From the peaks of the Andes to the very heart of central Africa, mother nature has peppered the globe with a host of natural remedies for erectile dysfunction.
But with so many to choose from – and with so much hearsay surrounding the topic – how do you know which ones really work?
If your head has been left spinning by tall tales, dubious anecdotes, and popular myths, then this article aims to set the record straight.
Maca (also known as Lepidium meyenii and Peruvian ginseng) is a “cultivated root belonging to the brassica family used in the Andean region for its supposed aphrodisiac properties.” In other words, it helps to put the motion in your ocean - though it’s still not clear exactly how it works.
How effective is Maca?
A study found that men affected by mild erectile dysfunction (ED) saw an improvement in their erections after being treated with maca. In a glorious trinity of sexual wellbeing, maca increased the men’s psychological, physical, and social satisfaction after twelve weeks of treatment.
But before you scramble to the Andes to frantically harvest maca, it should be noted that this trial used a relatively small sample size. Only 50 men were tested – and these men were only affected by “mild” erectile dysfunction.
How safe is Maca?
Reported side-effects from maca ingestion include moodiness, cramps, gastritis, and insomnia.
L-citrulline (also known as citrulline and citrulline malate) is a naturally-occurring amino acid that helps to improve blood flow to the penis. It is converted to L-arginine in the body, which is then used to create nitric oxide – an essential molecule needed to allow blood vessels to relax, allowing for a healthy erection.
How effective is L-citrulline?
Evidence shows L-citrulline can restore the erections of those with mild ED. In a trial consisting of 24 men, 50% of the men regained normal erectile function after taking L-citrulline.
How safe is L-citrulline?
Although one paper reports L-citrulline is “less effective than phosphodiesterase type-5 enzyme inhibitors” (like sildenafil and tadalafil), it concludes that “L-citrulline supplementation has been proved to be safe and psychologically well accepted by patients”.
If sildenafil and tadalafil are the trendy, fresh-faced poster-boys of male sexual enhancement, then Panax ginseng (also known as Korean ginseng or red ginseng) is the wise, grey-bearded grandfather.
Its supposed adaptogenic qualities have been used for 2000 years to boost everything from concentration to sexual stamina - and recent clinical studies are finding new evidence to support the latter.
How effective is Panax ginseng?
Panax ginseng has been found to increase penile rigidity, girth, and duration of erection in men with ED. Amongst its erection-enhancing qualities, it has also been shown to boost libido and satisfaction. More evidence is needed to determine how effective Panax ginseng is for treating ED, however, as the current evidence comes only from small trials.
How safe is Panax ginseng?
Caution is advised when using Panax ginseng in combination with certain pharmaceuticals such as warfarin, oral hypoglycemic agents, insulin, and phenelzine - best to talk to your doctor before trying it out.
Propionyl-L-carnitine (also known as Glycine Propionyl-L-Carnitine) is a naturally occurring amino acid found in the body. It’s thought to help treat erectile dysfunction by helping blood vessels to relax.
How effective is Propionyl-L-carnitine?
In summary - it’s something to consider for people with diabetes, where sildenafil doesn’t seem to have worked: a study discovered taking propionyl-L-carnitine (PLC) in combination with sildenafil was more successful in treating patients with both ED and diabetes than sildenafil alone.
How safe is Propionyl-L-carnitine?
The propionyl-L-carnitine and sildenafil combination had one small drawback: two patients reported mild gastric pain after taking the two together.
Perhaps the most exotic-sounding addition to our list, yohimbe (also known as yohimbine) is an extract of the bark of the central African tree Pausinystalia yohimbe.
Given its natural and tropical origins, you may be tempted to over-romanticise this particular natural erectile dysfunction curet. However, its effectiveness as a treatment is relatively, ahem, anti-climactic.
How effective is Yohimbe?
Not very. Only a handful of men have claimed yohimbine had any significant impact on their erections. Amongst the men who reacted positively to yohimbe, only a fraction of them (5%) reported being completely satisfied with the results.
How safe is Yohimbe?
Again, not very. The reported side effects of over-the-counter preparations of yohimbe include gastrointestinal upset, anxiety, increased blood pressure, headache, agitation, rash, fast or irregular heart rate and frequent urination.
Horny goat weed
Another natural erectile dysfunction treatment that has its roots buried in ancient tradition is the aptly-named horny goat weed.
Horny goat weed (also known as barrenwort, yin yan huo, and Epimedium grandiflorum) hails from the Berberidaceae family of plants. Its aphrodisiac properties were discovered (and legendary name coined) after a Chinese goat herder noticed his goats became particularly randy after eating the plant.
It is believed that the active ingredient in horny goat weed is icariin, a flavanol glycoside. Icariin has been shown to increase the production of nitric oxide in the penis (a key molecule for stimulating erections) and inhibit PDE5 – the enzyme that causes an erection to subside.
How effective is horny goat weed?
Surprisingly, there are no published studies on the effectiveness of horny goat weed on humans. There are, on the other hand, studies highlighting its efficacy on rats. Icariin has been shown to effectively treat ED in aged, diabetic, and even castrated rats.
How safe is horny goat weed?
As of yet, there have been no long-term toxicity studies for horny goat weed (or icariin) in any animal species. Until more is known, consult your doctor before attempting to treat your ED with horny goat weed.
The science behind natural remedies for erectile dysfunction: the final word
Scientific studies that investigate the effectiveness of natural remedies for erectile dysfunction can be helpful when it comes to dispelling common myths about ED.
But even they should be taken with a pinch of salt.
Sizing up sample sizes
Most of these studies are conducted with only a small number of participants. These small sample sizes make it challenging to know just how effective a natural cure for erectile dysfunction really is.
Larger secondary studies (such as systematic reviews and meta-analyses) give a more accurate picture of how efficacious a treatment might be.
For example, one landmark study which reviewed 6659 men in total revealed that sildenafil was an effective treatment for ED. 78% of men reported improvements in their erections, and 57% were able to successfully have penetrative sex.
Studies with larger sample sizes give more reliable evidence - and this is important when it comes to choosing the right ED therapy for you. To put it in perspective: the sample sizes for the natural erectile dysfunction treatment options explored in this article range from just 18 to 215 patients.
The bottom line
When considering natural remedies for erectile dysfunction, take into account that there is limited scientific evidence backing up their effectiveness. And remember: just because it’s natural, doesn’t mean it’s safe. It’s always worth speaking to your doctor about possible interactions with other medicines and side effects of natural supplements before you start taking them.
Nevertheless, it’s always good to know about all the options available - so you can take the right steps to make the right choices for you.
Feature Image: iStock/Madeleine_Steinbach