Viagra Alternatives: The Full List of ED Treatments

Written by the Manual Team · Medically approved by Dr Earim Chaudry - MD

In 30 seconds…

Viagra was the first pill to be approved to treat erectile dysfunction (ED). Yet, over twenty years on, the market is heaving with Viagra alternatives. The trick is knowing which ones are legit.

Viagra works by increasing blood flow to the penis, so that it becomes (and stays) erect long enough for you to have sex. Many medical Viagra alternatives – including those bought over the counter – work on the same principle, but differ in dosage and duration of effect.

Different Viagra alternatives work differently for each of us, so it is worth knowing what you are letting yourself in for before you try them. Meanwhile, changes to your lifestyle – and natural Viagra alternatives – can potentially help with your ED too.

Are there alternatives to Viagra?

At the beginning of the century, Viagra made up over ninety percent of the market for erectile dysfunction (ED) pills worldwide. These days, the growth in alternative Viagra treatments has meant that the ultimate dominance of the original has ended. 

There’s a range of alternatives to Viagra to choose from, including alternative medications, natural remedies, and simple changes to your lifestyle. There’s no longer any need to stick to the famous brand, particularly when some over-the-counter Viagra alternatives offer benefits that many men prefer.

In this article, we’ll run you through the full list of alternative medications for ED – from science-backed meds to nutritional supplements – and bust some myths along the way.

 

Alternative Medication

Pfizer’s famous ‘vitamin V’ used to be the only approved treatment for ED. That’s no longer the case. These days, there are plenty of Viagra alternatives that are just as safe, effective, and easy. Some of them work in slightly different ways, too – so there are different options you might prefer.

 

Sildenafil

Sildenafil
The little blue pill

It's just like Viagra - without the brand name and hefty price tag. Highly effective in helping you get and keep an erection. Clinically proven and used by millions of men worldwide. Easier erections, happy days.
Start from £15

Sildenafil (Viagra) was the first treatment to be clinically approved to treat erectile dysfunction. Sildenafil is the active agent present in Viagra and in its over-the-counter version, Viagra Connect. Simply put, Sildenafil is Viagra without the brand. Everything works the same, but whereas the RRP for Viagra Connect is around £5 per tablet, Sildenafil is available from Manual for as little as £2 per tablet.

Sildenafil targets an enzyme, PDE5, that affects muscle tone in the blood vessels supplying the penis. By relaxing and expanding your blood vessels, it improves the blood flow that your erections need. 

Take it 30-60 minutes before the action and it’ll last for 3-6 hours. Simple really – and it’s shown to be effective in eighty percent of men. This alternative to Viagra gives exactly the same results – but you can enjoy them without the price tag that comes with the famous brand.

 

Cialis (Tadalafil)

Tadalafil
The weekend pill

Known as the “weekend pill” for its long lasting effects, it’s the generic form of Cialis. Clinically proven to help you get an erection when you need it. For up to 36 hours!
Start from £15

You might know Tadalafil as its branded version, Cialis. Tadalafil targets the same enzyme as Sildenafil, but it lasts longer – up to 36 hours. That’s why they call it the ‘weekend pill’, as it gives you a bit more spontaneity. You don’t need to pop a pill every time before getting it on, and it actually gets to work quicker than other ED drugs – often within 30 minutes. 

The normal dosage of Tadalafil is 10mg. This has the desired effect in the vast majority of men who are experiencing ED. Studies comparing the PDE5 erectile dysfunction drugs has indicated that Tadalafil actually has a superior tolerability profile, meaning the lowest frequency of common side effects. It can also be taken in 2.5mg, 5mg, and 20mg doses.

Branded Cialis usually costs around £38 for four tablets of 10mg, which works out at around £9.50 per tablet. Tadalafil is more cost-effective, because it’s unbranded. At Manual, you can get Tadalafil starting from £3 per tablet for the same dosage. Don’t forget: Tadalafil and Cialis are identical.

 

Other

Spedra (Avanafil)

Another alternative to Viagra is avanafil, the agent found in trademark ED medications, Spedra and Stendra. This one should be taken fifteen to thirty minutes before sex. Whilst it’s a PDE5 inhibitor too, it is thought to be less effective than Sildenafil and Tadalafil, although it is known for its unique faster acting qualities. 

Levitra (Vardenafil)

Vardenafil functions in exactly the same way – and, like all the others, it shouldn’t be taken more than once daily. You’ll find vardenafil in ED medications like Levitra and Staxyn. Staxyn is designed to be dissolved on the tongue, rather than swallowed with water.

 

Absolutely Avoid...

It’s worth noting that Viagra is the most commonly counterfeited drug on the planet. That means that there’s a lot of fake Viagra alternatives around. Take care to ensure they are legit before buying anything. This matters, because fake Viagra can be cut with everything from printer ink to speed. You don’t want to be taking these! Buy from a registered pharmacy or MHRA approved online service provider.

 

Illegitimate Online Stores

In one study of 26 online vendors by Pfizer, the manufacturers of Viagra, 81% of the drugs they bought and tested were shown to be counterfeit. Obviously, as the manufacturer, Pfizer has a vested interest in the Viagra brand and we don’t know how or why the 26 online stores were selected. But at the same time, it shows that you must do due diligence, read reviews, and if in doubt go to your GP.

 

Kamagra

You might see websites selling Kamagra as a cheap over-the-counter Viagra alternative. Don’t buy it: it’s not a licensed drug in the UK – and these sites are certainly breaking the law. Kamagra is manufactured in India, and it is completely unregulated. It’s not worth your time when there are so many other Viagra alternatives around that are proven to be effective against ED.

 

Supplements

There are a number of nutritional supplements that people take for ED. And whilst most have been studied for their efficacy as a Viagra alternative, the results have been largely inconclusive. 

L-Arginine

L-Arginine is an amino acid that is usually found in fish, red meat, and dairy products. It is used by the body to make nitric oxide, a chemical that widens your blood vessels and improves blood flow – something similar to the PDE5 inhibitors like Sildenafil. 

These supplements do have medical uses – for angina and high blood pressure for example – and studies have shown that it may be effective for ED treatment. The trouble is that you need to take L-Arginine in fairly massive quantities for it to work as well as its medical alternatives. 

 

Tribulus

Some people take Tribulus as a supplement to reduce cholesterol and even to increase libido. There is currently no scientific proof that Tribulus can increase testosterone levels or combat ED – a study showed that people taking Tribulus didn’t experience a testosterone boost compared to a group taking a placebo.

 

DHEA

Another Viagra alternative with effectiveness supported by science is DHEA, or dehydroepiandrosterone, supplements. A study found that men with ED were more likely to have lower levels of this hormone. There is no definitive evidence of the use of DHEA effectively improving testosterone levels, and you should also be wary of the potential side effects like acne or liver disorder.

 

Other Remedies for ED

Beyond the formal medications, there are “natural” alternatives to Viagra that are increasingly popular. These range between everything from “erection tea” to acupuncture – but they’re not always hugely reliable. They range in their effectiveness and few are actually endorsed by medical professionals. Some of them are probably not worth the risk.

 

Herbal Viagra

“Herbal” Viagra is sold as a natural alternative to ED medication, but it is generally frowned upon by medical professionals. You’ll almost certainly have seen it advertised before – but if you’re thinking about taking it, maybe think twice. “Herbal” in this context can mean literally anything, and there is no way to know what it really contains. However, Panax Ginseng, sometimes known as “Herbal Viagra”, has been found to have some beneficial impact on ED.

 

The Dangers of Herbal Viagra

One notorious case involved a herbal Viagra that was stuffed full of unacknowledged medications for ED and for obesity. Others have been found to lower your blood pressure dangerously. Unless you are going for Panax Ginseng specifically, you can never know what herbal Viagra contains. It is best just avoided.

 

Erection Tea

Affectionately known as “boner brew”, erection tea is essentially an infusion of plants that have been shown to be vasodilating – meaning that they widen your blood vessels and improve blood flow. This is the same principle on which Sildenafil itself works. 

Erection teas can include things such as ginseng, ginger, lemon juice, and honey. The effectiveness of these infusions has never been studied. However, they’re completely harmless – perhaps even tasty.

 

Aphrodisiac Foods

Chocolate and oysters may be thought to be aphrodisiacs, but science doesn’t really agree. If you try saffron, pistachios, and fenugreek, however, you may well be onto something – again, without firm studies behind that.

 

Acupuncture

Many people are sceptical of acupuncture, but some studies show that it can be effective in tackling ED. One study has showed it worked in just under 40% of cases – but let’s just say it’s not the most pleasant or straightforward treatment for ED around.

 

Lifestyle Improvements

The medicinal Viagra alternatives and the herbal ones aside, there’s a lot of evidence that a healthy lifestyle can help ED. Just like the rest of your body, your sensitive parts aren’t immune to those benders and binges. A healthy lifestyle can go a long way towards improving erectile dysfunction, and this should be combined with any over-the-counter Viagra alternatives you might seek.

 

Better Sleep

If you’re tired, you’re much more likely to have reduced libido, reduced testosterone levels, and erectile dysfunction. Sleep deprivation increases the production of cortisol, a stress hormone that just makes you less interested in sex. One of the easiest alternatives to Viagra is a good night’s sleep of 7-9 hours.

 

Better Nutrition

Eating foods rich in fat and sugar increase your chances of erectile dysfunction dramatically. Given that ED is generally an issue of blood flow, cholesterol and high blood sugar can both make an erection more difficult. Reducing fatty foods is wise, whilst stocking up on fruit, veg, and whole grain products can help.

 

Exercise

A recent study confirmed what was already suspected among researchers: physical activity can help combat ED. By improving cardiovascular health and blood flow, exercise gets that blood going where you need it.

 

Stress Management

Stress and anxiety can affect your sexual performance, whilst stress about your sexual performance can affect it even further. Vicious cycle. And chronic stress can damage your arteries, in turn affecting your blood flow. This can knock your ability to get it up.

Finding ways to decrease your stress can help ED. This might include drinking herbal teas, like chamomile, that can reduce anxiety, or taking up yoga.

 

Meditation

Meditation is an increasingly popular way to reduce stress levels. After as little as 20 minutes of meditation a day over the course of a week, you can potentially see your stress levels reduce. Although this is just a small piece of the puzzle in reducing the impact of a stressful lifestyle.

 

Less Alcohol

One research paper found that up to 70% of heavy-drinking men suffer from some form of sexual dysfunction. That includes ED. Developing a lifestyle with less alcohol can improve your erections dramatically – and it will boost your libido too.

 

Less Porn

Watching a lot of porn can give you unreal expectations about  sex and it can prevent you from connecting fully with your partner. This, it is thought, can lead to PIED, or porn-induced erectile dysfunction. If you feel like this is the reason for your ED, talk to someone about it. Go to your GP or make an appointment with a counsellor. Reducing the amount of porn you watch can be your next step.

 

Key Takeaways

There are plenty of Viagra alternatives out there. Many of them, however, don’t have any scientific backing – and some can be downright harmful. Being aware of this can prevent you having a nasty surprise. On the other hand, there are many Viagra alternatives that are known to be effective. The PDE5 inhibitors such as Sildenafil and Tadalafil are the pick of the bunch – being just as effective as branded Viagra. Meanwhile, a healthy lifestyle will set you up well for your battle with ED. Sleeping well, eating well, and exercising can reduce the need for a Viagra alternative in the first place. 

That said, it’s important to remember that everybody is different – the individual response and tolerance to treatment varies. One product may work well for one person, but may not provide the desired results for another. Erectile dysfunction treatment must be optimised for each individual.