Most supplements sold for men’s sexual health have weak evidence behind them, and some “herbal” products have been found to contain hidden prescription drugs. If you’re having erection problems, the more useful step is a check-up: erectile dysfunction (ED) can be an early sign of diabetes, high blood pressure or heart disease, and there are proven treatments a doctor can prescribe.
Here’s what the research says about the popular supplements, why “all natural” sex products can be risky, and what actually helps.
What the research says about popular supplements
Ads for “power”, “stamina” and “josh” capsules are everywhere, from TV to Instagram. Very few of the ingredients have been tested properly in people with erection problems. This is where the better-studied ones stand:
| Supplement | What the evidence shows | Notes |
|---|---|---|
| Ginseng (Panax or Korean red ginseng) | A 2021 Cochrane review of 9 trials (587 men) found ginseng may have only trivial effects on erectile function compared with placebo, based on mostly low-certainty evidence | It might slightly improve men’s self-reported ability to have intercourse, but the overall benefit is small |
| L-arginine | A 2019 meta-analysis of 10 randomised trials (540 men) found some benefit in mild to moderate ED | Trials were small and short. Check with your doctor before taking it alongside heart or blood pressure medicines |
| Shilajit, safed musli, tribulus, ashwagandha and mixed “stamina” blends | We couldn’t find good-quality trials showing these treat erection problems | Blends often contain many ingredients in unknown amounts, which makes side effects and interactions hard to predict |
Two things to keep in mind. First, even where a supplement shows a small effect, it hasn’t been compared head to head with the medicines doctors use, which work for many men. Second, supplements don’t go through the same testing as medicines before they’re sold, so what’s on the label isn’t always what’s in the bottle.
For a broader look at herbal and traditional approaches, see our article on alternative medicine for erectile dysfunction. This one focuses on the safety of the pills and powders sold to men, and on what an erection problem may be telling you about your health.
The hidden-drug problem in “herbal” sex products
The US Food and Drug Administration keeps a running list of sexual enhancement products found to contain hidden ingredients. It warns that many products sold to improve sexual function are likely to be contaminated, that they’re often marketed as supplements, foods or “all natural” treatments, and that its list covers only a small fraction of what’s out there. A product not being on the list doesn’t make it safe.
The usual hidden ingredients are sildenafil or tadalafil, the active drugs in prescription ED tablets. Testing studies show how often this happens:
- A 2022 study in the journal Molecules tested 158 sexual enhancement supplements bought in the UAE. About 12.7% contained undeclared sildenafil, and about 14% contained at least one hidden ED drug. Honey-based products were adulterated more often than other forms.
- An earlier study of 85 Indian ayurvedic and herbal aphrodisiac products, published in the Journal of Pharmaceutical and Biomedical Analysis, found one that contained sildenafil, at a full therapeutic dose.
One in 85 may sound low, but think about what it means. If that product “works”, it’s because you’ve taken a prescription drug without knowing it, without a doctor checking whether it’s safe for you.
Why a hidden dose of sildenafil is dangerous
The NHS page on sildenafil says it isn’t usually prescribed with nitrates, such as GTN sprays or tablets used for chest pain (angina), and that combining it with “poppers” raises the risk of serious side effects. It may also not be suitable if you’ve recently had a heart attack or stroke, or have low or uncontrolled high blood pressure. Heart disease and erection problems often go together, so the men most tempted by these products can be the ones most at risk if they unknowingly mix a hidden ED drug with their heart medicines.
Erection problems can be an early warning for your heart
Erections depend on healthy blood vessels. The US National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) says ED may be a symptom of another health problem, and lists diabetes, atherosclerosis (narrowed arteries), high blood pressure and stroke among the common causes. The NHS sildenafil page puts it simply: erection problems can be a sign of conditions such as diabetes or heart problems.
So if you’ve been quietly buying capsules for months, the bigger risk may be what you’re missing. A basic check of blood pressure, blood sugar (fasting glucose or HbA1c) and cholesterol can pick up problems that are very treatable when caught early.
Common causes worth checking
The NHS page on erectile dysfunction notes that most men occasionally fail to get or keep an erection, usually because of stress, tiredness or heavy drinking. When it happens often, causes include:
- high blood pressure, high cholesterol and diabetes
- depression and anxiety, including worry about performance
- hormone problems, such as low testosterone
- side effects of medicines, including some antidepressants and blood pressure tablets
- smoking, alcohol and recreational drugs
Don’t stop a prescribed medicine on your own because you suspect it. Ask your doctor whether a switch is possible. If you’re curious about testosterone, our guide to boosting testosterone naturally covers lifestyle factors; low levels should be confirmed with a blood test before any treatment.
Treatments that actually work
NIDDK lists these treatment options, roughly in the order doctors try them:
- Lifestyle changes: stopping smoking, cutting down on alcohol, being more active, reaching a healthier weight and avoiding recreational drugs. The NHS also suggests a break from cycling if you ride more than 3 hours a week.
- Counselling: helpful when stress, anxiety or relationship problems are part of the picture. Your partner can join sessions.
- PDE5 inhibitor tablets such as sildenafil and tadalafil. These improve blood flow to the penis. Get them through a doctor, who will check your heart, blood pressure and other medicines first.
- Vacuum devices, injections or suppositories when tablets don’t work or aren’t suitable.
- Surgery, such as a penile implant, which most men never need.
The NHS warns that many websites sell fake medicines, so don’t buy ED tablets from unknown online sellers.
How to spot a risky “sex booster”
Be wary of any product that:
- promises results “in 30 minutes” or “lasting 72 hours”; those are drug-like effects
- claims to be “100% herbal” yet works like a prescription tablet
- is sold mainly through social media ads, roadside stalls or unknown websites
- has no clear manufacturer address, licence number or batch number
- is a honey sachet or “energy” product sold for sexual performance
- tells you to keep it secret from your doctor, or has only glowing reviews
If you take any supplement, tell your doctor and pharmacist. Our guide to supplement and medicine interactions explains why.
When to see a doctor
See a doctor (a GP, physician or urologist) if:
- erection problems keep happening for more than a few weeks
- you have diabetes, high blood pressure, high cholesterol, or smoke
- you also have low sex drive, tiredness or low mood
- you think a medicine you take may be the cause
- you’ve taken a sex supplement and feel unwell
Call 112 or go to hospital straight away if you have chest pain, breathlessness, fainting, or sudden weakness on one side of the body, especially after taking an ED tablet or an unknown sex product. Also get urgent help for a painful erection that won’t go down. Not sure whether chest discomfort is serious? Read our guide on gas pain versus heart attack, but if in doubt, call 112.
Frequently asked questions
Are ayurvedic sex supplements safe?
Some are harmless and some may contain hidden prescription drugs. Testing studies have found sildenafil in products labelled herbal, including in India. Buy only from licensed pharmacies and tell your doctor what you take.
Does ginseng help erectile dysfunction?
Barely. A Cochrane review found ginseng may have only trivial effects on erectile function, based on mostly low-certainty evidence.
Is erectile dysfunction a sign of heart disease?
It can be. ED shares causes with heart disease, including narrowed arteries, high blood pressure and diabetes. That’s why a check-up matters more than a supplement.
Can I take a sex supplement with my heart or BP medicines?
Ask your doctor first. A hidden dose of an ED drug can be dangerous with nitrates for angina, and some ingredients can lower blood pressure further.
Do I need a prescription for ED tablets?
Yes, get them through a doctor. A doctor checks your heart, blood pressure and other medicines before prescribing, which protects you from the interactions that make these drugs risky.
This article is for general information and is not a substitute for advice from a doctor. If you have symptoms or a health condition, please consult a qualified healthcare professional.
