Supplements may help to reduce erectile dysfunction (ED) symptoms, but patients should be careful when selecting them.
Approximately 30 million men in the United States live with erectile dysfunction (ED). Modern treatment for ED includes evidence-based medical interventions, such as prescription lifestyle medication or surgery, and lifestyle changes. Now, supplement use is becoming a popular method to alleviate ED symptoms. Therefore, it is important for consumers to know the potential benefits and risks of these options.
Prescription lifestyle medications, such as Viagra and its generic sildenafil, are extensively studied and have consistently demonstrated effectiveness at temporarily treating symptoms of ED. Supplements marketed to improve sexual function have not been as thoroughly research and typically demonstrate mixed results in their effectiveness.
This article provides an overview of the benefits and risks of modern prescription and supplemental treatments for sexual function and ED.
What Causes ED?
Male sexual arousal is a complex process, dependent upon a man’s brain, emotions, hormones, muscles, nerves, and blood vessels all working together to produce an erection. Erectile dysfunction (ED) is when a man is unable to achieve or maintain an erection.
Men who suffer from ED may also experience anxiety surrounding sexual performance, making it more difficult to engage in sex. Often, ED is one of the first symptoms of an underlying physical health condition, such as high blood pressure or heart disease. However, it is also common for ED to be caused by a combination of both physical and psychological factors.
Causes of ED include:
- Chronic health conditions, such as diabetes or heart disease
- Psychological conditions, such as depression or anxiety
- Prescription medications
- Substance use or alcohol dependence
- Tobacco use
- Sleep disorders, such as insomnia
- Low testosterone
Supplements vs. Prescription Medication
Popular treatments for ED include prescription medication, vacuum pumps, implants, and surgery. Some men may even choose to try supplements for ED. Many supplements claim to treat ED naturally and effectively, but the health benefits of supplements have not been as thoroughly tested as current prescription lifestyle medications.
The Food and Drug Administration (FDA) is not required to monitor and approve supplements. Thus, supplement claims are not investigated in the same way as prescription medications claims. This means the FDA will not remove a supplement from shelves unless they are able to prove the supplement is unsafe for consumption, although it has officially banned many supplements labeled as “herbal Viagra.”
A few things to review when considering supplements for ED:
- Active ingredients. Many supplements contain multiple active ingredients. Certain ingredients may interfere with current prescription medications, including ED medications.
- Correct dosage. The concentration of active ingredients within supplements can vary greatly between products, making it difficult to consistently take the correct dose.
- Unlabeled ingredients. Some supplements marketed for sexual function have been found to contain unlabeled ingredients, including active ingredients of prescription lifestyle medications (e.g. sildenafil).
Can You Take Supplements with ED Medications?
Using supplements for ED symptoms may interfere with current prescription ED medications. For supplements containing unlisted ingredients, it is likely they may contain active ingredients already present in the prescription medications a patient is taking. Unlisted ingredients can result in serious, potentially deadly interactions. It is important for anyone currently taking a prescription ED medication to speak with their medical provider prior to taking supplements.
Top 10 Supplements for ED
A majority of supplements marketed to treat ED have not been scientifically studied. Recent reviews of supplement use for ED have demonstrated mixed results, and self-reported benefits of supplement use for ED symptoms may be attributed to placebo effect.
A 2015 review in the Journal of Sexual Medicine evaluated the effectiveness of active ingredients in supplements promoted for ED treatment. The review found minimal evidence that supplements improve sexual function. However, a more recent systematic review found more promising results for herbal supplement use in treatment for ED.
The following table summarizes the most widely used supplements for sex drive and erectile dysfunction.
Supplements with Promising Results
|DHEA||Dehydroepiandrosterone (DHEA) is a hormone produced by the body’s adrenal glands. DHEA can be converted into estrogen or testosterone within the body. Some research has demonstrated DHEA as effective in improving erections in men with low DHEA levels. The supplement is generally considered safe to take in low doses.|
|Panax ginseng||Also known as red ginseng, it has been shown to effectively treat ED in some small studies. When compared to other supplements, ginseng demonstrated the strongest results in significantly treating ED. Additional studies are needed to confirm results.|
|L-arginine||This naturally occurring amino acid assists the body in producing nitric oxide. Nitric oxide relaxes blood vessels and improves blood flow, making it easier to achieve and maintain an erection. Multiple studies have shown L-arginine to be safe and effective at improving sexual function in men with ED.|
|Propionyl-L-carnitine||Studies have demonstrated this supplement to be effective when combined with prescription ED medication, such as Viagra. It is not recommended this supplement be taken without medical supervision.|
Supplements with Mixed or Limited Results
|Yohimbe||This supplement is made from African tree bark and has demonstrated effectiveness in treating SSRI-induced ED in limited clinical trials. This supplement should not be taken without medical consultation as it has been linked to severe side effects, such as increased blood pressure.|
|Rhodiola rosea||A single study showed this supplement to be effective at improving sexual function in twenty-six out of thirty-five men. Additional research is needed to confirm results.|
|B vitamins||B vitamins, such as thiamine, niacin, and folate may improve sexual function for those with vitamin B deficiencies. Evidence is currently limited and additional research is needed to explore this connection.|
|Saffron||The use of saffron-based supplements has provided mixed results. Preliminary results in small studies were positive, but additional research is needed to explore the effectiveness of saffron in treating ED.|
Supplements without Promising Results
|Ginkgo||Also known as ginkgo biloba, this supplement potentially improves blood flow throughout the body. It has not demonstrated success in improving sexual function when tested in humans.|
|Horny goat weed (epimedium)||This herb has not been tested in humans to treat ED. However, substances found within its leaves have been shown to improve sexual function.|