Supplements For Erectile Dysfunction: Do they work?

Take home points

• The vast majority of supplements for erectile dysfunction are unlikely to benefit erectile dysfunction.
• Most reviews of online erectile dysfunction supplements are not written and rated by genuine users.
• The two active ingredients found in dietary supplements with the strongest evidence of benefit for erectile dysfunction are L-arginine and Panax ginseng.
• Erectile dysfunction is a medical condition that requires the guidance of  a healthcare professional.
  

Supplements for erectile dysfunction

The perceived shame and embarrassment of erectile dysfunction can easily cause men to seek over-the-counter remedies (or in today's world, Amazon prime remedies.) Naturally, that opens the door to the world of dietary supplements, a market with genuine health-promoting products that is still littered with exaggerated marketing claims, contaminants, and ingredients with little to no evidence of benefit. It can be hard to know if anything on the market is worthwhile, and what that product might be.

A brief online scan for erectile dysfunction supplements will make it seem like some products fit the bill for improving erectile dysfunction: no prescription required, affordable, and positive user reviews. For example, the top 6 Amazon supplements for erectile dysfunction have an average of 2,121 reviews and a 3.92 star rating. However, a 2019 analysis found that after filtering out non-human and non-genuine reviews (using reviewmeta.com), there was a 77–90% decrease in the number of reviews for erectile dysfunction supplements that reported improved erection strength, duration, and sexual satisfaction.¹ We therefore recommend basing supplement decisions on scientific evidence and the advice of healthcare professionals, instead of user reviews.

Learn more about erectile dysfunction in our complete guide by clicking here

How could a supplement for erectile dysfunction work?

A dietary supplement that benefits erectile dysfunction could work by one of two ways, or a combination of both. First, a supplement could raise the level of nitric oxide in the body, particularly in the penis, and thereby improve the flow of blood and oxygen when an erection is triggered. Second, a supplement could normalise the hormones that relate to sexual function, such as correcting a testosterone deficiency. We note that testosterone-boosting supplements are largely ineffective, though, meaning that raising nitric oxide levels is more likely route to a supplement improving erectile dysfunction.

What do supplements for erectile dysfunction contain?

Although supplements sometimes contain just one active ingredient, every supplement for erectile dysfunction that we found contained a blend of numerous active ingredients (often using a ‘proprietary blend’ to avoid stating the doses of each active ingredient).

The 10 most common active ingredients in erectile dysfunction supplements are:

• Tribulus Terrestris
• Panax ginseng
• L-arginine
• Crocus sativus
• L-carnitine
• L-taurine
• Pinus pinaster
• Muira puama
• Maca root
• Zinc

Do supplements for ED work?

Although no supplement marketed to improve erectile dysfunction has been directly studied, up to 50 active ingredients in these supplements have been independently tested. Therefore, knowing if an erectile dysfunction supplement is potentially beneficial requires an assessment of its ingredient profile, looking at whether it contains the potentially effective active ingredients in sufficient amounts.

Thankfully, in August 2023, Gabriel Petre and his research team analysed 23 of the highest-quality studies that, in total, tested 41 active ingredients found in erectile dysfunction supplements.² Overall, they reported that only 6 active ingredients had two positive studies (or more) to support their use in erectile dysfunction. These 6 ingredients were Eurycoma longifolia, Panax ginseng, L-arginine, Corynanthe yohimbe, Tribulus terrestris and Pinus pinaster. However, the researchers noted some concern and/or a high amount of bias for most studies supporting these active ingredients, meaning that the studies were carried out in a way that may have increased the chance of a positive result. The researchers were least concerned with the studies in support of L-arginine and Panax ginseng supplementation studies; therefore, these ingredients are deemed to have the strongest evidence in support of a benefit for erectile dysfunction.

The researchers then went a step further and looked at the active ingredients contained within 27 popular erectile dysfunction supplements.² L-arginine was contained in 17 of the dietary supplements but none included the minimally effective dose (5  grams per day). Similarly, Panax Ginseng was contained in 13 of the dietary supplements but only 1 used the minimally effective dose (800 milligrams per day). Remarkably, all 27 supplements contained at least one ingredient without any positive evidence, and 24 of them contained at least one potentially effective ingredient below the minimally effective dose. The researchers concluded that dietary supplements for erectile dysfunction are “...usually blends of many substances that are frequently employed at a negligible dose or without any evidence.”

Instead of buying multi-ingredient erectile dysfunction supplements, L-arginine and Panax ginseng can be purchased as independent supplements for a fraction of the price. Buying these supplements in isolation is more cost-effective and will make it easier to consume the minimally effective dose. However, as discussed later, supplements are not a replacement for medical intervention. If you are concerned about your erectile dysfunction, you should visit your healthcare professional to discuss more effective medical treatments available.

What about testosterone supplements? Learn more about whether testosterone boosting supplements work by clicking here

Are supplements for erectile dysfunction safe?

Current research indicates that the 2 ingredients with the strongest evidence of benefit for erectile dysfunction, L-arginine and Panax ginseng, are considered safe for adults to consume. The observed safety level when consumed orally is up to 20 grams per day for L-arginine³ and up to 3 grams per day for Panax ginseng⁴, which are both considerably above their minimum effective doses for improving erectile dysfunction (L-arginine, 5 grams per day; Panax ginseng, 800 milligrams per day).

However, it is in the interest of consumers to know that despite the rarity of adverse events in response to dietary supplementation, there are still no safety requirements for manufacturers in Europe and the United States to market their supplements.⁵ Contaminants and non-listed ingredients are regularly found in commercial dietary supplements, which is a concern for many consumers. Also, supplements for sexual enhancement have been included in the Food and Drug Administration’s Tainted Supplements database, which lists confirmed reports of adulterated dietary supplements since 2007.⁶ We recommend a mindful approach to supplementation, choosing brands that are frequently tested by independent companies such as Labdoor.

Medical treatment vs erectile dysfunction supplements

Supplements for erectile dysfunction are not comparable to medical treatment, despite sharing the same goal. The US Food and Drug Administration (FDA) states that, “Unlike drugs, supplements are not intended to treat, diagnose, prevent, or cure diseases. That means supplements should not make claims, such as “reduces pain” or “treats heart disease”. Claims like these can only legitimately be made for drugs, not dietary supplements.”

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As explained in our article about erectile dysfunction treatment, there are many medical approaches that can improve symptoms of erectile dysfunction and improve quality of life. In brief, the current medical treatments for erectile dysfunction includes oral PDE5 inhibitors (a first-line treatment) and various applications, injections, and shockwave therapies in the penile region. Medical therapies have been included in the 2021 guidelines of the European Association of Urology Sexual and Reproductive Health to manage male sexual dysfunction.⁷

‍Learn more about the available treatment options for erectile dysfunction by clicking here

References

1. Balasubramanian A et al. J Sex Med 2019;16(6):843–852.
2. Petre GC et al. Nutrients 2023;15(17):3677.
3. McNeal CJ et al. J Nutr 2016;146(12):2587S–2593S.
4. Kim YS et al. Medicines (Basel) 2015;2(2):106–126.
5. De Cock KJ et al. J Pharm Biomed Anal 2001;25(5–6):843
6. Tucker J et al. JAMA Netw Open 2018;1(6):e183337.
7. Salonia A et al. Eur Urol 2021;80(3):333–357.