Alternatives to Viagra

Erectile dysfunction, also known as impotence, is a common condition that affects a man's ability to get or maintain an erection. It can be caused by physical or psychological issues or a combination of both.

ED can have a significant impact on a man's self-esteem and confidence, and may place strain on relationships. Identifying and addressing the root cause is important for both sexual health and your overall wellbeing.

Dr. Caroline Fontana Lead Prescribing Doctor

Continue reading to learn more about the different Viagra alternatives available, including prescription options, natural remedies, and lifestyle tips.

Viagra, also known as the ‘little blue pill’ is the most popular treatment for erectile dysfunction. It is available as a generic version, known as Sildenafil and is also available over the counter in some countries.

Despite its popularity, Viagra may not be suitable for all men. Very common side effects of Viagra are reported to occur in more than 1 in 10 people. Whether due to side effects, cost, medication interactions, the need for quicker results, or simply because it doesn’t work for them, many men look for safe and effective alternatives to Viagra.

If Viagra doesn't work for you, trying a different medication from the same family (PDE5 inhibitors) is often the first step.

Different PDE5 inhibitors have unique characteristics that may make it more suitable for your specific needs. Other popular alternatives include:

Tadalafil (Cialis)

Tadalafil (Cialis) is a great and effective long-lasting alternative to Viagra. It can be taken daily or when required, thus offering more flexibility and spontaneity.

There is also a daily treatment available known as Cialis Daily. As the name suggests, this is a low dose of the drug Tadalafil that can be taken daily, allowing for greater flexibility and spontaneity when it comes to sex.

Vardenafil (Levitra)

Levitra is another great alternative for men with certain medical conditions.

Levitra may also be more suitable for men over 50 who have medical conditions such as high blood pressure, cholesterol and diabetes, and who cannot take other impotence medications.

Avanafil

Avanafil (Spedra) is a fast-acting alternative to Viagra and may potentially cause fewer side effects.

Sildenafil (generic Viagra)

Sildenafil is the generic version of Viagra, which means that it contains the same active ingredient and works in exactly the same way to treat ED.

For men who can’t take oral medications or prefer non-pharmaceutical options, medical devices and procedures are available.

Alprostadil

Alprostadil is an ED medication that must be prescribed by a specialist. It’s a synthetic form of prostaglandin and works by relaxing blood vessels and increasing blood flow to the penis, resulting in more successful erections.

Alprostadil is available in several forms:

Alprostadil cream

• This is the most affordable form of the medication. The cream is applied to the head of the penis and urethra using an applicator. It starts working quickly, so ensure you are ready for sexual activity before using it.

Urethral suppositories

• These are fast-acting and work in as little as 10 minutes. These small pellets are inserted directly into the urethra using an applicator.

Penile injections

• Alprostadil is also available as an injection, usually sold under the brand name Caverject. This form is injected into the base of the penis.
• Alprostadil is most often prescribed to people with ED caused by a neurological disorder, prostatectomy, heart condition or diabetes.

Vacuum erection devices (VEDs)

Vacuum Erection Devices (VEDs), also known as ‘penis pumps’ are good alternatives for those who prefer not to take any medication.

How VEDs work:

These tubular devices fit over the penis and are controlled either by a hand pump or a battery. They work by reducing the air pressure in the tube, drawing blood into the arteries of the penis, causing an erection.

VEDs are more of a temporary treatment, with erections only lasting around 30 minutes. However, it has few side effects when used correctly, so it is suitable for people with moderate ED who are taking other medications or have long-term health problems.

Penile implants

A penile implant, or penile prosthesis, is a surgical procedure to treat ED. It involves the placement of an inflatable or inflexible rod to mechanically induce an erection. Penile implants are a treatment reserved for the most persistent and difficult cases.

The most common and successful type is known as a three-piece implant. This involves placing a fluid reservoir under the abdominal wall. A pump and release valve are implanted in the scrotum and two inflatable rods are placed inside the penis.

To use it, press the pump and the rods are filled with a solution to inflate them. After sexual intercourse, press the pump again to deflate the penis.

Herbal medicines and supplements are a popular choice for treating many medical conditions, including impotence.

The active ingredients in herbal treatments for ED or “natural Viagra” claim to increase libido and improve sexual performance, however, there is little clinical evidence to support these claims.

The following herbal products are commonly marketed as aphrodisiacs:

Panax Ginseng

Ginseng has been thought to work for ED by improving blood flow and boosting sexual function. However, a review of studies looked at whether ginseng helps treat ED. The results showed that while ginseng may offer a small improvement, it isn’t strong enough to be considered effective.

L-Arginine

L-arginine plays an important role in producing nitric oxide (NO), a key factor involved in achieving and maintaining erections. While some studies suggest that L-arginine may help improve ED, the evidence is limited and not as strong as that for prescription medications like Viagra.

Maca root

Maca root is a vegetable native to Peru. Some studies demonstrate that Maca root has beneficial effects such as improved sexual desire, erectile function, and subjective wellbeing in men. Maca may support general sexual wellness rather than be considered a reliable fix for ED.

Horny goat weed (Epimedium)

Horny goat weed is a medicinal herb which people use to treat many conditions including erectile dysfunction. Some research on animals suggests that icariin, a compound in horny goat weed, might support blood flow to the penis. However, the evidence is limited.

Tribulus terrestris

Tribulus terrestris is an herb that is indigenous to Southern Europe, Southern Asia, Australia, and Africa. It is used to treat infertility, low sex drive, and erectile dysfunction. However, further clinical trials with larger sample sizes are needed to evaluate its safety and effectiveness.

Before trying any natural treatment for male impotence, check with your doctor whether it is suitable for you to take. Avoid buying herbal products online, as it can be harder to verify the credibility of the product.

Warnings on herbal Viagra products

Many “herbal Viagra” products are unregulated and may contain hidden prescription medicines or harmful ingredients. These may cause serious side effects, especially when taken together with other medications. Be aware of bold claims on packaging and products with unclear ingredients. In the UK and EU, medicines and supplements must meet strict standards set by regulatory bodies, such as the MHRA (Medicines and Healthcare products Regulatory Agency).

The risks of unregulated supplements

Unregulated supplements can vary in strength and purity, and there is often no guarantee of their safety. Most unregulated ED supplements have not been properly tested for safety or effectiveness, so claims are often exaggerated or unsupported.

Herbal products may not necessarily be effective and are not as regulated as prescription medicines.

Dr. Caroline Fontana Lead Prescribing Doctor

The most common causes of ED are conditions that affect your circulation, such as high cholesterol, high blood pressure, and unhealthy habits like smoking. Therefore, positive lifestyle changes can significantly improve your condition.

Improving your diet, moving more, and cutting back on processed foods can work wonders for your vascular health, which may benefit your sexual function.

Silvia Fonda Nutritionist

Regular exercise and circulatory health

• Regular exercise such as walking, swimming, or cycling helps improve blood flow, which in turn may help improve ED. It also supports heart and blood vessel health, which is important for maintaining strong erections.

Stress reduction and mental health

• Stress, anxiety, and low mood are often linked to ED issues. Furthermore, anxiety and performance pressure can also trigger or worsen ED.
• Participating in stress-reducing activities like mindfulness, meditation, therapy, or hobbies you enjoy may help reduce performance-related anxiety.

Limit alcohol and tobacco

• Drinking too much alcohol can reduce arousal and interfere with the quality of erections. Meanwhile, smoking damages blood vessels, which can restrict blood flow and contribute to ED.
• Cutting down or quitting both may improve sexual function, as well as your lung and liver health.

Pelvic floor exercises

• Pelvic floor exercises, such as Kegels, can strengthen the muscles involved in erections. Studies show that regular pelvic floor training can significantly improve erectile function. Plus, they offer a non-invasive therapy option.

If ED is persistent, affecting your confidence or relationships, or you’re concerned, it might be time to speak to a healthcare professional. At euroClinix, you can complete an online consultation and, if approved, get treatment discreetly.

Start your consultation today

Viagra has been the go-to treatment for erectile dysfunction, but it’s not the only option. From other prescription medication options like Tadalafil, to VEDs, penile pumps, lifestyle changes, or natural supplements, there are many alternatives available.

If you’re experiencing ED, the first step is to speak to a healthcare professional to identify the cause and discuss safe, effective treatments tailored to you.

Although many herbal products claim to cure ED and are easily available online, make sure to stick to medically approved options.