Despite making unproven claims that they enhance sexual performance, over-the-counter medications have become a popular treatment for ED.
Sildenafil is the active ingredient in Viagra. Some products, such as the popular male enhancement nutritional supplement Extenze contain sildenafil. This unidentified ingredient can cause dangerous blood pressure drops by interfering with prescription drugs containing nitrates, like the vasodilator, nitroglycerin.
The Food and Drug Administration (FDA), has withdrawn this recommendation, particularly for patients with diabetes and hypertension who use nitrates to lower their blood pressure.
Although not well-studied, the following OTC dietary supplements or natural remedies may be effective in treating erectile dysfunction.
- Larginine Larginine is an amino acid, which is a building block for protein. It is naturally found in foods. It increases the body's production nitric dioxide, which helps dilate blood vessels. Although it is theoretically possible to increase blood flow to your penis by opening blood vessels, it has been shown that some companies misrepresent its effectiveness. 1 L-arginine (sometimes sold under the name Hombron) should not be taken with Viagra as it can cause a dangerous drop in blood pressure. Its safety and effectiveness need to be further investigated.
- Dehydroepiandrosterone (DHEA): Some studies suggest that DHEA supplements, which help create sex hormones like testosterone and estrogen, could help with ED, but others have found no evidence of their benefit. 2
- Ginkgo Ginkgo biloba might increase blood flow to penis which may improve sexual desire and counter ED. The National Center for Complementary and Integrative Health says there is no evidence that ginkgo has any benefit for any condition. Ginkgo may also cause side effects such as headaches, dizziness and stomach upset. Ginkgo should not be taken with Coumadin, a blood thinner or if you suffer from a bleeding disorder. 3
- Ginseng - While Ginseng (or Panax ginseng) may relax the body's smooth muscles and help produce an erection it is known for its main side effect of insomnia which can increase ED risk. To fully understand its effectiveness, more research is needed.
- Yohimbine The NCCIH doesn't endorse yohimbine as a traditional aphrodisiac to treat ED. 3 Yohimbine can cause serious side effects such as seizures and heart attack.
- Epimedium Grandiflorum: Although Epimedium grandiflorum is a traditional remedy to increase fertility, there isn't enough evidence to support its use in ED. 4
While none of these OTC supplements are approved by FDA for ED treatment, some studies have suggested that they might be useful in treating ED. These supplements should not be used in place of standard treatment. Before you try any supplement, consult your doctor.
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There are risks
OTC medication should not be mixed with standard ED drugs. The safety and effectiveness of store-bought medications are not regulated. Some manufacturers also make false claims about the ingredients or misreport them. The FDA found that almost 300 products marketed as ED have excessively high dosages or unreported ingredients 5.
Many OTC products have been found to contain unapproved amounts of prescription drugs, including Viagra, Cialis and Levitra. These supplements do not have quality control, and the ingredients may vary from one pill to another, which can make them especially dangerous.
Unregulated supplements can also interact with medications you're currently taking. This could lead to dangerous drops in blood pressure. L-arginine, for example, should not be taken with alpha-blockers or nitrates. This can cause a dangerous drop in blood pressure.
A word from Verywell
Our bodies experience changes as we age. This can lead to decreased testosterone production which can cause hormone imbalances that impact erections. Additional conditions such as obesity, diabetes, heart disease, and work-related stress can also contribute to the problem.
ED can also occur due to underlying psychiatric and physical issues, such as anxiety, depression, high cholesterol, high blood pressure, thyroid conditions, and an enlarged prostate/prostate. Side effects such as incontinence can also affect sexual intercourse and the ability for men to have erections. There are many other side effects.
You may need to consult a specialist or healthcare provider if you have tried OTC remedies for erectile problems without success. For example, a urologist can help you determine the root cause of your erectile dysfunction, develop a safe and effective treatment plan, explain why OTC remedies may not work, and even offer some alternatives.
