What You Should Know About Natural Herbal Remedies for Erectile Dysfunction

When evaluating a treatment for Erectile Dysfunction, there are three important considerations:

1. Is it the right treatment for the cause of your ED?
2. Is it an effective treatment?
3. Is it safe?

Choosing the Right Treatment

There are many different causes for ED, and you can’t choose an effective treatment without understanding your specific problem.  To understand how different conditions can affect erections, see our articles, “How Do Erections Work?” and “Causes of Erectile Dysfunction.”

If you intend to try herbal supplements, you should first consult a doctor to understand the underlying cause.  This is especially important, because sometimes ED is based on a serious underlying medical condition.

Effectiveness

Once you know the cause of your ED, you need to evaluate the effectiveness of the treatments you are considering.

Many herbal supplements are promoted as miracle drugs.  If there are claims that a supplement will do everything from curing baldness to preventing heart disease, it’s very likely that the claims are bogus.

There have been some clinical trials of herbal remedies used to treat erectile dysfunction, and in general the results are not impressive.  Some supplements have shown small improvements, mostly in men with minor ED.  The results are much less significant than those obtained from prescription medications.

A study¹conducted by the ED Treatment Information Center in 2018 found that 81% of the men who had tried herbal supplements were either Not at All Satisfied or Not Very Satisfied with the results.  18% were Somewhat Satisfied, and only 1% were Very Satisfied.

Consider this:  penicillin, the first successful antibiotic, was derived from molds that inhibit bacterial growth.  Scientists had to figure out why the molds slowed bacteria, and refine the active ingredients.  Using herbal supplements is somewhat like putting mold on a wound.  It might help, a little, but it’s certainly not going to help as much as using penicillin.

Also note that herbal supplements will not cure ED.  In order to be effective, even for very mild cases, you will need to take them on a daily basis.

Safety

When a doctor prescribes a drug, he makes sure that it won’t cause complications for any medical conditions you have.  He also checks it against the other medications you take, to be sure there aren’t dangerous effects when the drugs are combined.  When you use herbal supplements, you don’t have these safeguards.

Several of the supplements that are sold as ED treatments actually have side effects that, in some cases, can be severe.

Even more importantly, herbal supplements are not well regulated in the United States.  Studies have shown that 40-50% of herbal supplements do not even contain the supposed main ingredient, and many contain substances that are not listed which may have dangerous side effects².  Another study found that over two thirds of the products tested had substituted other plant species for the plants listed on the label, and a third of products also contained other fillers or contaminants³.  A study by the New York State Attorney General of herbal products sold at GNC, Target, Walgreens, and Walmart found that four out of every five products didn’t contain the ingredient they claimed!  Fourteen US states and territories have petitioned Congress to regulate the herbal supplements industry.

Many products contain undocumented “fillers” that can cause allergic reactions.  In recent years, the FDA has found over 300 herbal products that contain hidden, deceptively labeled, or dangerous ingredients⁴. And since 2015, the FDA has released public warnings on more than 160 ED supplements and “male enhancement” products found to contain dangerous ingredients and contaminants⁵ .   An independent study of FDA data, conducted in 2018, found almost 800 herbal supplements that contained unlisted ingredients⁶.

Most herbal supplements are produced in 3rd-world countries, and packaged for distribution under various brand names in the United States.  Growers often use chemical pesticides, and there is no testing for contamination.  So much for “natural.”

Remember the penicillin/mold example, above? If you put mold on a wound, you might get some of the benefits of penicillin…  but you might also get toxins and other harmful ingredients that are found in many molds.

No matter how you look at it, using herbal supplements is a risky proposition.

Specific Herbal Remedies for ED ^7 8

Note that the clinical studies referenced below are based on the use of tested, pharmaceutical grade supplements in controlled dosages.  Supplements purchased over-the-counter may not yield the same results.

Ashwagandha (withania somnifera)

Effectiveness: A study using rats found that ashwagandha actually worsened erectile dysfunction and lowered sex drive⁹. Another study of men with psychogenic erectile dysfunction found that ashwagandha performed no better than a placebo¹⁰.

Risks:  Large doses can cause upset stomach, diarrhea, and vomiting. 

Cannabidiol (CBD)

Effectiveness: There is no evidence that CBD cures erectile dysfunction.  (See our article on CBD.)

Risks:  Generally considered safe with mild side effects; may have harmful interactions with other drugs.

Dehydroepiandrosterone (DHEA)

Effectiveness: No evidence of effectiveness in humans.  Increases levels of estrogen, and may lower levels of testosterone.

Risks:  Appears to be safe at low levels.  May cause acne.

Fadogia Agrestis

Effectiveness: Found to increase testosterone in one 2005 study, conducted in rats.¹¹

Risks:  There is not enough clinical evidence to determine if fadogia agrestis is safe.

Ginko Biloba

Effectiveness:  Reputed to increase levels of dopamine and nitric oxide (NO).  No evidence of effectiveness for ED in humans.

Risks:  May reduce clotting and increase risk of bleeding.

Ginseng (Korean Red Ginseng)

Effectiveness: Stimulates blood flow into the penis by  increasing nitric oxide (NO).  There is some evidence that Red Ginseng performs better than a placebo in treating ED, but the existing studies are small and not conclusive¹².

Risks:  A small number of patients experience stomach upset, constipation,  headache or insomnia.

Goji Berry Extract (Lycium chinense)

Effectiveness: A study conducted with rats suffering from age-related ED¹³ suggests that Goji may have a positive effect by preventing the decrease of serum testosterone levels. The relationship between serum testosterone levels and ED is controversial. Goji extract has not been tested as an ED treatment in humans. There is no direct evidence that Goji improves erectile function.

Risks:  Goji berries are generally considered safe for short-term use. They may trigger allergic reactions, and may result in reduced blood pressure.

Horny Goat Weed (epimedium)

Effectiveness: No evidence of effectiveness for ED in humans.  Although it is reputed to increase levels of nitric oxide (NO), very little actually makes it into the bloodstream.

Risks:  May affect heart function.  May cause mood changes.

L-Arginine

Effectiveness: Reputed to stimulate blood flow into the penis by  increasing nitric oxide (NO).  The NO produced by L-Arginine is metabolized in the digestive tract; there is no evidence that improves erectile function¹⁴.

There are claims that L-Arginine has some benefit when taken on an ongoing basis with pycnogenol¹⁵ or with L-Citrulline¹⁶. However, the L-Arginine/pycnogenol study is very suspect. The study consisted of 40 men “without confirmed organic erectile dysfunction.” And there was no control group, to rule out placebo effects.

Risks:  Side effects may include nausea, cramps and diarrhea, as well as heart arrhythmia.

L-Citrulline

Effectiveness: In a small clinical study of 24 men with mild erectile dysfunction¹⁷, about half the subjects showed improvement.  Researchers concluded that L-Citrulline is more effective than L-Arginine for mild cases of ED, but less effective than PDE5 inhibitors (Viagra, Cialis, Levitra, etc.)

Risks:  L-Citrulline may cause harmful interactions with nitrates for heart disease, blood pressure medications, and PDE5 inhibitors.  Consult your doctor before taking L-Citrulline. Men with heart disease should not take L-Arginine.

Maca Root (Lepidium Meyenii)

Effectiveness: There is limited evidence that Maca Root may increase sexual desire or erectile function¹⁸. However, the total number of trials, the total sample size, and the average methodological quality of the primary studies were too limited to draw firm conclusions. 

Risks:  Side effects may include mild stomach upset, cramps, and mood swings.

Nattokinase

Effectiveness: Pharmaceutical-grade Nattokinase (NK) has been used in Japan for the treatment of cardiovascular disease¹⁹.  There is no clinical evidence that it is an effective treatment for ED.

Risks:  Nattokinase is a blood thinner which may make bleeding disorders worse.  It can also increase the risks of surgery.  It is generally safe in small dosages.

Pycnogenol (Pine Bark)

Effectiveness: Stimulates blood flow into the penis by  increasing nitric oxide (NO)²⁰.  May be effective  in the treatment of ED when used in combination with L-Arginine (see above).

Risks:  Safe in small dosages.

Tribulus

Effectiveness: In an animal-based clinical test, Tribulus was not effective in treating ED²¹.   There is no clinical evidence that it is an effective treatment for ED.

Risks:  Might decrease blood sugar levels to dangerous levels for diabetics.  Otherwise, probably safe in small dosages.

Vitamins

Effectiveness: There is some evidence that a shortage of certain vitamins (notable B3, C, and D) may be linked to erectile dysfunction.  For men with deficiencies, taking vitamin supplements may improve erections.  However, vitamins have no effect unless there is a deficiency.

Risks:  Safe if taken in recommended dosage.

Yohimbe

Effectiveness: Stimulates blood flow into the penis by  increasing nitric oxide (NO)²².  May also increase libido, but the mechanism is not understood.

Risks:  Side effects  include increased blood pressure, fast or irregular heartbeat, anxiety, insomnia.  May interact with blood pressure medications or anti-depressants.   May cause kidney damage.  Yohimbe shouldn’t be used without a doctor’s supervision.

Zinc

Effectiveness: A zinc deficiency can lower testosterone.  For men with a zinc deficiency, taking zinc supplements can raise testosterone, increase the libido, and improve erections.  However, zinc has no effect unless there is a deficiency.

Risks:  Generally safe if taken in recommended dosage.  Excess levels of dietary zinc has been linked to prostate cancer²³.

Ingesting high levels of zinc can also result in diarrhea, vomiting, and stomach cramps.

“Herbal Viagra”

There are a many supplements on the market that do not disclose their specific ingredients.  It’s impossible to evaluate the effectiveness and safety of these products, and we strongly advise not purchasing them.

Foods

Although a change in diet will not cure erectile dysfunction, it can sometimes lessen symptoms and slow the progression…  particular in men experiencing vascular and circulatory problems.  For more information, read our article on “Diet and Exercise for ED.”

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For More Information

Causes of Erectile Dysfunction

Treatments for Erectile Dysfunction

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References

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