The majority of over-the-counter remedies for erectile dysfunction do not have benefits for erectile dysfunction that have been scientifically proven, and the FDA does not regulate these products. Products like DHEA and L-Arginine, despite their claims, should be used with caution due to the risk of adverse effects.
Benefits
Some studies suggest that DHEA supplements can help treat ED by boosting testosterone levels, but others have found no evidence of this.
A 2018 review in the World Journal of Men's Health concluded that DHEA may be of benefit to "healthy, middle-aged, and elderly" males with mild ED but is likely ineffective in those with moderate to severe ED.6
Side Effects
The hormonal effects of DHEA can also cause significant side effects, such as:5
- Oily skin
- Acne
- Male-pattern hair loss
- Gynecomastia (breast enlargement)
- Shrinkage of the testicles
Because DHEA boosts the production of not only testosterone but also estrogen, it may increase the risk of hormone-sensitive breast, ovarian, and prostate cancers.5
3. Ginkgo Biloba
Ginkgo biloba, also known as the maidenhair tree, has been used for centuries as an herbal extract to treat a wide range of medical conditions, including hypertension (high blood pressure).7
Benefits
By decreasing blood pressure, Ginkgo biloba can theoretically improve blood flow to the penis. Others contend that it has an aphrodisiac effect and can increase sexual desire (libido) in both males and females.8
To date, the National Center for Complementary and Integrative Health (NCCIH) says that there is no solid evidence that ginkgo is beneficial for any health condition.7
Side Effects
Ginkgo biloba may also cause side effects such as:7
- Headaches
- Dizziness
- Stomach upset
- Nausea and vomiting
- Heart palpitations (skipped heartbeats)
- Constipation
- Diarrhea
- Anxiety
- Easy bruising
- Nosebleeds
Because Ginkgo biloba can interfere with blood clotting, it should never be taken with blood thinners like warfarin or if you have a bleeding disorder.9
Is it safe to buy erectile dysfunction pills online?
You should not buy ED pills online unless you have a prescription from a healthcare provider or are purchasing the pills from a reputable online pharmacy that provides you with a live telehealth appointment with a licensed physician.
4. Ginseng
Ginseng (Panax ginseng) is a fragrant root used for culinary purposes as well as a herbal remedy in traditional Chinese medicine.
Benefits
Ginseng is thought to boost the production of nitric oxide. It is also known to reduce blood pressure, which may improve blood flow to the penis. In addition, ginseng is thought to have mild stimulatory effects that may increase sexual arousal.10
Even so, there is little evidence of a true effect for ED.
A 2021 review of studies published in the Cochrane Database of Systematic Review concluded that ginseng has a "trivial effect on erectile function" compared to a placebo (sham drug), as well as a "trivial effect" on sexual satisfaction in males.10
Side Effects
Generally considered safe for use, ginseng can nevertheless cause side effects like:11
- Headaches
- Nausea
- Nervousness
- Insomnia
- Increased blood pressure (or decreased pressure)
- Diarrhea
- Rapid heartbeats
Ginseng should also be avoided if you are taking blood thinners. It may interfere with immunosuppressant drugs like prednisone and Imuran (azathioprine) used to treat inflammatory and autoimmune diseases.11
5. Yohimbine
Yohimbine (Pausinystalia johimbe) is an herbal remedy made from the bark of an African tree of the same name. Yohimbine acts as an aphrodisiac in some mammals. While some people believe that it has a similar effect on humans, the evidence supporting the claim is weak.12
Benefits
Yohimbine is also popularly used as a dietary supplement for the treatment of ED, where it is thought to increase blood flow to the genitals of both males and females.12
Some studies suggest that yohimbine may increase the likelihood of an erection when used alone or in combination with L-arginine. One review, however, suggests that while yohimbine can help improve erections in people with ED, it needs to be used with other treatments in order to restore sexual function.12
Side Effects
Despite its possible benefits, yohimbine can cause potentially severe side effects, including:13
The NCCIH does not endorse the use of yohimbine as it is associated with an increased risk of seizure and heart attacks. In some countries, yohimbine has been banned.13
6. Horny Goat Weed
Horny goat weed (Epimedium grandiflorum) is a traditional herbal remedy that is thought to increase libido, promote fertility, and treat ED.14
Benefits
Horny goat weed contains a plant-based compound known as icariin that works similarly to Viagra and other PDE5 inhibitors by blocking an enzyme that causes blood vessels to constrict (narrow). In doing so, blood vessels in the penis can dilate and engorge with blood.
Because of this effect, some people refer to horny goat weed as "herbal Viagra." Even so, studies have shown that horny goat weed is a very weak PDE5 inhibitor and that it is largely ineffective in treating people with ED.
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