Erectile dysfunction has many possible treatments, including prescription drugs, physical devices, and natural remedies. Do these methods work, and are they safe?

Erectile dysfunction (ED) is a common condition that refers to an inability to get or maintain an erection. A number of treatments may prevent ED from becoming a long-term condition.

It is not uncommon to experience problems with erections occasionally. However, if it happens routinely and disrupts a person’s life, they can try various treatments.

This article looks at the various ED treatment options and their risks, including natural remedies, alternative medicine, and prescription drugs.

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ED happens when blood flow to the penis is limited. Determining its cause can help people find the most appropriate treatments.

In some cases, ED has a physical cause, such as a treatable health condition or circulation problem. Treating any underlying conditions will help. People can take steps to boost their circulation, such as doing regular exercise, stopping smoking (if applicable), and making dietary changes.

A doctor may also recommend prescription ED drugs, such as sildenafil (Viagra).

Read more about pills for ED here.

ED can also happen due to stress, relationship factors, or emotional factors, such as anxiety, depression, or trauma. Mental health treatments and relationship counseling can help.

Some people also try natural or alternative treatments, including over-the-counter (OTC) pills, herbal remedies, and acupuncture.

It is important to understand the possible risks associated with ED treatments, especially natural remedies, which the Food and Drug Administration (FDA) have not approved.

While many natural remedies are available to buy in stores and online, none have received the FDA’s approval to treat ED.

The FDA do not recommend using OTC products for ED because no authorities regulate them for safety or effectiveness. These products often contain undisclosed ingredients, inappropriate doses of prescription drugs, or different doses of ingredients than the label suggests.

The Urology Care Foundation agree, saying that although supplements are popular and often cheaper than prescription drugs, they are not guaranteed to be safe or effective.

There are very few studies on the safety of natural remedies for ED. Some of the remedies have side effects varying from mild to severe.

The following list looks at some common natural remedies that people use for ED:

L-arginine

L-arginine is an amino acid, which is a building block of protein. It is a vasodilator, meaning that it can help open up the blood vessels. In theory, this could increase blood flow to the penis and help produce an erection.

A study from 2017 reported that many people with ED had low L-arginine levels, which suggests that the two may be linked.

However, scientific studies have not proven that taking L-arginine supplements can treat ED. More research is necessary before researchers know the safety and effectiveness of this remedy.

People should avoid taking L-arginine alongside prescription ED drugs, such as Viagra, as this combination can cause the blood pressure to drop too low. It can also lead to headaches or flushing.

Side effects of L-arginine may include nausea, stomach cramps, low blood pressure, and increased blood sugar levels.

Propionyl-L-carnitine

According to some sources, taking propionyl-L-carnitine alongside Viagra could improve erectile function better than taking Viagra alone.

That said, more studies are needed before researchers know the actual safety and effectiveness of this treatment.

Side effects are usually mild and can include a skin rash, nausea, diarrhea, and heartburn. This remedy may not be safe for people with vascular disease, high blood pressure, diabetes, or liver cirrhosis, among other conditions.

DHEA

Dehydroepiandrosterone (DHEA) helps create sex hormones, including testosterone and estrogen. Natural DHEA levels decrease as a person gets older, which may cause a decrease in sexual function.

While some studies suggest that DHEA supplements could help with ED, others have found no evidence of their benefit.

DHEA generally causes few side effects when people take it orally in recommended doses, though the side effects can include fatigue, headaches, acne, and an irregular heartbeat.

Ginkgo

Ginkgo biloba may increase blood flow to the penis, which could improve sexual desire and counter ED.

However, the National Center for Complementary and Integrative Health (NCCIH) say that there is no solid evidence that ginkgo is beneficial for any health condition.

Side effects of this supplement include headaches, dizziness, stomach upset, palpitations, and constipation.

It can also increase the risk of bleeding, so it may be dangerous for people taking blood thinners, such as warfarin (Coumadin), or those with other bleeding disorders.

Ginseng

Ginseng, or Panax ginseng, is a popular home remedy. Certain chemicals in this plant may promote the relaxation of the body’s smooth muscles, helping produce an erection.

Preliminary studies suggest that ginseng could help treat ED, though more high quality research is necessary to confirm this.

The most common side effect of ginseng is insomnia. Other side effects include increased heart rate, high or low blood pressure, and headaches.

Read more about ginseng and ED here.

Yohimbine

The main component of an African tree’s bark, yohimbine, is a traditional aphrodisiac.

The NCCIH report that there is not enough evidence that yohimbine from tree bark can treat ED.

Yohimbine hydrochloride, a different form of yohimbine, is available as a prescription drug for ED. This is a different product than dietary supplements made from tree bark.

Studies have linked yohimbine with serious side effects, including heart attack and seizures. Other side effects include stomach problems, anxiety, and high blood pressure.

Horny goat weed

Epimedium grandiflorum, also known as horny goat weed, is a traditional remedy for increasing fertility.

One study reports that it could improve sexual performance in people with renal failure on hemodialysis. However, there is not enough evidence to support its use.

This supplement is often well-tolerated. Side effects can include nausea, vomiting, irregular heartbeat, and dry mouth.

Certain activities or a lack of activity can have an effect on ED. People who have not already adopted the following lifestyle measures may find that they improve the symptoms of ED:

Regular exercise

Exercise can benefit ED by improving blood pressure, blood flow, mood, and stamina. It is also an effective method for improving overall health.

Read about the best exercises for ED here.

A healthful diet

A healthful diet helps keep the circulatory system, and the rest of the body, healthy. Eating a varied, nutrient-rich diet reduces the risk of heart disease, clogged arteries, obesity, and diabetes, all of which are risk factors for ED.

Read about foods for ED here.

Reduce smoking and alcohol

Smoking is a major risk factor for ED as it reduces blood flow to the penis. Drinking excess alcohol can also have an effect.

The Centers for Disease Control and Prevention (CDC) recommend that males limit alcohol intake to two drinks per day for males and one per day for females.

Reduce stress

Stress and anxiety can have a significant effect on sexual desire and erectile function. Common sources of stress include health, work, finances, and relationships.

Read about natural ways to combat stress and stress-relief products here.

Some people try alternative therapies, such as acupuncture and yoga. There are few studies available to support their effectiveness for ED. However, they may help reduce stress, which could improve ED.

People may also benefit from the placebo effect. A 2009 study found that taking an oral placebo pill resulted in as much improvement in ED symptoms as taking an ED drug.

Prescription medications can increase blood flow to the penis. The four main FDA-approved drugs for ED are:

  • sildenafil (Viagra)
  • avanafil (Stendra)
  • tadalafil (Cialis)
  • vardenafil (Levitra)

These drugs, known as PDE-5 inhibitors, relax the muscles in the penis to enhance blood flow.

Side effects of prescription ED drugs can include:

  • headaches
  • nasal congestion
  • flushing
  • muscle aches
  • indigestion

Prescription ED drugs are not safe for everybody, including people with very low blood pressure, uncontrolled high blood pressure, or liver or kidney disease.

People who are taking nitrate-containing medications should also avoid these drugs.

A person’s psychology or emotional health can have a significant effect on sexual functioning, including ED.

This includes mental health conditions, such as depression or anxiety. Negative experiences in the past can also affect a person’s current sexual functioning.

Speaking to a mental health professional, such as a counselor or psychologist, can often help people overcome stresses and anxieties linked with sex, relationships, and other areas of life.

Read about various mental health resources available.

Various physical devices can also help people get and maintain an erection. For instance, vacuum devices are mechanical pumps that create an erection by drawing blood into the penis. Alternatively, people can try ED rings, which are bands that a person places around the base of their penis to maintain an erection.

Read more about ED devices and other treatments here.

There are many possible ways to treat the symptoms of ED, and the best options depend on the underlying cause.

Where possible, a person should talk to a healthcare professional before taking any new supplements or OTC medications, as they can have side effects and interact with existing medications.