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Erectile dysfunction (ED) is a common condition treated with prescription medication. Medical professionals do not typically recommend over-the-counter (OTC) ED supplements, and most are not approved by the Food and Drug Administration (FDA).
Erectile dysfunction (ED) is a common condition that affects at least
This article looks at various treatment options for ED, including OTC pills, natural remedies, and prescription medications such as Viagra. It also discusses the evidence and risks associated with these options.
Viagra, or sildenafil, is only available by prescription in the United States. OTC viagra refers to any supplement or herb that claims to produce similar effects to Viagra and benefit ED.
In most cases, OTC Viagra products are backed up by limited research suggesting they can benefit sexual function.
OTC Viagra products are not FDA regulated for safety or effectiveness, and it
Please note that the writer of this article has not tried these products. All information presented is purely research-based and correct at the time of publication.
Medical News Today follows a strict product selection and vetting process. Learn more here.
Although many natural ED treatment options are available, the FDA does not offer its approval as it classifies them as supplements.
Due to this, ED supplement manufacturers are not legally allowed to state that their products treat ED. Instead, they may market products as sexual enhancers with the aim of helping people achieve or maintain an erection.
The
The following sections will look at the evidence behind common OTC ingredients marketed for treating ED.
Dehydroepiandrosterone
Dehydroepiandrosterone (DHEA) is an important hormone for sexual function. It helps create sex hormones, including testosterone and estrogen. The adrenal gland naturally produces this hormone.
Levels of DHEA in the body peak in a person’s 20s, then gradually decrease with age.
According to a
DHEA is also a common supplement for boosting energy, enhancing immunity, slowing aging, and improving weight loss. However, there is not enough evidence to suggest that it is effective for any of these uses.
One of its significant drawbacks is that athletes cannot take it. Another is that the lack of studies means there is no information on the proper form and dosage for the best results.
Since DHEA is readily available as a supplement, the premise is that people who take it do so for the long term. Unlike viagra, any potential results build up over time rather than producing an immediate erection or sexual benefit.
One DHEA product is from Spring Valley. Each bottle contains 50 tablets of 50 micrograms (mcg) of DHEA. At the time of publishing, it costs $5.94.
L-arginine
L-arginine is a common amino acid in men’s health supplements.
The body converts this amino acid into a chemical called nitric oxide. Nitric oxide may help the blood vessels open wider, improving blood flow.
Research suggests there is a link between L-arginine deficiency and ED.
Research from 2021 found a link between L-arginine deficiency and ED. L-arginine alongside prescription ED treatment such as tadalafil may help reduce symptoms of this condition.
Treating mild to moderate ED with
Additionally, a small-scale
That said, a person should be cautious when taking L-arginine or similar supplements, as side effects
As with other ingredients, the supplementation form of L-arginine means that any potential benefits arise from continuous use. However, scientists currently do not know how safe it is to take high dose arginine supplements for over 3 months.
This ingredient is relatively inexpensive. For example, this supplement bottle from Horbaach contains 30 servings of 4,000 mg each. The company writes that the formulation is free of additives or potential allergens, including gluten, wheat, lactose, and soy.
At the time of publishing, it costs $15.99.
Ginseng
Ginseng, or Panax ginseng, is a popular and widely used herbal remedy. It is available in the form of pills and creams. Manufacturers claim that it can help with fertility and improve sexual function.
Ginseng contains chemicals called ginsenosides. One action of these chemicals is to promote nitric oxide, which may help trigger an erection by relaxing the smooth muscles in areas of the penis.
A 2021 review found that ginseng has a trivial effect on ED in comparison to placebos. However, more research is necessary.
The National Center for Complementary and Integrative Health (NCCIH) writes that the
Other side effects of ginseng may include headaches, breast pain, issues with menstruation, fast heart rate, and changes in blood pressure. It may also affect the stomach. Ginseng can also interact with a variety of medications, such as calcium channel blockers, statins, and certain antidepressants. It is important to talk with a doctor before using ginseng.
Learn more about ginseng and ED.
Mason Natural offers a supplement product containing 60 daily servings of 1,000 mg ginseng. It has minimal inactive ingredients, and the company writes it is soy free. At the time of publishing, it costs $8.98.
Propionyl-L-carnitine
Propionyl-L-carnitine is one of the commercially available forms of L-carnitine. Key features
Some people use a supplementation form of this ingredient for these benefits and ED.
A
This means that while this ingredient can be beneficial with prescription medication, there is no evidence that propionyl-L-carnitine on its own would have the same beneficial effects.
Moreover, no research goes into how much to take, when to take it, and when it starts to become effective.
However, some people still prefer to add it to their diet to improve bodily function as a supplement.
Swanson sells a propionyl-L-carnitine and glycine supplement containing 60 vegetarian capsules. Each capsule delivers 515 mg of propionyl-L-carnitine. At the time of publishing, one bottle costs $30.41.
Yohimbe
Yohimbe is an African evergreen tree. Its bark contains a compound called yohimbine, which has
According to the
However,
The NCCIH also details its risks, which include:
- stomach problems
- increased blood pressure
- a fast or irregular heartbeat
- anxiety
It also states yohimbe is associated with heart attacks and seizures.
A person should speak with a doctor before taking yohimbe.
OTC products marketed for ED often claim to benefit those with ED by increasing the level of certain sex hormones and widening blood vessels to facilitate an erection.
However, there is currently
A label that suggests the product is a natural or herbal remedy does not make it safe. It is best to speak with a doctor before taking any supplement.
The
- claim to have fast results, such as within 30–40 minutes
- are available in single servings
- are labeled as alternatives to prescription drugs
- are marketed through unsolicited emails
- have labels in a different language without trusted translation
- contain warnings and directions that mimic those of prescription products
To date, there is not enough research to confirm that any store-bought supplements or pills are effective or safe for treating ED, and many products that manufacturers claim to be sexual enhancers have not undergone FDA testing or regulation.
The FDA has a database of
Importantly, the undisclosed ingredients in these supplements may interact with other medications a person is taking, potentially resulting in harmful consequences.
For example, these products may interact with drugs that contain nitrates, such as:
- nitroglycerin, which helps treat angina and coronary heart disease
- isosorbide or nitroprusside, which helps treat high blood pressure
- amyl nitrate, which helps treat angina
Potential risks of using OTC treatments for ED include:
- Drug interactions: Some supplements may cause unsafe interactions with other medications or supplements that an individual is taking.
- Undisclosed ingredients: Inaccurate reporting of ingredients could lead to a person taking medication, or a larger dose of a medication than is expected.
- Quality control: A lack of quality control and FDA regulation can lead to dangerously different levels of active ingredients in the same product.
A doctor may prescribe a drug that stimulates blood flow to the penis. This can help a person achieve an erection.
These drugs are known as PDE-5 inhibitors. They
The four main FDA-approved oral drugs for ED are:
- Sildenafil (Viagra): Individuals typically take sildenafil about 1 hour before sex, up to once daily. Side effects include headaches, flushing, and nausea. Hims offers generic Viagra at around $3 per dose. Branded Viagra costs from $139 per dose.
- Avanafil (Stendra): This improves blood flow; people can take up to 15 minutes before sex. Its effects usually last for up to 6 hours. The price makes this medication unsuitable for small budgets, costing $414.33 at Blink Health for six tablets.
- Tadalafil (Cialis): Depending on the doctor’s instructions, people can take tadalafil every day or as they need around 30 minutes before sex. Hims offers a generic version for around $82 per month.
- Vardenafil (Levitra): This works by increasing blood flow to the penis to help a person develop an erection. Serious side effects of vardenafil include fast heartbeat and hive allergic reactions. The generic version costs around $126 at Blink Health for six tablets.
Learn more about which is best out of Viagra, Cialis, Levitra, and Stendra.
Side effects
Different drugs vary in dose, how long they work, and possible side effects. Roughly
Some possible side effects include:
- flushing
- nasal congestion
- headache
- visual changes
- backache
- upset stomach
Interactions
Sildenafil, the
Some groups should not take ED medications, as they can be dangerous. This includes people who:
- take nitrate drugs or have heart problems
- have very low blood pressure or uncontrolled high blood pressure
- have liver disease
- have kidney disease
A person’s doctor can determine which medication is the best fit for them.
There are several other treatment options for ED. These include vacuum devices and ED rings.
Vaccum devices are mechanical pumps that create an erection by drawing blood into the penis. Around 77% of people who use vacuum devices or penis pumps for ED were satisfied with the results.
ED rings are bands that go around the base of the penis to help maintain an erection. A 2022 case report states that ED rings can be effective in improving ED.
Learn more about the various treatment options for ED here.
However, there are some risks involved with penis pumps and rings, including:
- bruising
- pain, including painful erections
- numbness and tingling
- burst blood vessels
A person should always speak with a doctor before trying a new ED treatment to ensure it is safe.
Certain lifestyle factors can increase a person’s chance of erectile problems. Controlling these factors may help improve their symptoms.
The following may
- not smoking
- reducing alcohol intake
- exercising regularly
- maintaining a moderate weight
Prescription medications can help people manage ED symptoms, but they require a consultation with a physician. The Journal of Sexual Medicine reports that, in general, males are less likely than females to seek medical care for safe and effective treatment.
As an alternative, some businesses offer telehealth services that include ED diagnostic and treatment options. The ability to access evaluation and treatment online can help people save money, time, and preserve anonymity, which may make it more likely that they can get the safe and professional help they need.
Learn more about the benefits of telemedicine.
However, telehealth should not replace in-person exams since ED can be
Here are some of the most commonly asked questions about Viagra and OTC alternatives for erectile dysfunction.
Are there over-the-counter pills that work like Viagra?
According to the
How can I get ED treatment without seeing a doctor?
Prescription medications, such as Viagra, are a widely
Telehealth makes it possible for people to consult with doctors and receive prescriptions for ED medications from the privacy of their homes. Telehealth can also help people save time and money and avoid feeling potentially uncomfortable.
What is the best over-the-counter ED treatment?
These lifestyle changes may include:
- not smoking
- increasing physical activity
- eating a healthy diet
- moderating alcohol use
- managing chronic conditions such as diabetes and high cholesterol
How do I talk with my partner about erectile dysfunction?
Both people with ED and their partners may wish to talk about the condition and how it is affecting their sexual and romantic life.
It is important that people choose a moment that is not stressful and allows for time to properly discuss the condition, such as during a walk or a quiet time at home.
ED is common, especially in males
Some people may find couples or individual therapy beneficial. Therapists can help people navigate any negative feelings toward themselves or their partners and can encourage healthy and constructive communication.
Am I too young to take Viagra?
While the risk of ED increases as a person ages, it is possible for younger people to have this condition. Research has found that around
Viagra is suitable for people who are 18 years of age and older. People of any age who believe they may have ED should contact a healthcare professional to discuss possible lifestyle changes and treatment.
Prescription medications may be an effective treatment for ED, although they are not safe for everyone. Telehealth options make it more convenient and private for people to access the medical consultations they need to obtain prescription ED drugs.
To date, research has not confirmed any OTC pills or supplements that safely or effectively treat ED, but prescriptions and supplements are not the only ways to address this condition. Individuals with questions about ED treatment should discuss options with their physicians.