Erectile dysfunction — the inability to get and keep an erection firm enough for sex — is a common problem. You've likely seen advertisements for erectile dysfunction herbs or supplements to "increase your sexual performance." Could they work for you?

Erectile dysfunction supplements and other natural remedies have long been used in Chinese, African and other cultures. But unlike prescription medications for erectile dysfunction, such as sildenafil (Viagra), vardenafil (Levitra, Staxyn), tadalafil (Cialis, Adcirca) and avanafil (Stendra), erectile dysfunction herbs and supplements haven't been well-studied or tested. Some can cause side effects or interact with other medications. And the amount of the active ingredient can vary greatly from product to product.

Here's a guide to erectile dysfunction herbs and supplements:

Studied in people, positive results, generally safe

Herb or supplement	Does it work?	Safety
DHEA	Some evidence shows that dehydroepiandrosterone (DHEA) increases libido in women and helps erectile dysfunction in men.	DHEA appears to be safe at low doses. It can cause acne.
L-arginine	Some evidence shows that taking high doses improves erectile dysfunction by stimulating blood vessels to open wider for improved blood flow.	Side effects may include nausea, cramps and diarrhea. Don't take L-arginine with sildenafil (Viagra).
Ginseng	One study of Panax ginseng showed it improved sexual function in men with erectile dysfunction. A cream preparation is used for premature ejaculation.	Panax ginseng contains many active ingredients. It appears to be safe used on a short-term basis. Insomnia, headaches and vertigo are common side effects.
Propionyl-L-carnitine	Studies have shown that propionyl-L-carnitine combined with Viagra might improve erectile function better than sildenafil alone.	Propionyl-L-carnitine is likely to be safe when used under medical supervision.

Studied in people, positive results, risky

Herb or supplement	Does it work?	Safety
Yohimbe	A number of clinical trials have shown that the primary component of this bark from an African tree can improve sexual dysfunction associated with selective-serotonin reuptake inhibitors (SSRIs) used to treat depression.	This herb has been linked to a number of side effects, including increased blood pressure, fast or irregular heartbeat, and anxiety. Yohimbe shouldn't be used without a doctor's supervision.

Not studied in people or negative results

Herb or supplement	Does it work?	Safety
Ginkgo	Ginkgo has the potential to increase blood flow to the penis. But there's no evidence of benefit for erectile dysfunction.	Ginkgo might increase the risk of bleeding.
Horny goat weed (epimedium)	Substances in the leaves of this herb have been used to improve sexual performance, but the herb has not been studied in people.	This herb might affect heart or breathing functions.

A number of nonprescription products claim to be herbal forms of Viagra. Some of these products contain unknown amounts of ingredients similar to those in prescription medications, which can cause dangerous side effects. Some actually contain the real drug, which should be given by prescription only. Although the Food and Drug Administration has banned many of these products, some potentially dangerous erectile dysfunction remedies remain on the market.

Just because a product claims to be natural doesn't mean it's safe. Many herbal remedies and dietary supplements can cause side effects and dangerous interactions when taken with certain medications. Talk to your doctor before you try an alternative treatment for erectile dysfunction — especially if you're taking medications or you have a chronic health problem such as heart disease or diabetes.

Feb. 09, 2023

Original article: https://www.mayoclinic.org/diseases-conditions/erectile-dysfunction/in-depth/erectile-dysfunction-herbs/ART-20044394