Herbal Viagra: Does Any Herb Work, and Is It Safe?

No herb has been shown to work like Viagra. Products sold as "herbal Viagra" or "natural Viagra" are food supplements, not medicines. Trials of herbs such as ginseng, horny goat weed and yohimbe show weak or mixed results at best. Some of these pills have also been found to contain sildenafil (the drug in Viagra) or similar drugs that are not on the label.

In the UK, sildenafil is mainly a prescription-only medicine. The exceptions are Viagra Connect and generic sildenafil 50mg, which a pharmacist can supply as a pharmacy (P) medicine after a consultation. Putting sildenafil in a supplement is illegal.

If you have been wondering about a herbal route because seeing a doctor feels awkward, you are not alone. There are discreet, tested options, covered below.

What is in these products, and do they work?#

"Herbal Viagra" is not one product. It is a loose label for any over-the-counter pill, powder or drink sold for erections. The ingredients vary a lot between brands, and the amounts often vary between batches.

Two systematic reviews are worth knowing about. A review of red ginseng found hints of benefit, but the trials were small and poorly designed. A wider review of herbal and alternative ED remedies reached a similar view: some signals, but low-quality evidence and no product ready to recommend over tested drugs.

Stories about Vuka Vuka in Zimbabwe, Ferula hormonis in Lebanon and other traditional remedies make good reading. They are folklore, not evidence. No trial has shown any of them beats a placebo for ED.

Why herbs do not act like sildenafil#

When you are aroused, your body releases a chemical signal (cGMP) that relaxes the blood vessels in the penis. An enzyme called PDE5 breaks that signal down. Sildenafil blocks PDE5, so the signal lasts longer and blood flow improves. It only works with sexual arousal.

Horny goat weed contains icariin, which blocks PDE5 weakly in the lab. The amount in a capsule is small and not standardised. Ginseng and L-arginine may nudge nitric oxide levels slightly. Yohimbine works differently: it acts on nerve receptors and raises adrenaline-like activity. That is why it can cause anxiety and a racing heart.

How often do these pills hide real drugs?#

More often than most people expect. Looking back over about ten years of US regulator warnings about supplements with hidden drugs, almost half involved sexual enhancement products. Sildenafil and tadalafil copies were the most common finds.

The UK has the same problem. The MHRA regularly seizes illegal and fake ED tablets sold online and through shops and social media. You can't tell by looking. A product can show a long list of herbs and still contain a full dose of sildenafil, or a lab-made copy that has never been tested in people.

Why hidden sildenafil is dangerous#

The biggest risk is nitrates. These include medicines for angina and heart disease, such as GTN spray and isosorbide mononitrate, and recreational nitrates such as poppers (amyl nitrite). Taken with sildenafil or tadalafil, any of these can drop your blood pressure sharply, causing collapse, a heart attack or a stroke. Supplements that lower blood pressure, such as L-arginine, can add to this effect, so check with a pharmacist or GP before combining them with these medicines.

With a prescribed medicine, a pharmacist or prescriber checks for this first. With a hidden ingredient, nobody does. Other risks of hidden drugs include:

• Doses far above the licensed 25mg to 100mg range
• Untested copies with unknown side effects
• Problems for men taking alpha-blockers, some blood pressure tablets or riociguat
• Men with heart disease taking a drug that strains the heart without knowing it

How to spot a dodgy product#

Be wary if the product:

• Says it "works like Viagra" or "better than Viagra" (a food supplement can't claim to treat ED)
• Has no full ingredient list, or hides behind a "proprietary blend"
• Shows no UK address and no way to contact a pharmacist
• Has no Traditional Herbal Registration (THR) number. A THR product has been checked for quality and safety, but THR covers minor conditions, and ED needs a diagnosis, so don't expect a registered herbal for it
• Is sold in a corner shop, on a marketplace or by a social media seller
• Needs no questions about your health

For an online pharmacy, check it is on the General Pharmaceutical Council (GPhC) register and shows the registered pharmacy logo, then click the logo to confirm it links to the register.

If you have already taken one#

You can't know the dose or what else was in the pill, so don't assume it is harmless. Some people, particularly those who take nitrates or have heart problems, may not feel a reaction straight away. Watch yourself closely for the next few hours, and if you take nitrates or have heart disease, speak to a pharmacist, NHS 111 or your GP promptly even if you feel fine.

Call 999 or go to A&E if you have chest pain, fainting, severe dizziness, sudden loss of vision or hearing, or an erection lasting more than 4 hours. Tell the staff exactly what you took. Keep the packet and any leftover pills.

For milder problems such as headache, flushing, a racing heart or anxiety, stop the product and speak to a pharmacist or GP. Report suspected side effects from any supplement or medicine through the MHRA Yellow Card scheme. Also tell your GP if you take regular medicines, particularly nitrates, blood thinners or blood pressure tablets, before trying any herbal product.

What to do instead#

ED is common. It can also be an early sign of heart disease, diabetes, low testosterone or a side effect of another medicine. A GP check is worth having whatever treatment you pick. If you are aged 40 to 74 in England, you can also ask about an NHS Health Check.

There are several routes to treatment:

• Pharmacist: Viagra Connect (sildenafil 50mg) has been available without a prescription since 2018, after a pharmacist asks about your heart, blood pressure and medicines. It isn't suitable if you take nitrates or have certain heart, liver, kidney or eye conditions. See our Viagra Connect guide.
• GP: Your GP can prescribe generic sildenafil or tadalafil. On the NHS this is limited to some groups, such as men with diabetes or after prostate surgery. Others may get a private prescription.
• Online prescriber: A UK-regulated online pharmacy asks the same health questions and posts the medicine to you in plain packaging. Your data is protected under UK GDPR. At Totiva, generic sildenafil starts from £1.37 a tablet in the 16 x 50mg pack (£21.99), while a 4 x 50mg pack costs £6.99 (£1.75 a tablet). Viagra Connect starts from £4.00 a tablet.

These medicines have decades of trial data behind them. Many men with ED find sildenafil or tadalafil helps. You can read about the risks of illegal alternatives in our guide to Kamagra oral jelly.

Lifestyle changes also help and work alongside medicines. Regular exercise, losing excess weight, stopping smoking, cutting back on alcohol and sleeping better all improve erections. Pelvic floor exercises have some trial support. If stress, anxiety or relationship worries play a part, talking therapy can help too.

If you would rather skip the supplement aisle, you can start a free online ED consultation and only pay if a UK prescriber approves treatment.