Erectile dysfunction is a male sexual dysfunction that is more common as men get older. Medications to treat this condition were previously available on prescription only, but options are now available over the counter.

It is important to determine if these over-the-counter (OTC) options work and if they are safe for long-term use. There are also several OTC dietary supplements claiming to be natural erectile dysfunction (ED) medications. This article will take a look at some of these options and see what evidence exists for their use.

OTC treatments and supplements

[man in bed taking pills for erectile dysfunction]
There are several over-the-counter remedies available which can help manage the symptoms of ED.

Here are four OTC treatments that are available and may help with the management of ED.


Dehydroepiandrosterone (DHEA) is a hormone that is made in the brain and produced by the adrenal gland. It is involved in the production of male and female sex hormones.

Levels in the body begin to decrease naturally after age 30. Some men have lower levels of DHEA than others, and DHEA has become a common OTC supplement. Although it may be helpful to some men, there is not enough evidence to say for certain that it helps with ED.

DHEA can cause adverse side effects as well. Men may experience the following problems:

  • breast tenderness
  • urinary urgency
  • aggression
  • reduced size of the testes
  • acne
  • sleep problems


This is the most common amino acid in men’s health supplements. L-arginine is converted in the body into a chemical called nitric oxide. Nitric oxide helps the blood vessels to open wider, improving blood flow.

Caution is advised when taking L-arginine, or similar supplements, as it can lower blood pressure. It can increase the risk of bleeding when taken with certain drugs. It may also alter blood sugar levels.


Ginseng is a popular and widely used herbal remedy. It is supposed to help with fertility as well as improve sexual function. It is available as pills or a cream.

[ginseng root on a bamboo mat]
Ginseng is a natural remedy with a number of possible health benefits, including improved sexual function.

Ginseng is a stimulant and can cause insomnia. Also, it may not be safe for people with heart disease, autoimmune diseases, or bleeding disorders.

Adverse side effects include:

Ginseng can also interact with a variety of medications. Individuals should check with their doctor before using ginseng as a complementary treatment.


Yohimbine is derived from the bark of an African tree and is supposed to improve sexual dysfunction.

Although this herbal supplement is often sold as a treatment option for ED, not enough research has been done to support this.

Yohimbine causes some adverse side effects, including increased blood pressure, fast or irregular heartbeat, and anxiety.

Summary of OTC options

With each of these OTC treatments not enough research has been done to prove that they treat ED.

Though many of them claim to be natural, or are marked as dietary supplements, they can also contain hidden ingredients that may be dangerous.

The United States Food and Drug Administration (FDA) have found that nearly 300 products, supposedly for ED, contain excessively high doses of undisclosed, potentially dangerous ingredients.

It is important to note that some OTC products claiming to be sexual enhancers often have not been tested or regulated by the FDA.

Critically, they may interact with other medications that a person is taking. People take a gamble if they decide to use them and may have little or no success.

It is very important for people with other health conditions, or who are taking additional medicines, to always speak to their doctor before taking any type of supplement. This includes those that are marketed as “natural.”

Prescription medications

Oral prescription medications are often successful in treating ED. There are four primary prescription medications that are FDA-approved and available:

[cialis and viagra]
There are only a few medications that are FDA-approved for treating erectile dysfunction. They include Viagra and Cialis.
  • sildenafil (Viagra)
  • vardenafil (Levitra, Staxyn)
  • tadalafil (Cialis)
  • avanafil (Stendra)

All four medicines help to enhance the effects of nitric oxide, which the body produces to relax muscles in the penis to allow an increased blood flow.

These four drugs are known as PDE-5 inhibitors. They are not magic pills and sexual stimulation is still needed to produce an erection.

Although these four drugs are similar, they vary in dosage as well as how long they work for and their possible side effects.

Possible side effects include:

  • flushing
  • nasal congestion
  • headache
  • visual changes
  • backache
  • upset stomach

A person’s doctor can determine which medication is the best fit for them.

Some people should not take medications for ED as they can be dangerous. These people include those who:

  • take nitrate drugs or have heart problems
  • have very low blood pressure or uncontrolled high blood pressure
  • have liver disease
  • have kidney disease

Other treatment options

There are several other treatment options for ED aside from oral medications and supplements. These options include:

  • self-injections – medication is injected directly into the penis
  • alprostadil urethral suppository
  • testosterone replacement
  • penis pump penile implants
  • blood vessel surgery

Before taking any medicine, it is important for a person to talk to their doctor. Currently, herbal medications are not viable treatments due to a lack of regulation and evidence that they work.

Erectile dysfunction is treatable and affected men can go on to lead normal sex lives. There are a variety of different treatment options, and a doctor can help with the best treatment plan.