Is There Anything Over the Counter That Works Like Viagra?

There are several medications and treatments used to treat erectile dysfunction (ED, impotency), including Viagra (sildenafil), testosterone replacement therapy, penile self-injection, and others. Some over-the-counter (OTC) supplements may help with erectile dysfunction, such as L-arginine in combination with pycnogenol, Korean red ginseng (also called panax ginseng), Yohimbe, Carnitine (propionyl-L-carnitine), and Dehydroepiandrosterone (DHEA).

Erectile dysfunction (ED, or impotence) is a condition that causes men to be unable to acquire or maintain an erection.

Treatment for erectile dysfunction is aimed at enabling a man to achieve and maintain an erection for sexual intercourse. 

Certain over-the-counter (OTC) supplements may help with erectile dysfunction, such as: 

• L-arginine in combination with pycnogenol 
  • Has been shown in studies to improve sexual function in men with ED 
• Korean red ginseng (also called panax ginseng)
  • Studies have shown improvements in erections
• Yohimbe
  • Some studies have shown it to be slightly more effective than placebo for ED
• Carnitine (propionyl-L-carnitine)
  • May improve erectile dysfunction
  • Also used to enhance the effectiveness of sildenafil (Viagra)
• Dehydroepiandrosterone (DHEA)
  • Declines in DHEA are associated with increased incidence of ED
  • DHEA supplements are often promoted to improve sexual health, though more study is needed

Tell your doctor before taking any over-the-counter supplement. Use caution with any product that claims to be a non-prescription “herbal Viagra.” Some of these products contain the actual drug, sildenafil, which should only be taken when prescribed by a doctor. They may also contain unlabeled ingredients that can cause serious side effects or interact with other medications you take. 

In addition to sildenafil (Viagra), medications used to treat erectile dysfunction include:

• Phosphodiesterase-5 inhibitors 
  • Tadalafil (Cialis)
  • Vardenafil (Levitra)
  • Avanafil (Stendra) 
• Testosterone replacement therapy 
  • Used when man's testes do not produce sufficient amounts of the hormone testosterone
  • Does not work to improve sexual function in men who produce normal amounts of testosterone
• Medications for depression and/or anxiety

Lifestyle modifications to treat erectile dysfunction may include:

• Weight loss in men who are obese
• Don’t smoke
• Limit or avoid alcohol
• Exercise regularly
• Eat a healthy, balanced diet 
• Pelvic floor exercises 
• Talk to your doctor about using different medications to treat hypertension and pain
  • Do not stop taking any prescribed medication without first talking to your doctor

Psychotherapy and psychoactive medications may be recommended for men who have erectile dysfunction due to depression and/or anxiety. Counseling with a sex therapist may be helpful for men with performance anxiety.

Medical treatments used to treat erectile dysfunction may include:

• Penile self-injection 
  • A medication (alprostadil or papaverine) is self-injected into the two chambers of the penis that are filled with spongy tissue and blood (corpora cavernosa) to cause an erection by allowing the blood vessels within the penis to expand so the penis swells and stiffens to create a fully rigid erection 
• Intraurethral alprostadil (MUSE)
  • Uses the same medication (alprostadil) as penile self-injection but instead a man inserts a device with an alprostadil pellet (suppository) into the urethra to create an erection
• Vacuum-assisted erection devices 
  • Involves placing the penis into a plastic cylinder and creating a vacuum around the penis to increase blood flow into the penis
  • A rigid ring is placed at the base of the penis to hold the blood inside the penis, keeping it erect
• Penile prostheses 
  • Surgically implanted devices that inflate to allow the penis to become erect
• Revascularization 
  • A surgical procedure used for young men who have experienced pelvic trauma