, although it can cause a tingling sensation in some people.
Propionyl-L-carnitine is an amino acid that is naturally produced by the body. It has been shown to increase nitric oxide production in the body, which is a messenger molecule that can help improve blood flow. Propionyl-L-carnitine also helps the body make energy by transferring long-chain fatty acids directly to the mitochondria. This helps improve energy levels and may improve erectile function.
Propionyl-L-carnitine is most commonly used to treat muscle pain and lack of energy. It has a long track record of being safe and effective. Propionyl-L-carnitine is available online and in some health food stores. Please exercise caution when taking Propionyl-L-carnitine with prescription medications, as it can affect blood pressure.
The Bottom Line
Viagra is the most popular PDE-5 inhibitor on the market, but it’s not the only one. There are many natural over-the-counter alternatives to Viagra.
It’s a good idea to look into each supplement further besides deciding to take it, as this is just an overview of your options.
You should still speak with a doctor before deciding to take any medications, OTC or not, as they still have side effects and may interact with medications you’re already taking. Your doctor also already knows about your allergies and medical history, so they will be able to guide you into making the best choice to manage your ED.
This blog post is for educational purposes only and does not constitute medical or other professional advice. Your specific circumstances should be discussed with a healthcare provider. All statements of opinion represent the writers’ judgement at the time of publication and are subject to change. Phoenix and its affiliates provide no express or implied endorsements of third parties or their advice, opinions, information, products, or services.
8 Natural Remedies for Erectile Dysfunction (ED, Impotence)
For centuries, men have tried all sorts of natural remedies for erectile dysfunction (ED) — the repeated inability to get or maintain an erection firm enough for sexual intercourse. But do they really work? It is simply not scientifically known at this point. Furthermore, you take these remedies at your own risk, because their safety profiles have not been established. What follows are commentaries by experts and reviews in the field of alternative treatments that are available over the counter for erectile dysfunction and impotence.
Causes of erectile dysfunction (impotence)
“Just because there is evidence doesn’t mean it’s good evidence,” says Andrew McCullough, MD, associate professor of clinical urology at New York University Langone Medical Center in New York City, and one of the original clinical investigators for the ED drug Viagra (sildenafil). “And before men with ED start down the naturopathic route, it’s smart to make sure that there isn’t some underlying medical condition that needs to be corrected.” Moreover, it is estimated that 30 million American men have erection problems, and 70% of cases are a result of a potentially deadly condition that blocks blood flow, like atherosclerosis, kidney disease, vascular disease, neurological disease, or diabetes. Additionally, ED can also be caused by certain medications, surgical injury, and psychological problems.
Erectile dysfunction drugs
Experts feel that treating erectile dysfunction on your own, without consulting a doctor, is unsafe. “If you have ED, the first thing you need is a diagnosis,” says impotence expert Steven Lamm, MD, a New York City internist and the author of The Hardness Factor (Harper Collins) and other books on male sexual health. He says men with severe erectile dysfunction probably need one of the prescription ED drugs, which include the PDE-5 inhibitors Levitra (vardenafil), Cialis (tadalafil), and Stendra (avanafil), as well as Viagra. But, he says, mild ED — including the feeling that “you’re not as hard as you could be” — often responds to natural remedies.
Natural treatment of erectile dysfunction without drugs
Acupuncture. Though acupuncture has been used to treat male sexual problems for centuries, the scientific evidence to support its use for erectile dysfunction is equivocal at best. In 2009, South Korean scientists conducted a systematic review of studies on acupuncture for ED. They found major design flaws in all of the studies, concluding that “the evidence is insufficient to suggest that acupuncture is an effective intervention for treating ED.”
Arginine. The amino acid L-arginine, which occurs naturally in food, boosts the body’s production of nitric oxide, a compound that facilitates erections by dilating blood vessels, increasing blood flow to the penis. Studies examining L-arginine’s effectiveness against impotence have yielded mixed results. A 1999 trial published in the online journal BJU International found that high doses of L-arginine can help improve sexual function, but only in men with abnormal nitric oxide metabolism, such as that associated with cardiovascular disease (a disease that damages blood vessels). In another study, published in 2003 in the Journal of Sex & Marital Therapy, Bulgarian scientists reported that ED sufferers who took L-arginine along with the pine extract pycnogenol saw major improvements in sexual function with no side effects. Arginine can be helpful, says Geo Espinosa, ND, director of the Integrative Urological Center at NYU Langone Medical Center. Espinosa says that men with known cardiovascular problems should take it only with a doctor’s supervision; L-arginine can interact with some medications.
SLIDESHOW
DHEA (Dehydroepiandrosterone). Testosterone is essential for a healthy libido and normal sexual function, and erectile dysfunction sufferers known to have low testosterone improve when placed on prescription testosterone replacement therapy. Similarly, studies have shown that taking over-the-counter supplements containing DHEA, a hormone that the body converts to testosterone and estrogen, can help alleviate some cases of ED. But DHEA can cause side effects, including suppression of pituitary function, acne, hair loss, and its long-term safety is unknown, says McCullough. For this reason, many experts discourage the use of the supplements.
Ginseng. Korean red ginseng has long been used to stimulate male sexual function, but few studies have tried systematically to confirm its benefits. In one 2002 study involving 45 men with significant ED, the herb helped alleviate symptoms of erectile dysfunction and brought “enhanced penile tip rigidity.” Experts aren’t sure how red ginseng might work, though it’s thought to promote nitric oxide synthesis. “I would recommend ginseng [for men with ED],” says Espinosa. Discuss with your doctor before taking it since ginseng can interact with drugs you may already be taking and cause allergic reactions.
Pomegranate juice. Drinking antioxidant-rich pomegranate juice has been shown to have numerous health benefits, including a reduced risk for heart disease and high blood pressure. Does pomegranate juice also protect against ED? No proof exists, but the results of a study published in 2007 were promising. The authors of this small-scale pilot study called for additional research, saying that larger-scale studies might prove pomegranate juice’s effectiveness against erectile dysfunction. “I tell my patients to drink it,” says Espinosa. “It could help ED, and even if it doesn’t, it has other health benefits.”
Yohimbe. Before Viagra and the other prescription erectile dysfunction drugs became available, doctors sometimes prescribed a derivative of the herb yohimbe (yohimbine hydrochloride) to their patients suffering from ED. But experts say the medication is not particularly effective, and it can cause jitteriness and other problems. “It’s not a great drug,” says McCullough. “And I suspect the herb is not as potent as the pharmaceutical version.” What’s more, evidence shows that yohimbe is associated with high blood pressure, anxiety, headache, and other health problems. Experts discourage its use.
Health News
Horny goat weed. Horny goat weed (Epimedium) and related herbs have purportedly been treatments for sexual dysfunction for years. Italian researchers found that the main compound in horny goat weed, called icariin, acted in a similar way as drugs like sildenafil.
Ginkgo biloba. Known primarily as an herbal treatment for cognitive decline, ginkgo has also been used to treat erectile dysfunction — especially cases caused by the use of certain antidepressant medications. But the evidence isn’t very convincing. One 1998 study published in the Journal of Sex & Marital Therapy found that it did work. But a more rigorous study, published in Human Pharmacology in 2002, failed to replicate this finding. “Ginkgo has come out of fashion in the past few years,” says Ronald Tamler, MD, assistant professor of medicine and codirector of the men’s health program at Mount Sinai Medical Center in New York City. “That’s because it doesn’t do much. I can say that in my practice, I have not seen ginkgo work — ever.”
There are many unproven herbals, dietary supplements, and natural remedies for ED. These include panax, propionyl-L-carnitine, L-citrulline, pomegranate, rhodiola rosea, golden root, Indian ginseng, zinc supplements, and ashwagandha.
Lifestyle changes can improve erectile dysfunction
No matter what erectile dysfunction treatment or treatments (whether herbal remedies or not) a man ultimately decides upon, experts say it’s important to eat healthily and to avoid smoking and heavy drinking. Moreover, adequate exercise, stress reduction, and sleep can improve erection problems in many. In addition, says Lamm, “A loving, receptive, and responsive partner is a home run. After all, this is still a couple’s issue.”
QUESTION
Chen, J. BJU International 83 (1999): 269-273.
“Erectile Dysfunction.” National Kidney and Urologic Disease Information Clearinghouse.
Espinosa, Geo. Integrative Urological Center, NYU Langone Medical Center.
Lamm, Steven. The Hardness Factor (Harper Collins).
Lee, M.S. BJU International, Feb. 23, 2009.
McCullough, Andrew. NYU Langone Medical Center.
Shabsigh, Ridwan, et al. “A Multicenter, Double-blind, Placebo-controlled Trial to Assess The Efficacy of Sildenafil Citrate in Men With Unrecognized Erectile Dysfunction.” Urology 76.2 Aug. 2010: 373-379. Stanislov, R. Journal of Sex & Marital Therapy 29 (2003): 207-213.
Tamler, Ronal. Men’s Health Program, Mount Sinai Medical Center, New York City.
Viagra alternatives: Pills, natural remedies, and over-the-counter options
Viagra is a well-known treatment for erectile dysfunction, but many other medications and approaches can help achieve and maintain erections.
Research indicates that erectile dysfunction (ED) affects over 12 million men in the United States each year. Although the prevalence of this issue increases with age, it does not just affect older adults.
However, a range of treatments and strategies can improve or reverse ED. Options include drugs and other medical treatments, lifestyle changes, and alternative approaches.
In this article, we look into various alternatives to Viagra, answer some frequently asked questions, and discuss when to contact a doctor.
The table below offers a quick comparison of Viagra to its alternatives:
Why use it? Price Lasts for Pros Cons Viagra (sildenafil) starts working in 30–60 minutes depends on insurance, location, and pharmacy 4 hours different doses available Beyond Viagra, several medications can help with having and keeping erections.
Oral medications
Oral drugs, including Viagra, may be the first approach to treating ED.
Viagra is effective because it slows the action of phosphodiesterase type 5 (PDE5), an enzyme in the blood vessel walls.
Other prescription-only PDE5 inhibitors include:
- Vardenafil: Available under the brand names Levitra and Staxyn, this drug is available in regular and disintegrating tablet forms. A person takes it 1 hour before sex, and it can be effective for up to 7 hours.
- Tadalafil: Available under the brand names Adcirca and Cialis, a person takes this 1–2 hours before sex. Each dose can last up to 36 hours.
- Avanafil: Available in the U.S. as Stendra, a person takes this drug 15–30 minutes before sex, and the effects can last up to 6 hours.
There are various telehealth companies that stock ED medications, including:
- Roman: This company offers sildenafil or tadalafil and requires people to schedule an online appointment with its doctors. A person can benefit from personalized treatment, free delivery, and ongoing follow-ups. The platform also offers treatment for those with concerns about hair loss, premature ejaculation, and allergies. Learn more about Roman.
- Hims: This company addresses men’s health concerns. First, people complete an online form so that a physician can learn more about their symptoms. Once a person receives a treatment plan, they can have a follow-up appointment with Hims doctors. Learn more about Hims.
- Lemonaid Health: This brand offers medication for various health conditions. People can access ED medication starting from $2 per pill after scheduling an online appointment with a doctor.
Nonoral drugs
Penile self-injections
Certain medications, such as alprostadil (Caverject), papaverine, and phentolamine (Regitine), are available as an injection directly into the side or base of the penis.
This method generally works very quickly and is highly effective. However, this approach may cause side effects, including swelling, pain, and stinging. It may also cause permanent damage with improper use.
Urethral suppositories
A person can use a special applicator to insert very small alprostadil suppositories into the urethra, a method that can help stimulate erections.
This method generally works quickly, and a person can also self-administer this treatment.
However, these suppositories could affect a fetus if a sexual partner is pregnant. It could also cause side effects and not be as effective as other methods.
Testosterone replacements
A doctor may recommend this approach if they believe that ED is due to low levels of testosterone. A person can take synthetic testosterone via pills, patches, and injections.
In some people, drug treatments may be unsuitable, perhaps due to other health issues. In these cases, a doctor may recommend:
Vacuum erection devices
These are hollow tubes, also known as penis pumps. They attach to a hand- or battery-operated pump and work by drawing blood into the penis. The person can then maintain the erection using a tension ring.
Wearable devices
One example is Eddie by Giddy, a nonprescription, Class II medical device to help treat ED. The maker states that it uses constriction and tension to help maintain erections.
The Food and Drug Administration (FDA) has registered the device, but no scientific studies have evaluated its effectiveness.
Penis implants
Implants are inflatable or bendable rods that a surgeon implants into the erection chambers of the penis. However, doctors typically only recommend this approach as a last resort .
Keep in mind
It’s important to be careful when purchasing or consuming any alternative products, including those that claim to be herbal versions of Viagra.
The Food and Drug Administration (FDA) has issued several statements warning consumers about the safety of such goods. They say these products may contain hidden synthetic chemicals or other ingredients that could be harmful. There has not been enough research to support the usage of these supplements fully.
Many companies sell dietary supplements, herbal preparations, and food products as remedies for ED.
Some alternative herbal treatments, including the following, are also marketed for this purpose:
- Dehydroepiandrosterone (DHEA): A 2018 article states that aging causes a decline in DHEA, which leads to symptoms of depression, aggressive behavior, and low libido, among others. The research also notes that some trials suggest DHEA supplements may help improve a person’s well-being.
- Ginseng: According to a 2021 study , ginseng may improve an individual’s ability to have intercourse. In an older study , participants who took red ginseng experienced a decrease in premature ejaculation and improvement in sexual performance.
- L-arginine: Researchers of a 2017 study wrote that L-arginine is a safe ingredient but may not be effective in restoring erectile function. However, if individuals combine it with other supplements, they may experience different results. For example, an older study from 2003 found that taking L-arginine with pycnogenol may help improve sexual function in persons with ED without causing any side effects.
- Propionyl-L-carnitine:An older study found that acetyl-L-carnitine and propionyl-L-carnitine can be safe and help improve the effectiveness of sildenafil and restore sexual potency.
However, as the FDA reports, nearly 300 supplements and foods that supposedly enhance sexual function contain undisclosed drug ingredients. These supplements do not undergo analysis by the FDA for quality or purity.
With this in mind, it is vital to consult a healthcare professional before starting a supplement. Additionally, people should choose a brand that engages in third-party testing and certification.
Certain lifestyle changes may help improve erectile function:
- Eating a balanced diet: Flavonoid-rich foods, such as blueberries, strawberries, blackberries, and citrus fruits, may reduce ED for some people.
- Maintaining a moderate body weight: Having overweight or obesity may cause or worsen ED.
- Getting regular exercise: Physical activity can improve circulation, reduce stress, and contribute to a moderate body weight.
- Quitting smoking:Research indicates a strong link between cigarette smoking and ED.
- Avoiding heavy drinking and Illegal use of substances: Doing so may improve sexual function.
- Seeking help for mental health conditions: Addressing anxiety, depression, and sources of sustained stress, for example, may help.
The generic name for Viagra is sildenafil. The drug also has another brand name: Revatio. It works by slowing down the action of PDE5, an enzyme in the blood vessel walls.
This enzyme breaks down a substance responsible for blood flow in the penis. Inhibiting the enzyme increases blood flow to the area and helps achieve and maintain erections.
However, sildenafil can only help maintain an erection that a person also has physically stimulated.
Common side effects of the drug include headache, facial flushing, indigestion, nasal congestion, and a blue tint to an individual’s field of vision.
The following are some of the advantages and disadvantages of Viagra.
Pros
- effective treatment for erectile dysfunction
- easily available by prescription in most pharmacies and online telehealth services
- some insurance providers may cover part, or all, of the costs of this medication
- available in different strengths
- available in both generic and brand-name forms
Cons
- more expensive than generic sildenafil
- can cause side effects such as headaches, nausea, and rash
- not suitable for people who take nitrates
- not suitable for people who have ischemic optical neuropathy or other inherited degenerative eye conditions
