Erectile dysfunction (ED) affects millions of men around the world. In the United States alone, approximately 30 million men have ED.

Men over 75 years old are more likely to have it, but even men in their 20s can experience it.

Symptoms of ED include:

  • the inability to achieve an erection
  • the inability to sustain an erection

Over-the-counter (OTC) treatments, including those made with herbs, may help to address this condition. The following ED pills are available over the counter:

  • dehydroepiandrosterone (DHEA)
  • L-arginine
  • ginseng
  • yohimbe
  • propionyl-L-carnitine

Many other treatment options are available for ED management, including:

Five prescription medications are available:

The steroid hormone DHEA is found naturally in some soy products and yams. According to the landmark Massachusetts Male Aging Study from 1994, low levels of DHEA are associated with a higher risk of ED.

The Natural Medicines Comprehensive Database states that taking DHEA may improve ED-related symptoms in some men, provided that the ED isn’t caused by diabetes or a nerve disorder. They conclude that there’s “insufficient evidence to rate effectiveness for” DHEA as an ED remedy.

More studies are needed to determine if it’s a safe and effective choice for ED.

DHEA may help increase low libido in women in addition to possibly helping men with ED. Notably, a study of mice found that DHEA helps to increase vaginal muscular strength.

Be wary of products that advertise that they contain “natural” DHEA. The human body can’t naturally produce DHEA by consuming sources that contain it. Any claim that a product can provide the body with “natural” DHEA is false.

Learn more about DHEA supplements.

L-arginine, an amino acid, may help treat ED by improving blood flow to the penis. However, it can cause mild cramping and nausea.

Because of its effect on nitric oxide in the nerves, L-arginine is needed for the process of getting and maintaining an erection. Experts still don’t know how effective L-arginine supplementation is for ED.

Experiments that tout the benefits of L-arginine as an ED treatment often combine L-arginine with other common ED drugs, such as glutamate and yohimbine.

It may also be paired with a tree bark extract known as pycnogenol.

L-arginine has also been used, successfully, as part of hormone level testing and to treat metabolic alkalosis in children.

However, more research and larger studies need to be done before the Food and Drug Administration (FDA) approves it as an ED treatment.

Alternative medicine advocates have long celebrated ginseng as a powerful aphrodisiac.

Of particular interest is Korean red ginseng, which is also known as Chinese ginseng or Panax ginseng. Research has been conducted on its ability to treat ED symptoms, too.

A 2012 study placed 119 men with mild to moderate ED — and no serious comorbidities such as endocrine system disease — into two groups.

One group received a placebo. The other group received four ginseng pills a day, with each pill containing 350 milligrams (mg) of Korean ginseng berry extract.

Researchers found that taking the Korean ginseng berry extract pills for 4 to 8 weeks led to improvements in:

However, the men who took the placebo also saw their symptoms improve at similar rates.

There may be a role for ginseng in helping treat ED, but more research is needed to narrow down appropriate doses and potential side effects.

Research in rabbits and rats show promise for further studies in humans.

A type of ginseng known as tissue-cultured mountain ginseng 100 was found to help relax penile smooth muscle, which leads to better erectile function. Blood testosterone levels also improved.

One human study involving 52 people showed that a combination of ginseng and vitamin D may help improve ED, especially when compared to a placebo.

There were no safety issues or negative effects noted after 6 weeks.

Yohimbe is another supplement that helps treat ED by stimulating penile blood flow.

It promotes the production of norepinephrine, a neurotransmitter that’s vital to achieving erections. Research shows that it can improve orgasmic function and ejaculation in men as well.

Yohimbe is also known by the name of its most active ingredient, yohimbine.

Yohimbe has been linked with a number of side effects, including:

As a result, some medical experts are hesitant to recommend it. Proceed with caution before trying yohimbe. Speak to your doctor first before trying it.

Propionyl-L-carnitine is a chemical that occurs naturally in the body, It’s related to the amino acid derivative L-carnitine.

Propionyl-L-carnitine is often used to address blood flow and other issues related to the circulatory system, making it an ideal ED remedy.

Multiple studies have shown that propionyl-L-carnitine and L-carnitine also enhance the effects of the popular drug sildenafil (Viagra).

OTC medications for ED have often sparked controversy in the medical community.

The FDA has warned about the “hidden risks” of ED products available online. In 2009, the federal agency published a list of 29 online OTC products, generally referred to as “dietary supplements,” to be avoided.

These products haven’t been approved for sale by the FDA, and many of these supplements contain harmful ingredients.

Hidden ingredients

Some OTC treatments for ED may be effective, but they may not be safe.

Dietary supplements aren’t regulated by the FDA in the same manner as traditional OTC or prescription drugs.

Some dietary supplements sold online contain ingredients not listed on the label, and these ingredients could be dangerous for some people who ingest them.

The amount of active ingredients in products containing these supplements may not be consistent either.

Potentially harmful side effects

The unlisted ingredients may also cause harmful side effects in certain users.

Some herbs effective in treating animal ED may not have been tested on humans, resulting in unanticipated side effects.

In addition, OTC treatments can interact with other drugs taken for ED, making the supplements unsafe.

Ingredients in these OTC treatments can also cause unsafe interactions with drugs taken for other conditions too.

Using an OTC drug that contains sildenafil at the same time as a drug that contains nitrates, such as one for diabetes or heart disease, can cause a dangerous drop in blood pressure.

Traditional ED treatments such as sildenafil, vardenafil, and tadalafil are often also used to treat pulmonary hypertension.

A 2013 study shows that combining ED treatments containing these medications with nitrates or alpha-blockers can cause problems.

Talk to your doctor before trying an OTC treatment for ED.

Always check to be sure that an herbal or a dietary supplement has been approved or at least tested by a trusted agency such as the FDA or the National Center for Complementary and Integrative Health (NCCIH).

Some untested treatment options may temporarily resolve your issues, but it’s not worth the risk. Proper research or medical consultation are key to finding a successful ED treatment.