Erectile dysfunction (ED) affects millions of people around the world.
Symptoms of ED include:
- the inability to get an erection
- the inability to sustain an erection
Over-the-counter (OTC) treatments, including those made with herbs, may help address this condition. These treatments include:
Before deciding to try an OTC treatment, talk with a doctor. This is especially important if you:
- have any health conditions or concerns
- are undergoing treatment for a health problem
- are taking medications or other supplements
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.
Similarly, a 2020 review found conflicting research on whether DHEA was helpful for sexual function. More research is needed to determine whether it’s a safe and effective choice for ED.
If you do decide to try DHEA, be wary of products advertising 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.
Because of its
However, limited research seems to suggest it plays a role in combination with other ED drugs, such as:
- Cialis. A small, 120-person
study from 2020found that pairing tadalafil (Cialis) and L-arginine could significantly increase sexual health and testosterone levels in men over age 60, compared with either substance alone.
- Viagra. Additionally, a
study from 2019found that combining L-arginine and sildenafil (Viagra) worked better for treating ED than sildenafil alone.
- Yohimbine. An older study from 2002 also found that L-arginine combined with yohimbine worked well for treating ED. However, it was a very small study with only 45 participants.
- French maritime pine back extract. A 2019 review found that L-arginine paired with pine bark extract was more effective than L-arginine alone.
However, more research and larger studies need to be done before the Food and Drug Administration (FDA) approves it as an ED treatment.
In an animal study done on rabbits and rats, 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 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.
Another study from 2021 involving 52 people found that a combination of ginseng and vitamin E may help improve ED, especially when compared with a placebo. There were no safety issues or negative effects noted after 6 weeks.
Overall, 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.
Yohimbe is another supplement that helps treat ED by stimulating penile blood flow.
Yohimbe is also known by the name of its most active ingredient, yohimbine.
Yohimbe has been linked with a number of side effects, including:
At very high doses, it can also be fatal.
As a result, some medical experts are hesitant to recommend it. Proceed with caution and speak with your doctor before trying yohimbe.
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 a potential ED remedy.
OTC medications for ED have often sparked controversy in the medical community.
Some OTC treatments for ED may be effective, but they may not be safe.
Dietary supplements are not regulated by the FDA in the same manner as traditional OTC or prescription medication.
Some dietary supplements sold online contain ingredients not listed on the label, and these ingredients could be dangerous for some people who take 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 ED in animals may not have been tested on humans, resulting in unexpected side effects.
In addition, OTC treatments can interact with other medications taken for ED, making the supplements unsafe.
Ingredients in these OTC treatments can also cause unsafe interactions with medications taken for other conditions.
Traditional ED treatments such as sildenafil (Viagra), vardenafil (Levitra, Staxyn), and tadalafil (Cialis) are often also used to treat pulmonary hypertension.
Many treatment options are available for ED management. These are backed by more data than OTC supplements. Your doctor may suggest:
Five prescription medications are available:
- sildenafil (Viagra)
- tadalafil (Cialis)
- vardenafil (Levitra, Staxyn)
- avanafil (Stendra)
- alprostadil (Caverject, Edex, MUSE)
What causes ED?
There are many causes of ED, including mental, emotional, and physical.
Emotional and mental causes may include:
Physical causes include:
There may be a single cause of ED or several causes, so it’s important to see your doctor for a diagnosis.
How do you know whether ED is physical or mental?
If you’re experiencing erections while you sleep, it’s an indication of normal physiological erectile function. If that’s the case, your ED could have an emotional or mental cause rather than physical.
If you’re not sure whether you’re experiencing erections at night, consider an erection self-test. It can help you determine whether your ED is physical or mental.
Is it safe to combine ED treatments?
Combination therapy for erectile dysfunction is possible in certain instances, but it does not apply to every treatment.
In some cases, combining treatments can be unsafe or even dangerous.
Before combining ED treatments, speak with your doctor.
Talk with 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
Some untested treatment options may temporarily resolve your issues, but it’s not worth potential health risks. Proper research or medical consultation are key to finding a successful ED treatment.