Viagra alternatives: Pills, natural remedies, and over-the-counter options

Viagra is a well-known treatment for erectile dysfunction, but many other approaches can help achieve and maintain erections. They include medical devices, supplements, and lifestyle changes.

Research indicates that erectile dysfunction (ED) affects over 30–50 million men in the United States each year. Although the prevalence of this issue increases with age, it does not just affect older adults.

A range of treatments and strategies can improve or reverse ED. Options include drugs, other medical treatments, lifestyle changes, and alternative herbal treatments.

In this article, we look into various alternatives to Viagra, answer some frequently asked questions, and discuss when to contact a doctor about ED.

The table below offers a quick comparison of Viagra to its alternatives.

The generic name for Viagra is sildenafil. The drug also has another brand name: Revatio. It works by slowing down the action of PDE5, an enzyme in the blood vessel walls.

This enzyme breaks down a substance responsible for blood flow in the penis. Inhibiting the enzyme increases blood flow to the area and helps achieve and maintain erections.

However, sildenafil can only help maintain an erection that a person has physically stimulated.

Common side effects of the drug include headache, facial flushing, indigestion, nasal congestion, and a blue tint to an individual's field of vision.

The following are some of the advantages and disadvantages of Viagra.

When looking for help with erectile dysfunction, people can look at the following cheaper alternatives to Viagra:

Leading a more active lifestyle: Being more active can help to improve ED. For instance, a 2018 study found that 160 minutes of weekly exercise lessened the symptoms of ED in the participating males.

Healthy diet: Eating a nutritious and balanced diet can also lower a person's risk of ED. A study of over 21,400 males found that following a Mediterranean or Alternative Healthy Eating Index 2010 diet had a lower risk of ED.

Generic medications: Viagra is the branded version of the generic drug sildenafil. Buying generic versions of ED drugs can save people a significant amount of money. People can also consider other generic ED drugs, such as tadalafil (Cialis) and vardenafil (Levitra). Learn more about how ED medications compare.

Wearable devices: Devices people can wear before or during sex to get or maintain an erection may be more cost-effective than medication. They are typically reusable, and a person may not have to replace them as often as they would have to renew a prescription for ED medication.

Beyond Viagra, several medications can help with having and keeping erections.

Oral medications

Oral drugs, including Viagra, may be the first approach to treating ED.

Viagra is effective because it slows the action of phosphodiesterase type 5 (PDE5), an enzyme in the blood vessel walls. This helps the muscles in the penis to relax and encourage blood flow, ultimately helping a person get an erection.

Other prescription-only PDE5 inhibitors include:

Vardenafil: Available under the brand names Levitra and Staxyn, this drug is available in regular and disintegrating tablet forms. A person takes it 1 hour before sex and it can be effective for up to 7 hours.

Tadalafil: Available under the brand names Adcirca and Cialis, a person takes this 1 hour before sex. Each dose can last up to 36 hours.

Avanafil: Available in the U.S. as Stendra, a person takes this drug 15–30 minutes before sex, and the effects can last up to 6 hours.

Various telehealth companies stock ED medication, including:

Roman: This company offers sildenafil or tadalafil and requires people to schedule an online appointment with its doctors. A person can benefit from personalized treatment, free delivery, and ongoing follow-ups. The platform also offers treatment for those concerned about hair loss, premature ejaculation, and allergies. Learn more about Roman.

Hims: This company addresses men's health concerns. First, people complete an online form so that a physician can learn more about their symptoms. Once a person receives a treatment plan, they can have a follow-up appointment with Hims doctors. Learn more about Hims.

Lemonaid Health: This brand offers medication for various health conditions. People can access ED medication starting from $2 per pill after scheduling an online appointment with a doctor.

Nonoral drugs

Alternatives to pills and tablets include:

Penile self-injections

Certain medications, such as alprostadil (Caverject), papaverine, and phentolamine (Regitine), are available as an injection directly into the side or base of the penis.

This method generally works very quickly and is highly effective. However, this approach may cause side effects, including swelling, pain, and stinging. It may also cause permanent damage with improper use.

Urethral suppositories

A person can use a special applicator to insert very small alprostadil suppositories into the urethra, which can help stimulate erections.

A person can self-administer this treatment, and it generally works quickly.

However, these suppositories could affect a fetus if a sexual partner is pregnant. It could also cause side effects and be less effective than other methods.

Testosterone replacements

A doctor may recommend this approach if they believe that ED is due to low testosterone levels. A person can take synthetic testosterone via pills, patches, and injections.

Drug treatments may be unsuitable in some people, perhaps due to other health issues. In these cases, a doctor may recommend:

Wearable devices

Some wearable devices can help a person maintain an erection, such as Eddie by Giddy.

Eddie by Giddy

Eddie by Giddy is a nonprescription, Class II wearable medical device that people can wear on a flaccid or erect penis. It is a C-shaped device that hooks onto the base of the penis. It has a tension band that constricts the penis.

The device constricts the veins in the penis, enabling blood flow into, but not out of, the penile shaft. This helps a person to keep an erection.

Although the Food and Drug Administration (FDA) registered the device, no scientific studies have evaluated its effectiveness.

It comes in various sizes and has a 30-day money-back guarantee.

Eddie by Giddy is also available on a subscription plan that costs $1.55 a day and renews every 4 months.

Penis implants

Implants are inflatable or bendable rods that a surgeon implants into the erection chambers of the penis. However, doctors typically only recommend this approach as a last resort.

Vacuum pump

Vacuum pumps help people get an erection but do not help a person sustain one. One option a person can consider is the Pos-T-Vac Erectile Vacuum System.

Pos-T-Vac

The Post-T-Vac is a manual or battery-operated vacuum pump. The manual options offer more control over the suction.

To use a vacuum pump, a person puts their penis into the pump. This creates a vacuum around the penis to enhance blood flow. The suction helps facilitate an erection, but a person must wear a tension band to sustain it.

The manufacturers state not to wear a tension band longer than 30 minutes.

Learn more about the best ED pumps.

Many companies sell dietary supplements, herbal preparations, and food products as remedies for ED.

Some alternative herbal treatments, including the following, are also marketed for this purpose:

Dehydroepiandrosterone (DHEA): A 2018 article states that aging causes a decline in DHEA, which leads to symptoms of depression, aggressive behavior, and low libido, among others. The research also notes that some trials suggest DHEA supplements may help improve a person's well-being.

Ginseng: According to a 2021 study, ginseng may improve an individual's ability to have intercourse. Learn more about ginseng and ED.

L-arginine: A 2019 study found that those who took 1,500 to 5,000 mg of l-arginine significantly improved their ED symptoms.

However, supplements and foods that supposedly enhance sexual function could contain undisclosed drug ingredients. This includes undisclosed sildenafil and tadalafil, which can be dangerous for some people. They can interact with nitrate medication and lower blood pressure to dangerous levels. People with diabetes, heart disease, high blood pressure or cholesterol may take nitrate medication.

These supplements do not undergo FDA analysis for quality or purity.

With this in mind, it is vital to consult a healthcare professional before starting a supplement. Additionally, people should choose a brand that engages in third-party testing and certification.

According to the British National Health Service (NHS), certain lifestyle changes may help improve erectile function, including:

Eating a balanced diet: Flavonoid-rich foods, such as blueberries, strawberries, blackberries, and citrus fruits, may reduce ED for some people.

Maintaining a moderate body weight: Having overweight or obesity may cause or worsen ED.

Getting regular exercise: Physical activity can improve circulation, reduce stress, and contribute to moderate body weight.

Quitting smoking: Research indicates a strong link between cigarette smoking and ED.

Avoiding heavy drinking and Illegal use of substances: Doing so may improve sexual function.

Seeking help for mental health conditions: Addressing anxiety, depression, and sources of sustained stress, for example, may help.

ED can result from physical, psychological, and emotional factors.

Medical conditions that may cause ED include:

The American Urological Association (AUA) also lists dyslipidemia as a risk factor for ED. This is an imbalance of lipids, including cholesterol, low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein (HDL), and triglycerides.

Mental health conditions and factors that may contribute to ED include anxiety, depression, guilt, stress, and low self-esteem.

Other factors that may play a role include:

alcohol and illegal drug use

overweight or obesity

low levels of exercise

smoking

Anyone with symptoms of ED that last for a few weeks or more should contact a healthcare professional.

This is particularly important for people who suspect that an underlying health issue, such as heart disease, may be causing their ED.

This health issue can also be a side effect of certain medications, so a doctor may address it by changing a person's ongoing treatment plan.

Drugs that may cause ED can include antidepressants, blood pressure medication, antihistamines, benzodiazepines, and opiods.

Below are some of the most common questions and answers about alternatives to Viagra.

Do I need a prescription for erectile dysfunction pills?

People in the U.S. usually need a doctor's prescription for ED medication.

Do natural Viagra alternatives work?

There is not enough scientific evidence to suggest that herbs and other supplements can treat ED. However, various lifestyle changes, such as quitting smoking and eating a balanced diet, may help.

Can I purchase Viagra alternatives online?

Some companies employ licensed medical professionals to help determine if someone may benefit from a Viagra alternative. If the healthcare professional approves, the company can ship the treatment to the person's front door.

There are various options for people who cannot or do not want to take Viagra. These alternatives include other medications, medical devices, and lifestyle changes.

Individuals should speak with a doctor about treating ED safely.

Credit: Medical News Today