Though they are among some of the most popular and widely used medications available for erectile dysfunction, oral ED medicines are not suitable for everyone. 

When consulting about different types of ED treatment with a doctor, men with certain medical conditions or taking specific medications may be advised against taking them. 

So, for those who are living with erectile dysfunction but aren’t ready or able to use prescription medication like Viagra, are there alternatives? 

Let’s take a look:

Herbal remedies 

The first and most important aspect of herbal remedies to consider is that in the case of erectile dysfunction, and with respect to several other conditions too, the efficacy (and indeed safety) of such treatment has not been rigorously studied. 

It is therefore important before embarking on a course of treatment with any herbal remedies to first speak with your doctor to ensure that it is safe; and if they do express safety concerns, to consider non-tablet treatment options for ED

Panax ginseng

Korean red ginseng, otherwise known as panax ginseng, is one herbal extract which has been lauded in the press as a viable natural treatment for erectile dysfunction. It is widely available over-the-counter in capsule form. 

However, in clinical studies, it has only produced mildly favourable results in comparison to a placebo; and one meta-analysis determined that more research needed to be done in order to identify whether or not korean red ginseng produced any significant erectile dysfunction results. 

Horny goat weed

Horny goat weed, the name given to epimedium, is another herbal option some have turned to when attempting to treat ED. Icariin, the functioning constituent in epimedium, is thought to have PDE5 inhibiting qualities much like tadalafil and Cialis, or sildenafil in Viagra. 

Evidence, however, is once again sparse; icariin has shown positive results in improving erectile function in diabetic rats and has been successful in inhibiting PDE5 in laboratory conditions, but whether or not it is effective at medicating impotence in humans is not yet clear. 

Ginkgo biloba

Ginkgo biloba is a tree extract again sold in capsule form, but is also available as a liquid which can be mixed with water. Like other ‘natural remedies’, it is thought to facilitate blood flow by increasing nitric oxide activity. 

It has been tested on subjects experiencing more general sexual dysfunction induced by SSRI medication and produced positive results, but research into its erectile potency in particular is thin.

Yohimbe

Taken from the bark of the Yohimbe, a tree found in West Africa, this herbal remedy is available as a supplement, but it has also been developed into a prescription drug called Yohimbe Hydrochloride, which was issued by some doctor for ED prior to the discovery of Viagra. 

The theory is that it helps to widen blood vessels, which, in turn, can help increase penile blood flow. 

But while its ability to tackle ED symptoms sufficiently has been questioned, numerous potentially harmful side effects have been associated with Yohimbe, including high blood pressure, as well as kidney problems. 

For this reason, doctors typically advise against its use. 

Pomegranate juice 

A popular antioxidant, pomegranate juice has been lauded as having some useful qualities for those looking to improve their overall health. 

It can help blood flow and reduce the likelihood of respiratory illnesses, such as those related to high blood pressure. 

But what does it do for sexual performance? 

In 2007, research was carried out by Californian scientists which apparently showed that of the men tested, 47 per cent displayed improvements after drinking a glass of pomegranate juice each day for four weeks. 

But the NHS found flaws in the investigation and the suggestion that pomegranate juice improved ED symptoms with any degree of significance. 

Results: can we really treat impotence with natural remedies? 

The consensus on the effectiveness of natural remedies is still fairly inconclusive. While some doctors champion them as a viable alternative to medicinal treatments, other studies suggest that they do not measure up to the efficacy of prescription medication. 

Taking measures to prevent symptoms is perhaps the best option available to those looking to treat ED without taking formulated medicine. Numerous self-help techniques can contribute towards the alleviation of symptoms, such as limiting alcohol intake, quitting smoking, cutting down on fatty foods and reducing stress.

In cases where these measures don’t help, talking about the problem often can. Remember that your partner is affected. Talking about the issue with them can help you to overcome it, as can discussing it with your doctor. 

Hormone supplements

Male sexual function relies on testosterone production, and can become compromised in individuals who have a low presence of this hormone. 

Dehydroepiandrosterone, known also as DHEA, is a form of testosterone replacement therapy, and has shown to be conducive towards healthy libido and erectile potency. 

The long-term health effects of this treatment however have not been thoroughly assessed and, consequently, doctors tend to discourage its use when treating impotence. 

Acupuncture

The ancient Chinese practice of inserting needles into various points in the body has been championed as a healer of so many physical and mental ailments, including erectile dysfunction. 

During a typical consultation, a practitioner will usually assess your overall condition first. Then, once you have been put into position (usually lying down) the insertion of needles will begin. It may cause tingling at first but, generally speaking, is largely painless. After insertion, you will be left in position for around half an hour. Then the needles will be taken out. This practice is thought to work by relaxing tension in the muscles and helping to improve blood flow. 

Clinical studies into the use of this treatment are yet again sparse. One study found it to be beneficial in treating those patients with psychogenic-induced instances. But in this experiment, acupuncture was also accompanied by discussion of the condition and results; which those undertaking the research equated to a level of therapy. 

Another meta analysis, which formed a comprehensive review conducted by Korean researchers in 2009, found that of the 80 studies found, less than half were based on clinical observation; and of these, only four were deemed reliable. And even amnog this narrow-down selection, results were mixed at best. 

Overall, it is not considered to be directly beneficial for those with ED. Once more, practices such as this one are something which an individual should not embark upon without first having consulted with their physician. 

Lifestyle as ED medicine 

Making lifestyle adjustments is perhaps the most effective course of action someone with erectile dysfunction can take, whether or not they are able to take prescription medication such as Viagra or Cialis. 

Addressing those concerns that may be causing symptoms is usually the first thing a doctor will do; as impotence can on occasion be an early indicator of an unlying health problem. 

Vascular flow to the penis can become inhibited by conditions such as high blood pressure, diabetes and obesity. With this in mind, it is important for those who are experiencing symptoms to make sure they are: 

  • Eating a healthy and balanced diet
  • Quitting smoking (if you do smoke)
  • Reducing alcohol intake (stick to the ‘low-risk’ guidelines where possible). 
  • Abstaining from recreational drug use 
  • Taking regular exercise
  • Getting sufficient sleep regularly 
  • Avoiding stress as much as possible 

Read more about how to prevent ED.

Talking therapy

Finally, it’s important to consider therapy as another ‘natural alternative’ to conventional prescription ED treatments such as Viagra or Cialis. 

ED and psychological problems can often be linked, and social pressures can cause some men to be reluctant to seek support for these. 

It is estimated that around 10-20 percent of all erectile erectile dysfunction cases stem from psychological roots. Anxiety, stress, past sexual experiences and mental attitude towards sex can all lead to difficulties achieving and maintaing ane rection suitable for sexual activity. 

It can be beneficial to address psychological barriers before commencing ED treatment. Your doctor may suggest psychosexual counselling, cognitive behavioural therapy or sensate focus therapy. Some sessions may involve both the patient and their partner as the stress of ED can have an impact on the couple as a whole.

Page last reviewed:  29/07/2020