Erectile dysfunction (ED) is a common medical condition that primarily affects men older than 40. Among other symptoms, ED can make it difficult to get and maintain erections during sexual activity, placing an unwanted burden on your intimate relationships as well as on your physical and emotional health. While you can’t get standard prescription ED pills over the counter, some supplementary treatments do not require a prescription.
In this article, I’ll describe five of the most common over-the-counter (OTC) ED medications, as well as their risks, potential side effects, and some available brands. Keep in mind that before beginning any OTC ED treatment, it’s important to talk to your doctor to determine which treatment option, if any, is right for you.
What Is Erectile Dysfunction?
Erectile dysfunction, sometimes called impotence, is the inability to get and keep an erection that is firm enough for sexual intercourse.
While ED is not something that many people talk about with friends or loved ones, it is very common: An estimated 30 million American men live with ED.
ED can have a negative impact on self-esteem, intimacy, and relationships, and contribute to increased stress levels.
The most common symptoms of ED include:
- Difficulty getting an erection during sexual activity
- Difficulty keeping an erection during sexual activity
- Difficulty achieving an orgasm during sexual activity
- Difficulty with ejaculation
- Reduced interest and sexual desire
There are several potential causes of ED, including underlying health issues such as heart disease or diabetes, so it’s important to speak to your healthcare provider as soon as possible if you’re experiencing symptoms.
Treating Erectile Dysfunction with Medication
Currently, four types of oral ED medications are approved by the Food and Drug Administration (FDA) to treat ED in men:
All of these are phosphodiesterase-5 inhibitors (also known as PDE-5 inhibitors). They work by enhancing the effects of nitric oxide to relax the penile muscles, expand blood vessels that go into the penis, and improve penile blood flow. This helps improve the ability to get and maintain erections.
Additional standard treatment options for ED management include:
- Penile implants
- Vacuum erectile devices (VEDs)
- ED rings
- Blood vessel surgery
- Injectible or suppository drugs
- Testosterone replacement therapy (TRT)
When used as advised by a medical professional, these treatments are safe and may help men secure more satisfying sex lives.
Erectile Dysfunction Treatment Over-the-Counter Alternatives
In addition to the FDA-approved ED medications and other standard treatment options listed above, the following OTC treatments might help mitigate the symptoms of ED. Always seek medical advice from a healthcare provider before trying any of these, as not everything is effective or safe.
Dehydroepiandrosterone (DHEA) is an important hormone for sexual function that’s naturally produced in the body. Generally DHEA levels peak when a person is in their 20s and gradually decrease thereafter.
For men with lower levels of DHEA, one study suggests that oral DHEA treatment may help reduce the symptoms of ED. However, experts agree that we need more research on the effectiveness of DHEA for treating ED.
If you wish to try DHEA, some OTC brands are:
- Nature’s Lab
- Superior Labs
- Zhou Nutrition
L-arginine is an amino acid that naturally helps boost nitric oxide production in the body.
If you wish to try L-arginine, some OTC brands are:
- Klaire Labs
- Pure Encapsulations
- Thorne Research Perfusia-SR
Ginseng, also known as panax ginseng, Korean red ginseng, or Chinese ginseng, has long been a popular herbal remedy in alternative medicine, especially Traditional Chinese Medicine (TCM).
In alternative medicine practices, ginseng is used as an adaptogen to help improve physical and sexual function, boost general vitality, and fight aging. Some research also suggests that ginseng and compounds in the root called ginsenosides may be beneficial for supporting immunity and cognitive function and preventing cancer, diabetes, and other conditions.
For ED, one systematic review concluded that red ginseng in particular may be effective in the treatment of ED. However, like most OTC ED remedies, additional research is required to provide conclusive evidence.
If you wish to try ginseng, some OTC brands are:
- Buddha’s Herbs
- Nature’s Way
The bark of the African evergreen yohimbe tree contains a compound called yohimbine, which has been traditionally used as an aphrodisiac.
Supplement companies market yohimbe as a natural remedy to support weight loss and treat conditions like ED, high blood pressure, angina, and diabetes-related nerve damage (diabetic neuropathy).
Unfortunately, the National Center for Complementary and Integrative Health (NCCIH) says that evidence is insufficient to promote the use of yohimbe to treat ED or other medical conditions. What’s more, yohimbe can cause significant side effects, including increased blood pressure and irregular heartbeat, and has been found to be dangerously strong. For these reasons, doctors and healthcare professionals generally do not recommend supplementing with yohimbe.
If you wish to try yohimbe, some OTC brands are:
Propionyl-L-carnitine (PLC) is a naturally occurring amino acid related to the amino acid derivative L-carnitine. A handful of studies suggest that when used as with sildenafil (Viagra), PLC may enhance the effects of the prescription drug.
If you wish to try PLC, some OTC brands are:
Warnings & Risks of OTC ED Treatment
These ED treatments are considered supplements. Because supplements are not regulated by the FDA, they may contain ingredients or produce side effects that are undisclosed or unknown. The amount of active ingredients in supplements can also vary, which can lead to differences in effectiveness across brands.
As with any treatment option, it’s important to speak with your healthcare provider before trying one of these OTC pills.
The FDA also recommends caution when considering OTC products that:
- Claim to provide fast-acting results (within 30-40 minutes)
- Are advertised as alternatives to prescription medications
- Come in single servings
- Are sold through unsolicited messages or emails
- Have labels written primarily in another language
- Have warnings and directions that mimic FDA-approved products
Is OTC ED Treatment Right for You?
Currently, there isn’t sufficient evidence to prove that OTC treatments are effective at treating ED. If you’re curious about trying an OTC treatment in conjunction with prescription medication or as a standalone treatment, talk to your doctor to determine which OTC option, if any, is right for you.
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l-arginine and Erectile Dysfunction. (2019).
Treatment of erectile dysfunction with pycnogenol and L-arginine. (2003).
Efficacy and Safety of a Novel Combination of L-Arginine Glutamate and Yohimbine Hydrochloride: A New Oral Therapy for Erectile Dysfunction. (2002).
Preliminary observations on the use of propionyl-L-carnitine in combination with sildenafil in patients with erectile dysfunction and diabetes. (2004).
Pharmaceutical quantities of yohimbine found in dietary supplements in the USA. (2016).
Biological Activities of Ginseng and Its Application to Human Health. (2011).