Natural alternatives to Viagra (sildenafil): do herbal treatments work?

If you’ve ever visited a gas station, you’ve likely seen a product or two offering “male enhancement” at the checkout counter. Pills like these are  marketed as a natural, no-prescription-necessary alternative to treating erectile dysfunction (ED). But do they work?

When it comes to gas station pills, the answer is probably no. However, if you’re looking for natural alternatives to Viagra, some supplements may improve symptoms of erectile dysfunction. More research is needed, but natural alternatives to Viagra including red ginseng, yohimbe, and more could potentially increase your libido and/or improve erectile function.

The term “natural Viagra,” refers to a supplement or ingredient that treats ED similarly to medications like Viagra (generic name sildenafil). 

In order to understand what natural Viagra does (or what it’s supposed to do), let’s look at how this prescription medication works. To keep it brief, Viagra belongs to a class of drugs called PDE5 inhibitors. These drugs work by blocking the enzyme PDE5, which causes blood to leave an erect penis. In other words, it helps you stay hard. 

Natural Viagra supplements make similar claims. But, like all supplements, those claiming to be a form of herbal Viagra aren’t regulated by the U.S. Food and Drug Administration (FDA). That means you can't be sure of their purity or strength. Not only could these products be ineffective, they could also be dangerous for some people. 

However, some natural remedies for ED have shown promise in early scientific studies.

If you’re looking for a drug-free ED remedy, there are some supplements and herbs that may mimic the effects of their prescription counterpart, Viagra.

1. Horny goat weed

Horny goat weed is a medicinal herb that has been used in traditional Chinese medicine for thousands of years to treat fatigue and low libido. 

Some anecdotal reports and studies suggest horny goat weed might help address ED by improving erections. Horny goat weed contains icariin, a mild inhibitor of PDE5, which is how Viagra works (Dell'Agli, 2008). 

However, studies on the effects of icariin have only been conducted on animals and petri dishes, meaning it might not work the same way in the human body. No clinical trials on horny goat weed's effect on ED in humans have been conducted.

2. Korean red ginseng

Korean ginseng has been touted as an ED treatment for years, and unlike some other natural alternatives to Viagra, studies have found it may actually be effective at alleviating symptoms of ED. 

In a meta-analysis involving over 2,000 men with ED, researchers found that red ginseng improved erectile function in participants. While results are promising, authors of the study did caution that more studies are needed before red ginseng is touted as the next herbal Viagra (Borrelli, 2018).

3. Yohimbe

Yohimbe is a dietary supplement made from the bark of an African evergreen tree. Yohimbine, the active ingredient in yohimbe bark, is a common ingredient in supplements sold as aphrodisiacs and male sexual enhancers. 

A 2014 review of studies determined that yohimbine was superior to placebo for treatment of ED, but it has yet to be compared to PDE5 inhibitors like Viagra (Corazza, 2014).

4. DHEA

One of the causes of ED is low testosterone. Dehydroepiandrosterone, or DHEA for short, is a hormone produced in the adrenal glands, which sit atop the kidneys. In our bodies, DHEA boosts certain hormones, like testosterone. 

But, studies on the use of DHEA supplements to boost testosterone have been mixed. While some research shows that the supplement causes testosterone levels to rise, others found the supplement had no effect (Liu, 2013). And either way, there’s no clear evidence that DHEA will boost testosterone in a way that has any meaningful effect on symptoms of ED (Morales, 2009).

5. L-citrulline and L-arginine

Some researchers believe that L-citrulline, an amino acid, can cause blood vessels to relax similarly to how Viagra works. It's the precursor of L-arginine, another amino acid that has been shown to improve blood flow (Cormio, 2011). 

A large analysis that looked at ten studies including 540 participants found that there was potential for L-arginine to help with ED. The researchers found that dosages between 1500 mg and 5000 mg offered significant improvements in ED over placebo and participants had higher self-reported scores of sexual satisfaction and erectile function (Rhim, 2019). 

If natural alternatives to Viagra aren’t for you, there are other options to help with ED (Sooriyamoorthy, 2022):

Medical devices

Several medical devices can be helpful for ED, including penis pumps and cock rings. A penis pump works by drawing blood into the penis, giving you harder erections. A cock ring is placed around the base of the penis (or around the penis and testicles) to keep blood from flowing out once it’s entered. This can help erections stay firm and last longer. 

Penis implants—which include a rod, semi-rigid implant, or one that can be inflated before sex—are also an option. These devices are typically reserved for extreme cases of ED.

Lifestyle changes

Lifestyle changes like exercising regularly, eating a heart-healthy diet, and avoiding alcohol and smoking (both of which can damage blood vessels and nerves that produce a healthy erection) can also help with symptoms of ED. Regardless of whether you’re taking Viagra or a natural alternative to Viagra, these lifestyle changes can have a significant effect on your ability to get and maintain an erection.

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Natural alternatives to Viagra or devices aren’t your only choices to treat ED. Other PDE5 inhibitors – like Cialis (tadalafil) and Levitra (vardenafil), or non-oral ED medications like alprostadil, which is injected into the penis or placed in the urethra as a suppository, may be a better fit for you (Sooriyamoorthy, 2022). 

If low testosterone is the cause of your ED, testosterone replacement therapy (TRT) may be successful to treat ED. TRT comes as a patch, gel, or injection (Sooriyamoorthy, 2022).

When it comes to natural alternatives to Viagra, you have options. But, before taking any supplements that claim to treat ED, speak with a healthcare provider. They can help rule out any serious underlying medical condition that may cause ED and develop a safe and effective treatment plan for you.

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How we reviewed this article

Every article on Health Guide goes through rigorous fact-checking by our team of medical reviewers. Our reviewers are trained medical professionals who ensure each article contains the most up-to-date information, and that medical details have been correctly interpreted by the writer.

Current version

January 31, 2023

Written by

Michael Martin

Fact checked by

Chimene Richa, MD

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About the medical reviewer

Chimene Richa, MD

Dr. Richa is a board-certified Ophthalmologist and medical writer for Ro.