Erectile dysfunction (or ED for short) is a growing problem in the United States. With the increase in obesity, diabetes, and blood pressure problems coupled with the large amount of antidepressant use this increase is no surprise to those of us in pharmacy. There are a huge number of supposed natural remedies out there that improve erections for affected men, but little evidence for their effectiveness exists. In this article, we will look at the natural products that may help and talk about the prescription meds that can help.
Before we start, if you have any medical issues or take other prescription medications then you should discuss herbal or nutraceutical use with a medical or pharmacy provider.
The most effective herbal product is Yohimbe (or Yohimbine) which comes from the bark of a tree (Pausinystalia yohimbe). It improves erections in up to 20% of men with ED. Yohimbe is a natural product so it must be safe, right? Not quite...this is a very common misconception. Natural products are the source of many of our prescription medications which we all know can have varying levels of safety. Yohimbe is one natural product that has a pretty serious side effect profile. It works by activating the parasympathetic nervous system. Thus, it can cause high blood pressure, heart rate irregularities, dizziness, nervousness, and irritability. Since I have never found a patient that I could recommend its use as an over-the-counter product I don't even stock it.
Unfortunately no other herbal or natural products have the same, documented possible effectiveness as Yohimbe. There are a number of products that may be effective though. The first products are Arginine and L-Carnitine. These are amino acids normally found in many proteins that you already eat. It is thought that arginine consumption can increase nitrate levels in men. (Nitrate is important in the erection process.) However, it is unknown what dose and frequency is needed to help with ED. L-carnitine has been shown in preliminary studies to help improve the effectiveness of the impotence drug Viagra®. Again, it is unknown at which dose the benefit can be seen. There are also some possible drug interactions with high doses of these amino acids so use caution and talk to your pharmacist.
Ginkgo is an herbal product that could possibly help patients with ED. It is thought to work by relaxing vascular smooth muscles which could help with producing an erection. It is reported to be most effective in patients with low libido and ED from antidepressant use. Ginkgo has many drug interactions as well so its OTC use should be discussed with a doctor or pharmacist.
One final herbal product is Coleus. It is from the plant Coleus forskohlii and has been used in Asian medicine for a very long time. Some reports state that it helps improve ED when used with other therapies. Not to sound like a broken record but this product also has many drug interactions so its use should be discussed with a medical professional.
Regarding prescription products, there are the 3 major products that you see commercials for all the time. Viagra®, Cialis®, and Levitra®. These products have tons of information on the Internet so I won't bore you with the pharmacology of these products. They are effective for many men but come at a very high cost. Fortunately there is a generic drug called sildenafil that is the same active ingredient as Viagra®. Your doctor may prescribe sildenafil 20mg tablets off label for your ED treatment. Fortunately this generic drug costs a fraction of the price of Viagra®. Our pharmacy actually has a pretty impressive deal for patients who choose to use our pharmacy for this product. We have 90 tabs of sildenafil 20mg for $79. That is way better than $250 for 6 tablets of brand name, isn’t it?
In the end, ED is an embarrassing problem for many men and their spouses. Fortunately there is help out there. If you have any further questions or would like to discuss further natural solutions for this problem, give us a call at 785-614-3492 or send me a text at 785-414-9777.