Erectile dysfunction is a condition that affects a man’s ability to achieve or maintain an erection suitable for sex.

The condition can affect men at any age, but according to the American Academy of Family Physicians, erectile dysfunction (ED) is most common when a man is 75 years or older.

Recent innovations in medical treatments mean that there are now more medications available to reduce ED. However, some men prefer to take herbal supplements as an alternative.

Many herbs show potential to be effective in improving men’s sexual function, but little evidence actually exists to support the use of any herbal medication in the treatment of ED. People should always exercise caution when taking any form of herbal supplementation.

The United States government do not monitor herbs. There is no consistency in the strength or purity of the herbs sold, so they may be contaminated or mislabeled. Some herbs may interact with medications taken, so anyone considering taking herbs should talk to a doctor or pharmacist about potential problems.

What is it: DHEA is a supplement that mimics a natural steroid hormone in the body and may help treat ED in men.

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DHEA supplements mimic the action of a natural steroid hormone.

The dosages for DHEA vary from person to person. Some men take between 20 and 75 milligrams (mg) for about 6 months, while others may take between 100 to 400 mg for up to 8 weeks.

How does it work: Natural DHEA levels subside as a person ages. Increasing the amount of adrenal hormone may help the body create hormones that improve sexual functions as well as energy levels.

Research: A 1999 study published in the journal Urology showed that DHEA treatment improved sexual performance. However, the study was a very small one. Since then, other research has shown inconsistent results, with one report in 2012 suggesting that DHEA does not help ED.

Side effects: DHEA is usually safe when taken in low doses. However, acne can be a side effect.

What is it: This Chinese herb has been used to reduce the causes associated with sexual dysfunction, including erectile dysfunction. Women may also take it to reduce the incidence of painful intercourse and loss of libido.

How does it work: Researchers do not know the exact mechanism by which the supplement works. But scientists believe it alter the levels of certain hormones in the body, which may in turn improve sexual performance.

Research: Taking horny goat weed hasn’t been studied in people. However, a study published in The Journal of Sexual Medicine studied the effect of a purified extract of epimedium on rats. It found that rats who received the extract demonstrated greater incidences of blood flow than those who did not.

Side effects: Using this herb could affect a person’s heart function. Those with heart disease should not take it as it can cause irregular heartbeat. The medication can also interact with other drugs.

What is it: Ginkgo biloba is an herb that practitioners have used for thousands of years to treat a number of health conditions. Examples include dementia, anxiety, and poor blood flow to the brain.

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Ginkgo has been used to treat many health conditions. Some believe it may improve blood flow to the male sexual organs.

How does it work: Proponents of taking ginkgo for erectile dysfunction believe ginkgo dilates blood vessels to promote blood flow to the sexual organs.

Research: The Mayo Clinic rank the evidence for ginkgo in treating erectile dysfunction a “C,” meaning that there is unclear scientific evidence for the herb’s use.

According to Columbia University, ginkgo may be effective in helping treat sexual dysfunction that has been caused by taking selective serotonin reuptake inhibitors (SSRIs), medications prescribed to treat depression.

Side effects: Ginkgo can increase the risk for bleeding, and people who take blood thinners should not take it.

Other side effect risks include nausea, headache, stomach upset, and mouth irritation.

What is it: L-arginine is an amino acid that scientists in the 1800s first isolated from animal horn. It is incorporated into supplements to increase the amount of nitric oxide in the body.

How does it work: When taken in high doses, l-arginine can stimulate blood vessels to become larger. This improves blood flow, which could help a man get an erection.

Research: L-arginine is often combined with glutamate and yohimbine hydrochloride as a treatment for ED.

In one study published in the Journal of Sexual and Marital Therapy, researchers gave participants a combination of l-arginine and Pycnogenol, the registered trademark brand name for French maritime pine bark extract.

After treatment for 3 months, 92.5 percent of the 40 men enrolled who experienced ED reported achieving a normal erection.

Side effects: Side effects of taking l-arginine can include stomach upset, including cramping and diarrhea. The supplement can also adversely interact with taking the medication Viagra.

What is it: Ginseng is an herb that Korean herbal practitioners promote for its ability to treat erectile dysfunction. Another name for red ginseng is Panax ginseng.

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There are several theories as to why red ginseng might help treat erectile dysfunction. More research is required to support these theories.

How does it work: Researchers aren’t exactly sure how red ginseng reduces erectile dysfunction symptoms.

One theory is that it influences hormones responsible for achieving an erection. Another is that it promotes blood flow through increasing the amount of nitric oxide.

Research: A 2008 review published in the British Journal of Clinical Pharmacology found that red ginseng was often more effective than placebo when reducing ED symptoms.

However, human studies usually have a small sample size, which makes it difficult for researchers to draw firm conclusions on the benefits of red ginseng.

Side effects: Taking red ginseng can cause insomnia. However, researchers largely regard it as safe when taken on a short-term basis.

What is it: Yohimbine is a supplement made from the bark of an African tree. Before medications such as Viagra, doctors often recommended yohimbine as a treatment for ED.

How does it work: Yohimbine works by triggering receptors in the body that trigger the release of the hormones epinephrine and norepinephrine. These can block the effects of other compounds that may otherwise constrict the blood vessels in the penis.

Research: The American Urological Association do not recommend taking yohimbine as a treatment for ED because of its many side effects. However, it has been shown to enhance libido and sexual motivation in animal studies.

Side effects: Taking this supplement is associated with many side effects. Examples include high blood pressure, rapid heart rate, and anxiety. Men should not take yohimbe without consulting their doctor first.

When to see a doctor about ED

Men should not be afraid to see their doctor about ED if they experience it.

There are many medications, lifestyle changes, and even counseling that could help a man reduce the incidence of ED. If he wishes to, and has discussed the treatment with his doctor, he may even wish to take an herbal supplement to reduce ED.

A man should see his doctor about his ED if he has experienced changes in sexual desire, changes in erectile function after taking a new medication, or other changes in sexual function.

The condition is very treatable. Men should never be afraid to talk to their doctor about ED as sometimes the condition can indicate an underlying medical condition that should also be treated.

Many potential causes of ED exist. These include:

  • anxiety
  • atherosclerosis, a condition that causes a buildup of plaque in the arteries
  • chronic kidney disease
  • depression
  • diabetes
  • heart and blood pressure-related conditions
  • history of injury to the penis or surrounding organs
  • stress
  • taking certain medications, such as antidepressants, antihistamines, appetite suppressants, and tranquilizers

Achieving and maintaining an erection requires several things to happen. These include sensory stimulation, increased blood flow, increased blood pressure in the penis, and the contraction of muscles in the penis. If one or more of these steps are interrupted, ED can occur.