Viagra Alternatives

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Viagra is probably the best-known ED treatment. It was the first ED drug that hit the market in 1998. Since then, it has been proven to be safe and effective for millions of men. It contains the active ingredient, sildenafil citrate; and is often referred to as the “blue pill”.

Newer medications have subsequently joined the ED arena to help men achieve and maintain erections. Each has subtle differences. Compared to Viagra, some medications work quicker; last longer; are not affected by food; and do not cause side effects such as headaches that are associated with Viagra. There are also alternatives which can be taken daily to provide a continuous solution to ED.

No erectile dysfunction treatment is better than the other. Each has its pros and cons, and your GP or pharmacist can advise on which would suit you and your lifestyle best.

 

Medical Viagra substitutes

You can try medical alternatives to Viagra if Viagra does not suit your lifestyle or is not working as well as you want. Like sildenafil, they work by improving blood flow to the penis. These include:


Tadalafil

Tadalafil, also known by its brand name Cialis, is taken 30 minutes before sexual activity and can last for up to 36 hours. Alternatively, it can be taken as a daily pill to allow for more sexual spontaneity. Tadalafil reviews and scientific research indicate that it is a highly effective treatment. It has been dubbed as the best alternative to Viagra (sildenafil).


Vardenafil

Vardenafil, also known by its brand name, Levitra, is taken around 25 minutes before sexual activity, and similar to Viagra, effects can last around 4 to 6 hours. It is the recommended option for diabetics.


Avanafil

Avanafil, also known by its brand name Spedra, is effective in as little as 15 minutes and usually lasts around four hours.

 

Overview of medical substitutes for Viagra

 

Vardenafil (Levitra)

Tadalafil (Cialis) 36-hour

Tadalafil (Cialis) Daily

Spedra (Avanafil)

Price

Prices from £11.99

Prices from £8.89

Prices start from £19.45

Prices start from £16.45

Strengths

5mg, 10mg, 20mg

10mg, 20mg

2.5mg, 5mg

50mg, 100mg, 200mg

Dose

Take around 25 minutes before sex

Take around 30 minutes before sex

To be taken daily

Take around 15 minutes before sex

Duration of action

Lasts for 4-6 hours

Lasts for up to 36 hours

Continuous effect when there is sexual stimulation

Lasts for up to 4 hours

Time taken to work

Works within 25 minutes

Works within 20-30 minutes

Works spontaneously upon sexual stimulation

Works within 15-20 minutes

How it is taken?

Can be taken with or without food

Can be taken with or without food

Can be taken with or without food

Best taken on an empty stomach 

Side-effects (common)*

Headache, facial flushing, nasal congestion

Headache, facial flushing, nasal congestion

Headache

Headache, facial flushing, nasal congestion

Prescription required?

Yes 

Yes

Yes

Yes

Unique selling points

  • Effective for diabetics
  • Available as multiple strengths
  • Fast acting
  • Has a long duration of action
  • Do not need to schedule sexual activity
  • Mild side-effect profile
  • Fast onset of action

*For a full list of side-effects, please consult product literature

 

Other medical alternatives

There are other alternatives to Viagra, which do not involve taking an oral pill. These are available by prescription only, or via a medical professional, such as a pharmacist. They include:


Alprostadil cream

Alprostadil cream, also known by its brand name Viatros, is applied to the opening at the top of your penis. Alprostadil is a synthetic hormone that widens your blood vessels and improves blood flow to your penis. This cream takes 5 to 30 minutes to work and lasts for up to 2 hours. It is usually only recommended if you have already tried other forms of ED treatment. Pain in the penis is a common side effect. You should not use more than one dose a day and more than 3 doses a week.


Alprostadil injections

Alprostadil injections are given at the base of your penis. You will be shown how to do this by a nurse or doctor who gives you your first injection. You start on a small dose and can gradually increase it if needed. An injection of alprostadil takes around 15 minutes to work and lasts for about 1 hour. You should not administer more than one injection a day and more than 3 injections a week. Alprostadil injections contain the alprostadil hormone to widen your blood vessels and improve blood flow to your penis. It can cause pain in your penis.


Penile implants

A penile implant, also called a penile prosthesis, is a treatment for ED that is usually recommended if you have tried other ED treatments without success. It involves surgery to place inflatable or flexible rods into your penis. Inflatable rods have a mechanism filled with saline solution and a pump concealed in your scrotum. You press the pump to allow saline solution to travel to the device, which inflates to give you an erection. Afterwards, the device can be deflated.


Testosterone replacement

Testosterone replacement therapy (TRT) is an ED treatment for men with a low testosterone level, known as hypogonadism. TRT aims to restore your testosterone levels to normal. It is a lifelong treatment and may take from 4 weeks to several months to see ED improvement. TRT can be administered in several ways including injections, gels, creams, pills, and implants, with differing strengths that last varying lengths of time and are given at different time intervals. Before commencing testosterone therapy, you will need a blood test to confirm whether low testosterone levels may be causing ED.

 

Cheaper alternatives to Viagra

When you’re buying ED treatments, price is inevitably going to be a considering factor. Brand name Viagra might have once been the go-to treatment for ED treatment. However, since the expiry of Viagra’s patent, other drug companies have been able to manufacture non-branded version of the drug, using the same active ingredient, sildenafil citrate.

Sildenafil tablets are the unbranded version, often referred to as generic Viagra. Both Viagra and sildenafil (generic Viagra), have the same active ingredient, so there is no clinical difference between the two. As sildenafil is not branded, it is usually cheaper than Viagra. In fact, sildenafil is now more commonly used than Viagra as it works in the same way, but it is available as a lower cost to the consumer. By the same token, Viagra is restricted for NHS patients due to its higher cost in comparison to the generic version. 

The same rings true for other medical Viagra substitutes in pill form. The generic drugs tadalafil and vardenafil, are proven to be as effective and cheaper than their branded versions of Levitra and Cialis.

 

Viagra alternatives over the counter

Viagra 50mg tablets can be bought over the counter for ED treatment under the name of Viagra Connect. It is intended to be a non prescription substitute for Viagra.

In 2017 Viagra Connect was reclassified from a “Prescription Only Medication” to a “Pharmacy” medication. This means that Viagra Connect is available at all UK online and high-street pharmacies after a consultation with a pharmacist. The decision to make Viagra Connect a non-prescription ED treatment was made to increase awareness of ED; encourage men to proactively seek help for this problem that affects many men; and reduce the purchase of non-regulated alternatives, such as Kamagra.

 

Natural alternatives to Viagra

There are many natural herbal alternatives to Viagra that are available over-the-counter. However, many of these options have not been fully tested and lack in scientific research to prove that they help with ED.


DHEA

Dehydroepiandrosterone (DHEA) helps create sex hormones including testosterone. There is some evidence that DHEA helps erectile dysfunction in men. It appears to be safe in low doses, but it can cause acne.


Horny goat weed

Substances in the leaves of this herb have been shown to give small improvements to erectile dysfunction, as well as aphrodisiac effects when tested on animals. It is thought that icariin, the chemical in horny goat weed, acts as a PDE5 inhibitor (like Viagra). There are no high-quality human studies. Horny goat weed should be taken with caution as it can affect the heart or breathing functions.


Ginseng

Certain chemicals in Ginseng may promote the relaxation of your body’s smooth muscles and help produce an erection. There is one study of Panax ginseng that showed it improved sexual function in men with ED. It appears to be safe on a short-term basis, but insomnia, headaches and vertigo are common side effects.


L-arginine

There is some evidence that high doses of L-arginine improve ED by stimulating blood vessels to open wider and improve blood flow. There are some side effects of L-arginine including nausea, cramps, and diarrhoea, and it should not be taken with sildenafil.

 

Non-medical alternatives to Viagra

There are other non-medical alternatives to Viagra to treat and potentially cure ED.


Lifestyle changes

Certain lifestyle factors increase your chances of developing ED. Therefore, it follows that managing these risk factors can reduce your risk of developing erectile dysfunction and possibly reduce their effects on ED. Lifestyle changes you may consider include:

Losing weight

There are many scientific studies that show that losing weight can help improve sexual function or reverse ED. Men with a BMI over 30 may significantly improve their ED symptoms by losing weight.

Quitting smoking

Men who smoke are more likely to suffer from ED. Smoking damages blood vessels and nicotine may reduce blood flow to your penis. Stopping smoking can help improve ED.

Improving diet

Eating a balanced diet with plenty of natural foods like fruit, vegetables, whole grains and fish, and fewer red and processed meats and refined grains decreases your likelihood of ED. Flavonoid-rich foods found in blueberries, blackberries, and strawberries, as well as cherries, grapes, apples, pears, and citrus fruit, may lower your risk of ED.

Good sleep

A lack of sleep and disrupted sleep have been linked to a higher risk of ED. Sleep deprivation and poor quality can change the levels of a man’s hormone, testosterone, and lead to ED.

Exercise

Regular physical activity can improve your circulation and cardiovascular health. This means your heart can pump blood more efficiently and improve ED. Exercise also helps maintain a healthy body weight and reduce stress.   

Reducing stress

Stress can cause ED. It can also lead to further anxiety about ED. Reducing stress through mindfulness, meditation, counselling, or Cognitive Behavioural Therapy (CBT) can help reduce ED.

Less porn

There is some evidence to suggest that watching too much pornography can lower a man’s libido and cause problems with their sexual performance, such as erectile dysfunction.


Penis pumps

Penis pumps, also called vacuum pumps and vacuum erection devices, are generally safe ED treatments that help draw blood into your penis and strengthen your erection. Penis pumps are less expensive than many other ED options. They can cost from £15 to £100. It is common practice to use penis pumps alongside ED medication, like Viagra.


Pelvic floor exercises

Pelvic floor exercises can strengthen the muscles responsible for sustaining blood flow to your penis. This helps you to get and maintain erections to treat ED. Pelvic floor exercises can be very effective in treating ED. Your costs involve an initial exercise advice session of around £250, and a set of practice sessions of around £150 per session for 6 to 8 sessions. You need to commit time to do your pelvic floor exercises. They should be done a few times each day for best results and continued for your lifetime. It can take 4 to 6 weeks to see a difference in your erections.


Sex therapy

Several studies have found that sex therapy can improve erectile dysfunction. You can have sex therapy on your own or with your partner. It helps you to identify whether your ED is psychological, and it supports you to practically work through any issues. Sex therapy is particularly useful for men with ED caused by stress, sexual performance anxiety, relationship problems and poor sexual communication. It can also cause significant improvements in your sex life and relationship. This therapy is provided over time and therefore the results are not instantaneous. Sex therapy costs £50 to £120 per session and may be cheaper for online therapy. Your costs depend on the number of sex therapy sessions you need.


Acupuncture

Acupuncture may help to stimulate energy imbalances and relieve physical symptoms such as ED. There is some research to suggest that acupuncture may be effective in treating ED. However, this is not proven by conclusive studies and have mainly focused on ED caused by psychological issues and not physical concerns. Acupuncture treatments are generally reasonably charged at anything from £35 to £100 and upwards. Your costs will depend on the number of sessions you require.


Jelqing

Jelqing is an ancient Arabic penile massage technique. It aims to stretch and lengthen your penis and achieve harder erections. It is non-invasive and low-cost but also scientifically unproven to have any effects. Usually, jelqing is done for 5 to 20 minutes, several days a week. These penis-stretching exercises can cause side effects including bruising, pain, and fibrosis.


Penis rings

Penis rings are bands that fit around the base of your penis to help maintain an erection. They help to maintain the blood supply during an erection, reducing the drainage of blood whilst they are being used. Research indicates that using penis rings with ED medications, ED devices or vacuum pumps can significantly improve erectile function. It is not advisable to wear a penis ring for longer than 20 minutes. Cutting off blood flow to your penis for too long could cause damage. There are many types of penis rings. They are typically cheap to buy and start from £5 up to around £30.  

 

So, what are the Viagra alternatives?

Erectile dysfunction (ED) is a common sexual problem affecting many men. Whilst Viagra has revolutionised the treatment of ED, it has some drawbacks and is not suitable for everyone. Men may seek alternatives before deciding on their preferred ED treatment, or if Viagra is not working for them. Natural substitutes and certain techniques are not proven, and are not included in any official medical frameworks or guidelines for treating ED. It is important to research these alternatives and seek medical advice from a medical professional. You should not attempt to treat ED by yourself, without speaking to your doctor or pharmacist.  

In summary, 12 Viagra alternatives include:

  1. Different medication – alternative pills to treat ED including unbranded versions such as Sildenafil that offer a cheaper option and non-prescription Viagra Connect.
  2. Alprostadil cream – placed on the top of your penis to improve blood flow.
  3. Alprostadil injections – injected at the base of your penis.
  4. Penile implants - surgery to place inflatable or flexible rods into your penis.
  5. Testosterone replacement – life-long treatment that restores testosterone levels to normal.
  6. Natural alternatives available at health shops - over-the-counter herbal treatments.
  7. Lifestyle changes - changes in your lifestyle, such as diet, exercise, sleep, stress, and weight loss may see your ED improve.
  8. Penis pumps – help bring blood into your penis and strengthen erections.
  9. Physical training - can benefit ED by improving blood pressure, blood flow, mood, and stamina. Pelvic floor exercises target the muscles at the bottom of your pelvis and prevent blood from flowing out from an erect penis.
  10. Sex therapy – talking therapy and practicing techniques and strategies to improve your ED.
  11. Acupuncture – Chinese medicine to relieve body imbalances that may relieve ED.
  12. Techniques using jelqing motions and penis rings – jelqing massage and penis rings may help ED.

Whilst all of our content is written and reviewed by healthcare professionals, it is not intended to be substituted for or used as medical advice. If you have any questions or concerns about your health, please speak to your doctor.