Viagra Alternatives: The Latest & Best Options

What can I use instead of Viagra?

If you have found that Viagra isn’t working anymore, or you would like to try a treatment that perhaps lasts longer than Viagra does, there are other options. These include:
 

Tadalafil

Tadalafil, also known by its brand name Cialis, is taken 30 minutes before sexual activity and the effects can last for up to 36 hours. Alternatively, it can be taken as a daily pill, known as tadalafil daily, 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.

Pros:

• Lasts longer than Viagra
• Available as a daily pill which has a continuous window of action
• Not affected by food

Cons:

• It is slightly more expensive than generic Viagra

Price:

• From £8.89/4 tablets

Vardenafil

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

Pros:

• Has a similar window of action to Viagra
• Does not need to be taken on an empty stomach

Cons:

• Slightly more expensive than generic Viagra
• It is not as effective as Viagra

Price:

• From £11.99/4 tablets

Avanafil

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

Pros:

• Fastest acting ED drug
• Not affected by food

Cons:

• More expensive than generic Viagra
• Not as effective as Viagra

Overview of medical substitutes for Viagra

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

Medical alternatives to Viagra

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 Vitaros, 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.

Pros:

• Does not interact with other oral medication
• Few side effects

Cons:

• Not as effective as oral medication

Cost:

• From £65/tube

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.

Pros:

• Works within 5 minutes
• Suitable alternative for those that cannot take oral tablets

Cons:

• Painful
• Cannot be used more than three times a week
• Expensive
• Not as effective as oral tablets

Cost:

• From £18.90/injection

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.

Pros:

• Suitable option for those that cannot use oral tablets
• High success rate

Cons:

• Expensive
• Painful

Cost:

• From £1500

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.

Pros:

• Can address ED without using ED treatment
• Can have a positive impact on sex drive, sleep, mood and energy

Cons:

• Can cause side effects such as hair loss

Cost:

• From £70/month

Cheaper alternatives to Viagra

When you’re buying ED treatments, price is inevitably going to be a considered. 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 versions 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 difference between the two. As sildenafil is not branded, it is usually cheaper than Viagra. In fact, sildenafil is now more commonly used instead of Viagra, as it works in the same way, but at a fraction of the price. 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.

Pros:

• Works in the same way to Viagra

Cons:

• None

Cost:

• From £5.89/4 tablets

Viagra alternatives over the counter

Viagra 50mg tablets can be bought over the counter, under the name of Viagra Connect. It is intended to be a non-prescription substitute for Viagra. It contains the same active ingredient, and works just as well as 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.

Pros:

• Available over the counter

Cons:

• Expensive

Cost:

• From £19.99/4 tablets

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.

Pros:

• Low risk of side effects

Cons:

• No clinical data to prove that they work

Cost:

• Varies

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.

Pros:

• Will contribute to general well being

Cons:

• Will not work where ED is a result of irreversible damage to health

Cost:

• Free

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.

Pros:

• Suitable for those that cannot take oral tablets

Cons:

• Can cause damage such as tissue injury, damage to blood vessels and impaired sensation
• Painful

Cost:

• From £20

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.

Pros:

• Non-invasive
• Low side effects

Cons:

• Unlikely to work for those who have psychological ED
• Not enough evidence to suggest that it works

Cost:

• Free

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.

Pros:

• Can help to address psychological ED without the use of medication or medical devices

Cons:

• Not suited to those who are uncomfortable opening up

Cost:

• From £40/session

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.

Pros:

• Drug-free approach

Cons:

• Not backed by scientific evidence
• Low chance of success
• Painful

Cost:

• From £50/session

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.

Pros:

• Drug-free approach

Cons:

• Can cause tissue damage and scarring
• Not backed by science
• Some healthcare professional advise against this method

Cost:

• Free

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.  

Pros:

• Drug-free approach

Cons:

• Can cause pain if used incorrectly
• Can cause damage

Cost:

• From £10

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.