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Author: Kire Stojkovski M.D
Kire Stojkovski is a practicing medical doctor whose work has been published in some of the most respected medical journals.
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Daniel Boyer is a practicing Doctor of medicine and is passionate about medical research. He specializes in molecular biology, histology, and pharmacology.
Viagra has dominated the world of sexual health medicines since its introduction in the late 90s. As the first FDA-approved pill for erectile dysfunction, it revolutionized the industry and gave hope to millions of men previously left with few options.
However, while Viagra has certainly had a significant impact, it is not without its drawbacks, and many men find themselves seeking alternatives to Viagra for various reasons.
The search for the best Viagra alternatives stems from various individual needs and circumstances. For some men, the high cost of Viagra can be prohibitive, especially considering that insurance companies don’t always cover it.
In response to these needs, a range of Viagra substitutes has emerged on the market, both prescription and over-the-counter, as well as natural Viagra alternatives. This comprehensive guide aims to provide a detailed overview of Viagra alternatives available, helping you to make an informed decision about what may work best for you.
Here is a quick overview of where you can buy the best Viagra Alternatives:
- BlueChew – Best Chewable Alternatives to Viagra
- Hims – Best Viagra Alternatives Overall
- Roman – Best Consultation Service
- RexMD – Best for Free Generic Viagra Samples
- The Phoenix – Best Unique Medical Device
- Eddie by Giddy – Best Non-Drug Viagra Alternative
Understanding Viagra and How It Works
Before diving into the world of Viagra alternatives, it’s important to understand what Viagra is and how it works. Viagra, also known by its generic name sildenafil, is a type of drug called a PDE5 inhibitor. It works by relaxing the muscles in the walls of blood vessels, which increases blood flow to certain areas of the body, including the penis.
This increased blood flow allows men with erectile dysfunction to achieve and maintain an erection when sexually aroused. [1]
Despite its effectiveness, Viagra doesn’t work for everyone. It may not provide the desired results for some men, or the side effects may outweigh the benefits. Additionally, Viagra requires a prescription, which can be inconvenient or even embarrassing for some men. For these reasons, many men seek out Viagra substitutes.
The Drawbacks of Viagra
While Viagra has undoubtedly helped many men regain their sexual function, it’s not a one-size-fits-all solution. One of the main drawbacks of Viagra is its potential side effects. These can range from mild symptoms like headaches, flushing, or stomach upset to serious complications like sudden vision loss or hearing loss.
Some men may also experience an erection lasting longer than four hours, a condition known as priapism requiring immediate medical attention. [1] [2]
Another significant drawback of Viagra is its cost. Without insurance, the price of Viagra can be prohibitively high for many men. Additionally, the fact that Viagra requires a prescription can be inconvenient for some men, especially those who prefer to maintain their privacy or who have difficulty accessing healthcare services.
Finally, Viagra isn’t suitable for everyone. Men with certain health conditions, such as heart disease or high blood pressure, or taking certain medications may not be able to take Viagra safely. For these men, the Viagra alternatives can provide a much-needed solution.
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Prescription Alternatives to Viagra
Fortunately, for those seeking a substitute for Viagra, several prescription Viagra replacements are available that work similarly. These erectile dysfunction pills include Tadalafil, Vardenafil, and Avanafil.
Tadalafil
Tadalafil, known as Cialis, is a PDE5 inhibitor, considered better than Viagra. It increases blood flow to the penis, helping men with erectile dysfunction achieve and maintain an erection. However, unlike Viagra, which lasts for around four to six hours, the effects of Tadalafil can last for up to 36 hours, earning it the nickname “the weekend pill.” [3]
The starting daily dose range is 2.5 to 5 mg, but it can be changed if necessary. You can take it only once a day, with or without food. Tadalafil is also used to treat pulmonary arterial hypertension (PAH) under the trade name Adcirca (tadalafil 20-mg tablets). [4]
Vardenafil
Vardenafil, sold under Levitra and Staxyn, is another PDE5 inhibitor known as knock-off Viagra. It works in the same way as Viagra and Tadalafil but has a slightly different chemical structure. This means that it may work better for some men, particularly those who haven’t had success with Viagra or Tadalafil. Vardenafil typically lasts for about four to five hours.
You should take it 30 minutes to an hour before sexual activity, not more than once daily. The starting dose is 2.5 mg. [5]
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Vardenafil (Staxyn)
Staxyn, another form of vardenafil, is unique in dissolving on the tongue, eliminating the need to take it with water. The tablet is placed on the tongue about an hour before sexual activity.
Avanafil
Avanafil, marketed as Stendra, is the newest PDE5 inhibitor for treating ED. It works like the other drugs in this class but has a faster onset of action, often working within 15 minutes. This makes it a good option for men who prefer not to plan sexual activity in advance. It comes available in doses of 50 mg, 100 mg, and 200 mg. [6]
Where to Buy the Best Viagra Alternatives?
In recent years, several online platforms have emerged that offer convenient and discreet access to replacements for Viagra. These include BlueChew, Hims, Roman, RexMD, The Phoenix, and Eddie by Giddy.
BlueChew – Best for Chewable Alternatives to Viagra
BlueChew is an online service that offers chewable tablets of sildenafil, vardenafil, or tadalafil. According to our BlueChew Review, they provide a discreet, convenient, and affordable way to access these prescription medications without visiting a doctor in person.
BlueChew’s medical providers will assess your needs, prescribe the appropriate medication, and ship directly to your door.
They also offer BlueChew free trial, where you can get one month free for the Active plan or $20 off for any other plan.
- 24/7 US Licensed Medical Providers;
- Rx Consultation;
- Professional Medical Support;
- No Waiting Rooms, No Appointments;
- 30/45 mg Sildenafil, 6/9 mg Tadalafil, or 8 mg Vardenafil Chewable Tablets;
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Hims – Best Viagra Alternatives Overall
Hims is another online platform that offers prescription medications for erectile dysfunction, including sildenafil, tadalafil, and avanafil, according to our Hims ED Review. They also provide a range of other men’s health products and services.
- Free Online consultation with licensed healthcare experts;
- Free Consultation;
- Brand-name and generic Viagra and Cialis;
- Brand name Stendra;
- Video, call, or chat consultations, depending on state regulations;
- Free shipping;
Roman – Best Consultation Service
Roman is an online men’s health platform that offers a range of erectile dysfunction treatments, including alternatives to Viagra, like tadalafil, as well as a range of other men’s health products and services.
- Free online consultation;
- Affordable ED treatments start at just $4 per dose;
- Branded and generic Cialis and Viagra;
- Unlimited follow-ups with US-licensed physicians after prescription;
- Free shipping for 2-4 days;
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RexMD – Best for Free Viagra Samples
RexMD is another online platform offering prescription medications for erectile dysfunction. They offer brand-name and generic versions of substitutes for Viagra, providing a range of options for different budgets.
RELATED: Free Viagra Samples
Like the other services mentioned, RexMD provides a convenient and discreet way to access these medications, with a team of medical professionals available to assess your needs and prescribe the appropriate treatment. They also offer 2-night free Viagra samples.
- Free delivery;
- FDA- approved drugs like Viagra and Cialis;
- Fast consultation with a licensed healthcare expert;
- Two night-free generic Viagra samples;
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The Phoenix – Best for Unique Medical Device
The Phoenix is a unique device that uses low-intensity sound waves to treat ED. This treatment, known as shockwave therapy, effectively improves erectile function in some men. The Phoenix allows men to access this treatment from their homes, offering a non-invasive and drug-free alternative to Viagra and other erectile dysfunction medications.
- 90-day home trial;
- 1-year warranty;
- 24/7 expert help;
- 94% success rate;
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Eddie by Giddy – Best Non-Medical Viagra Alternative
Eddie by Giddy is an FDA-registered class II medical device designed to treat erectile dysfunction. Its primary feature is its unique design that applies pressure to veins, helping maintain an erection without restricting circulation.
- Available in 4 sizes;
- Free resizes;
- Free shipping;
- Stay-Giddy subscription plan;
- 30-day money-back guarantee;
Risk Factors and Side Effects of the Viagra Alternatives
Before deciding on any Viagra substitutes, it’s crucial to understand the potential risks and side effects. ED medications can interact with other drugs, and they can cause serious side effects in individuals with certain health conditions.
You shouldn’t take ED medications if you:
- take nitrates, which are usually prescribed for chest pain or angina;
- have low blood pressure (hypotension);
Additionally, individuals with uncontrolled high blood pressure, liver disease, or on dialysis due to kidney disease may be advised against taking ED medications.
Common side effects of ED drugs include headache, indigestion or upset stomach, back pain, muscle aches, and nasal congestion. In rare cases, some ED drugs can cause a painful erection that won’t go away, known as priapism. If an erection lasts more than 4 hours, immediate medical attention is required. [7]
RELATED: Best ED Pills Online
Natural Viagra Substitutes
Several OTC Viagra alternatives may relieve individuals who cannot or prefer not to take medication for ED. Some of the best pills like Viagra over the counter include:
Dehydroepiandrosterone (DHEA)
Dehydroepiandrosterone (DHEA) is a hormone produced by the adrenal glands. It plays a role in producing other hormones, including testosterone and estrogen. DHEA levels naturally decline with age, and some studies have shown a correlation between low DHEA levels and the development of ED.
The Potential Benefits of DHEA as a natural substitute for Viagra:
Hormonal Balance: DHEA supplementation may help restore hormonal balance in individuals with low levels of DHEA, potentially leading to improved erectile function. By increasing DHEA levels, there is a possibility of positively influencing testosterone and estrogen levels, which can impact sexual health.
Blood Flow and Nitric Oxide: DHEA has been suggested to enhance blood flow and increase nitric oxide production, similar to how Viagra works. Nitric oxide is a key factor in achieving and maintaining an erection as it relaxes the blood vessels in the penis, allowing for increased blood flow.
Psychological Well-being: Some evidence suggests that DHEA supplementation may positively affect mood, overall well-being, and sexual satisfaction. Addressing psychological factors such as stress and anxiety can improve sexual function. [8]
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L-arginine
L-arginine is a semi-essential amino acid, meaning the body can synthesize it but may also be obtained through dietary sources and supplementation. It serves as a precursor for nitric oxide (NO), a molecule that helps relax and dilate blood vessels, facilitating increased blood flow to the penis and supporting erections.
The Potential Benefits of L-Arginine as a natural substitute for Viagra:
Nitric Oxide Production: L-arginine produces nitric oxide, which is crucial in achieving and maintaining erections. By increasing nitric oxide levels, L-arginine can help improve blood flow to the penis, potentially enhancing erectile function.
Vasodilation and Blood Flow: L-arginine promotes vasodilation, relaxing the blood vessels and improving blood flow. This increased blood circulation can improve erectile function by facilitating the delivery of oxygen and nutrients to the penile tissues.
Combination Therapy: L-arginine may be combined with other supplements or medications for enhanced effects. For example, some studies suggest that combining L-arginine with Pycnogenol, a natural plant extract, may have synergistic benefits in improving erectile function. [9]
Red Ginseng
Red ginseng, or Korean or Panax ginseng, is a popular substitute for Viagra over the counter[e]. It is a perennial plant used in traditional medicine for centuries. The roots of the ginseng plant are harvested, steamed, and dried, resulting in a characteristic red color. This process is believed to enhance the therapeutic properties of the herb. [10]
Non-Oral Viagra Alternatives
Non-oral Viagra substitutes offer viable solutions for individuals who cannot or prefer not to take oral medications.
Alprostadil Injections and Suppositories:
Alprostadil is a substitute for Viagra that can be administered directly into the penis through injections or suppositories. It works by relaxing the blood vessels and increasing blood flow to the penis, facilitating an erection.
Alprostadil injections are self-administered using a fine needle, while suppositories are inserted into the urethra using an applicator. These methods provide a localized and efficient approach to achieving and maintaining an erection. [11]
Testosterone Replacement Therapy:
Testosterone is a hormone that plays a crucial role in male sexual function, including the ability to achieve and sustain an erection. Testosterone replacement therapy (TRT) involves the administration of testosterone through various methods such as gels, patches, injections, or pellets.
By restoring testosterone levels to a normal range, TRT can improve erectile function in men with low testosterone levels, enhancing sexual performance. [12]
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Penile Implants:
For individuals who have not found success with other treatments or have severe ED, penile implants can be considered. This surgical procedure involves the insertion of a device into the penis, allowing for an erection to be achieved when desired.
There are two main types of penile implants: inflatable implants and malleable (bendable) implants. These devices provide a long-term solution for ED and can be manually activated to achieve an erection. [13]
Vacuum Erection Devices (VED):
Vacuum erection devices, or penis pumps, are non-invasive devices that create a vacuum around the penis. This vacuum draws blood into the penile tissues, causing an erection. Once an erection is achieved, a tension ring is placed at the base of the penis to maintain the erection.
VEDs are a safe and effective option for individuals who cannot or prefer not to use medication or undergo surgical procedures. [14]
Lifestyle Changes as Substitute for Viagra
In addition to medication and supplements, certain lifestyle changes can help improve sexual function. These include regular exercise, a healthy diet, adequate sleep, stress management, and reduced alcohol and tobacco use. For some men, these changes can be enough to improve erectile function and reduce the need for Viagra or other medications.
Regular Exercise: Get Moving for Better Performance
Engaging in regular exercise is not only beneficial for your cardiovascular health but can also improve your sexual function. Exercise helps promote healthy blood circulation, which is essential for achieving and maintaining an erection.
Doing pelvic floor exercises will help you build up the muscles around the penis. This will make the blood flow to these muscles more easily. Regular pelvic floor exercises can take a few months to see any changes.
Additionally, physical activity releases endorphins, boosting your mood and reducing stress, contributing to a more satisfying sexual experience. Aim for at least 30 minutes of moderate-intensity exercise most days of the week, such as brisk walking, jogging, swimming, or cycling. [15]
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Balanced Diet: Fuel Your Body for Optimal Performance
Eating a balanced diet rich in fruits, vegetables, lean proteins, whole grains, and healthy fats provides the necessary nutrients for sexual health. Certain foods, such as those rich in antioxidants (e.g., berries, dark chocolate) and omega-3 fatty acids (e.g., fatty fish, walnuts), have been associated with improved blood flow and sexual function.
Additionally, maintaining a diet low in processed foods, sugar, and excessive alcohol consumption can positively impact erectile function and overall sexual satisfaction. [15]
Open Communication and Emotional Connection: Strengthen Intimate Bonds
Building and nurturing emotional connections with your partner is crucial for a satisfying sexual relationship. Open and honest communication about desires, boundaries, and concerns fosters understanding and intimacy. You can also talk to a counselor who specializes in sex therapy.
Engage in activities that promote emotional connection, such as spending quality time together, engaging in shared interests, and expressing affection. Building a strong emotional foundation can enhance trust, intimacy, and sexual satisfaction. [15]
Viagra Alternatives: FAQ
This section answers some of the most commonly asked questions about Viagra alternatives.
Are Alternatives to Viagra Safe?
Yes, most Viagra substitutes are safe for most men. However, like all medications, they can have side effects and may not suit everyone. Always consult with a healthcare professional before starting any new medication.
How Can I Get a Prescription For Viagra Alternatives?
You can get a prescription for a substitute for Viagra from a healthcare medical provider. Many online platforms like BlueChew, Hims, Roman, and RexMD also offer online consultations with healthcare professionals who can prescribe these medications.
Are There Natural Alternatives to Viagra?
Yes, several natural alternatives to Viagra can help to improve sexual function. These include herbs like ginseng and maca, supplements like L-arginine and DHEA, and dietary changes such as increasing your intake of foods like dark chocolate and oysters.
Conclusion: Choosing the Best Viagra Alternatives for You
In conclusion, there are several effective Viagra substitutes available, both prescription and over-the-counter, as well as natural Viagra alternatives. The best Viagra alternatives depend on your needs and circumstances.
Whether you choose a prescription medication like Tadalafil or Vardenafil, an over-the-counter product, or a Viagra alternative natural supplement, you must consult a healthcare professional to ensure the treatment is safe and appropriate.
Remember, while Viagra alternatives can help to improve sexual function, they are not a cure for erectile dysfunction. Lifestyle changes like regular exercise, a healthy diet, adequate sleep, and stress management can also play a crucial role in enhancing your sexual health.
In the end, the goal is to find a solution that not only improves your sexual function but also fits with your lifestyle and personal preferences. Doing so allows you to regain sexual confidence and enjoy a satisfying sex life.
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References:
[1] – Hatzimouratidis K. Sildenafil in the treatment of erectile dysfunction: an overview of the clinical evidence. Clin Interv Aging. 2006;1(4):403-14. doi: 10.2147/ciia.2006.1.4.403. PMID: 18046917; PMCID: PMC2699643.
[2] – Ausó E, Gómez-Vicente V, Esquiva G. Visual Side Effects Linked to Sildenafil Consumption: An Update. Biomedicines. 2021 Mar 12;9(3):291. doi: 10.3390/biomedicines9030291. PMID: 33809319; PMCID: PMC7998971.
[3] – Coward RM, Carson CC. Tadalafil in the treatment of erectile dysfunction. Ther Clin Risk Manag. 2008 Dec;4(6):1315-30. doi: 10.2147/tcrm.s3336. PMID: 19337438; PMCID: PMC2643112.
[4] – Henrie AM, Nawarskas JJ, Anderson JR. Clinical utility of tadalafil in the treatment of pulmonary arterial hypertension: an evidence-based review. Core Evid. 2015 Nov 2;10:99-109. doi: 10.2147/CE.S58457. PMID: 26587013; PMCID: PMC4636095.
[5] – LiverTox: Clinical and Research Information on Drug-Induced Liver Injury [Internet]. Bethesda (MD): National Institute of Diabetes and Digestive and Kidney Diseases; 2012-. Vardenafil. [Updated 2017 Aug 2]. Available from: https://www.ncbi.nlm.nih.gov/books/NBK548920/
[6] – LiverTox: Clinical and Research Information on Drug-Induced Liver Injury [Internet]. Bethesda (MD): National Institute of Diabetes and Digestive and Kidney Diseases; 2012-. Avanafil. [Updated 2017 Aug 2]. Available from: https://www.ncbi.nlm.nih.gov/books/NBK548149/
[7] – Sooriyamoorthy T, Leslie SW. Erectile Dysfunction. [Updated 2023 May 30]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK562253/
[8] – El-Sakka AI. Dehydroepiandrosterone and Erectile Function: A Review. World J Mens Health. 2018 Sep;36(3):183-191. doi: 10.5534/wjmh.180005. Epub 2018 May 11. PMID: 29756417; PMCID: PMC6119841.
[9] – Rhim HC, Kim MS, Park YJ, Choi WS, Park HK, Kim HG, Kim A, Paick SH. The Potential Role of Arginine Supplements on Erectile Dysfunction: A Systemic Review and Meta-Analysis. J Sex Med. 2019 Feb;16(2):223-234. doi: 10.1016/j.jsxm.2018.12.002. Erratum in: J Sex Med. 2020 Mar;17(3):560. PMID: 30770070.
[10] – Lee HW, Lee MS, Kim TH, Alraek T, Zaslawski C, Kim JW, Moon DG. Ginseng for erectile dysfunction. Cochrane Database Syst Rev. 2021 Apr 19;4(4):CD012654. doi: 10.1002/14651858.CD012654.pub2. PMID: 33871063; PMCID: PMC8094213.
[11] – Jain A, Iqbal OA. Alprostadil. [Updated 2022 Jul 18]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK542217/
[12] – Barbonetti A, D’Andrea S, Francavilla S. Testosterone replacement therapy. Andrology. 2020 Nov;8(6):1551-1566. doi: 10.1111/andr.12774. Epub 2020 Mar 9. PMID: 32068334.
[13] – Bettocchi C, Palumbo F, Spilotros M, Palazzo S, Saracino GA, Martino P, Battaglia M, Selvaggi FP, Ditonno P. Penile prostheses. Ther Adv Urol. 2010 Feb;2(1):35-40. doi: 10.1177/1756287209359174. PMID: 21789081; PMCID: PMC3126066.
[14] – Hoyland K, Vasdev N, Adshead J. The use of vacuum erection devices in erectile dysfunction after radical prostatectomy. Rev Urol. 2013;15(2):67-71. PMID: 24082845; PMCID: PMC3784970.
[15] – Maiorino MI, Bellastella G, Esposito K. Lifestyle modifications and erectile dysfunction: what can be expected? Asian J Androl. 2015 Jan-Feb;17(1):5-10. doi: 10.4103/1008-682X.137687. PMID: 25248655; PMCID: PMC4291878.
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