Choosing the Right Pill to Treat ED

As with maca, we recommend extracts over powders and advise men to focus on the icariin content of the extract over raw dose numbers.45 Panax

Why is this medication prescribed?

They’re thin, round, and flexible O shapes that you fit around the base of your penis to constrict blood flow. Because they’re bigger than your penis is thick when it’s flaccid, they won’t stop blood from flowing in, but if you can get the blood in there and the penis thickens, they can stop that blood from flowing out. For some men, the use of rings also provides an additional physical or psychological stimulus, increasing the odds of a successful erection. The best part about rings is that you can use them in conjunction with just about any other ED treatment on the market, from PDE5 inhibitors and supplements to shockwave devices and penis pumps. However, penis rings come with a unique set of risks, most notably the danger of completely cutting off blood flow to the penis and the possibility of something called penile entrapment.

Epimedium extract

Cases of entrapment, which are more commonly seen with metal penis rings, occur when you can get the ring on, but you can’t get it off.34 This can result in numerous complications, but it’s fairly easy to manage with the help of a medical professional, who will likely need to remove the ring by force (e.g., with bolt cutters or a saw). In our estimation, the rings offered by Hims are among the best out there. They come in two sizes that should serve the vast majority of men, and they’re flexible enough to come off safely when it’s time to remove them. Ideal for men who have postsurgical ED (e.g., after prostatectomy) Water-based pumps demand use in the shower Penis pumps are essentially little vacuum chambers out of which you pump the air after inserting your penis. Some do this with manual pumps, while others work electronically. ginseng (red ginseng) is sometimes called “herbal Viagra.” There have been more than a handful of studies providing evidence that Panax ginseng can help with ED.

• Counterfeit Pills: Extremely common online; may contain incorrect doses or harmful substances.
• "Herbal Viagra" Products: Often illegally laced with prescription drugs like Sildenafil.
• Too-Good-To-Be-True Prices: A major red flag for counterfeit or substandard medications.
• Lack of Prescription Requirement: Legitimate sources require a consultation with a licensed provider.
• Fake Pharmacy Websites: Check for physical address, pharmacist contact, and VIPPS seal.

However, the studies leave a fair bit to be desired in their methodologies and size.21 The evidence thus far points to the need for more research into the potential of red ginseng as an effective treatment. DHEA (dehydroepiandrosterone) is a precursor to the sex hormones testosterone and estrogen that our body’s adrenal glands typically produce.

Production of DHEA naturally drops as we age.

How should this medicine be used?

As the air is sucked out of the chamber, the vacuum force in its place applies suction to your penis, causing it to fill with blood.35 Penis pumps occupy a specific section of ED research that focuses on treatment for men who've undergone radical prostatectomies or similar surgeries that have caused their ED.36 In some cases, another side effect of such surgeries is a phenomenon in which the penis retreats somewhat into the body. They’ve been shown to work for other types of ED, as well, but the majority of the research seems to focus on postoperative ED. Some research has also highlighted the potential for pumps to help with Peyronie’s disease, a painful curvature of the penis that involves calcium deposits around the shaft.37 As with other device-based therapies, you might want to use penis pumps as one part of a multipronged treatment approach. They pair well with rings to ensure that the blood you’ve drawn into your penis doesn’t escape. The biggest fault of penis pumps is that they can be a pain to use, both literally and figuratively (he vacuum pressure can be uncomfortable).

More FAQ

Some brands, like Bathmate, are designed to be used with water in the chamber, which softens the experience. But these necessitate a shower or a bath that can get in the way of foreplay and slow down a passionate moment. Prescription ED medications are safe and effective ways for most men to treat ED. However, not all men want to take prescription medication, and some men cannot take PDE5 medicine safely. Based on our research, we believe you may find an effective treatment for very mild cases of ED using a nutritional supplement. Several studies on diabetics have uncovered an inverse relationship between serum DHEA levels and the incidence of ED.22 Those results suggest that possibly a third of men with diabetes-related ED could treat their ED using DHEA.

Further information

As with any medication or supplement, it’s important to discuss this with your primary care provider to make sure there’s nothing in your medical history that might make these alternative treatments unsafe for you. Nutritional supplements don’t work as strongly as prescription ED medications, based on clinical research. Research is still less thorough for supplement ingredients, which makes it harder to assess reliability and safety for everyone. They also typically come in only one dose, so the efficacy can be wildly different in men with disparate BMIs and metabolisms. And from a cost standpoint, supplements are often much more expensive than prescriptions, especially considering generic options.

The Bottom Line

Still, if your ED isn’t too severe, you’re determined to avoid getting a prescription for it, or you aren’t a viable candidate for prescription medication, these alternatives may be sufficient. Some companies tailor their supplements to target ED and increase sex drive and performance. Others may aim to boost testosterone or specifically increase the volume of ejaculate, often concurrently improving fertility. There’s a bit of ingredient crossover from one category to the next, so you can pick your preferred supplement based on your most pressing concerns, and you very well may see benefits elsewhere in your sexual health, as well. Here’s a quick look at the three main categories of complex nutritional supplements that might help with ED: Male enhancement pills have the closest link to ED of the bunch, with ingredients that typically try to improve blood flow and relax the musculature of the corpus cavernosa (the chambers of the penis that fill with blood to create an erection). The World Anti-Doping Agency and many collegiate and international competitive organizations have banned DHEA as a performance-enhancing drug.

Other targets: Therapeutic roles

And even with a good complex supplement, you won’t know which of its ingredients are working for you, in particular, and which may not be. Here’s a quick look at some popular single-ingredient supplements people look to for help with ED. Not all of the items on this list are home runs, but their prevalence in the marketplace demands that we address them: Studies using high doses of maca root powder have illustrated its ability to improve erectile performance.43 But maca isn't always well-absorbed, so extracts made from the powder are superior to consuming 10g of the dried and ground root. L-Arginine is an amino acid we naturally have within our bodies. Under normal circumstances, it plays a role in nitric oxide production, which in turn plays a crucial role in allowing blood to rush into the penis to cause an erection. The quantities you’ll encounter in male enhancement supplements aren’t likely to help you break any home run records, but they could still show up on mandatory drug tests.

• VibraPlus: Herbal, natural formula aiming to enhance stamina and erection quality, caution advised for unproven claims.
• MaxMan: Dietary supplement designed for libido boost, not a direct ED treatment, use with medical advice.
• Max Performer: Nutritional supplement, claimed to support erectile health, but evidence for effectiveness is limited.

You might also find that DHEA raises your cholesterol levels, so if you have high cholesterol levels already, DHEA might not be the right choice.

• GoodRx & SingleCare: Coupon cards and apps to compare and lower prescription prices at pharmacies.
• Manufacturer Savings Cards: Available for brand-name drugs like Cialis or Stendra (eligibility required).
• Online Pharmacy Verification: Use only VIPPS-accredited pharmacies to avoid counterfeit drugs.
• Insurance Formulary Check: See which ED medications are covered under your specific plan.
• Buying in Bulk: Some services offer cost savings with 3-month or 6-month supplies.

CBD is also a popular ingredient for erectile performance, especially if anxiety and psychogenic ED are at issue, and some of our favorite CBD companies have introduced sex-focused products that include some of these ingredients.

Which Makes You Harder?

These can include L-arginine or maca root.19 38 Some other ingredients are there to improve libido or reduce anxiety, the latter of which might help with psychogenic ED. A few ingredients in these supplements may also work to increase testosterone levels or ejaculate volume. Testosterone boosters may help with ED if low testosterone is at the source. Some prominent testosterone boosters, like tongkat ali and ashwagandha, also have anti-anxiety effects, which might help with cases of psychogenic ED, regardless of testosterone levels.39 40 And because erectile performance often suffers with low testosterone, some brands will include erection-supporting ingredients in their testosterone boosters, even when there’s less evidence connecting them with testosterone. A great example of this is the potent maca extract in Innerbody Testosterone Support and Roman’s supplement.

Serious side effects

Volume pills often better resemble fertility supplements sildenafil viagra price than ED solutions. In fact, our top-rated volume pill is a male fertility supplement by Bird & Be. Again, some ingredient crossover means you can find volume pills that have beneficial potential for ED. It would be understandable if you wanted to try a single supplemental ingredient as opposed to a complex formula. With the exception of a few great products out there, many such complex supplements include a few iffy ingredients or subclinical doses that call their potential safety and efficacy into question. Among these gummies, Neurogan’s Pure Intimacy is an easy top pick, as it combines an effective dose of CBD with both maca root and horny goat weed.

• Viagra Sildenafil: The most widely used ED medication, effective within 30-60 minutes, lasting 4-6 hours, requires prescription.
• Generic Sildenafil: Affordable alternative to Viagra, identical active ingredient, equally effective, available at pharmacies worldwide.
• Viagra Coated Tablets: Designed for faster disintegration in the mouth, for quicker onset, but consult a doctor before use.

Side effects with all of the supplements mentioned here tend to be mild, if any occur.

Most men don’t experience any, but it’s always wise to share your supplement plans with your healthcare provider before adding anything new to your regimen.

Comparing Side Effects

In one study, a third of men reported that they experienced significant improvement in sexual function while using L-arginine.19 A separate study of men ages 25-45 examined the effect of taking both L-arginine and pycnogenol (chemicals taken from French pine trees) together for ED treatment.20 Participants were given L-arginine for one month; nothing happened. Then the men were given both L-arginine and pycnogenol for a month. After this second month, 80% of the men reported that their sexual function was mostly restored. Using this same combination for a third month, over 92% of the men had what they considered normal erections. While erection-specific research has only been conducted in animals, horny goat weed is among the most popular herbal remedies for ED.