Viagra Alternatives & Substitutes: Beyond the Little Blue Pill

ED is far more common than you might think, but embarrassment to admit to the condition forces a lot of people to suffer in silence. A 2020 study found that upwards to 48% of men experience erectile dysfunction. Almost half!

The good news is that there are treatments for ED, such as the popular medication Viagra.

While Viagra is the most well-known erectile dysfunction treatment, as well as the first prescription ED treatment to hit the markets, there are also a number of Viagra equivalents available.

Understanding what erectile dysfunction is can help you, and a healthcare practitioner from Felix, identify the best treatment option for you.

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What is erectile dysfunction?

Erectile dysfunction (ED) is a clinical condition that is defined as persistent, recurrent difficulty getting and/or maintaining an erection. It’s common for many individuals to experience erectile dysfunction at some point in their lives. For some, it may resolve on its own over time.

There are a lot of misconceptions about erectile dysfunction, and 75% of all people experiencing ED symptoms are dealing with their condition alone.

Even if you don’t suspect there’s any underlying issue, it’s always best to contact a healthcare practitioner, if you start to experience any of the symptoms of erectile dysfunction.

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7 Doctor-recommended Viagra alternatives

Viagra is the brand name of the generic medication, sildenafil. It was also the first prescription oral treatment used for erectile dysfunction.

Viagra is part of the PDE5 inhibitor family of medications, meaning that it promotes both muscle relaxation and better blood flow, which encourages an erection with sexual stimulation

It’s important to note that Viagra doesn’t increase sexual drive. It only helps you get and maintain an erection, in combination with stimulation. It won’t cause unwanted erections, like some films and television shows have implied in the past.

There are some common side effects of Viagra, which can include:

• Dizziness
• Headache
• Flushing (normally in the face)
• Nausea or indigestion
• Blurred vision
• Changes in vision colour
• Runny nose
• Sinus congestion
• Sore throat

Should you start to experience any serious side effects, it’s important to talk to your healthcare practitioner right away, or seek immediate medical attention.

If you’d prefer an alternative Viagra replacement, either because you’d like a different option, or your healthcare practitioner from Felix thinks another medication would be a better solution, there are plenty of doctor-recommended alternatives to Viagra.

You might be wondering, “what works like Viagra?” Here are seven of the most commonly suggested Viagra substitutes:

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1. Levitra

Levitra is another prescription oral treatment Viagra substitute, which is a PDE5 inhibitor. Levitra is the brand name for the generic medication vardenafil.

Despite the popular myth that oral medications can cause an erection, without sexual stimulation, you don’t have to worry about unwanted erections. Levitra requires stimulation in order to cause an erection in patients.

Some of the common side effects of Levitra include:

• Nasal congestion
• Indigestion
• Dizziness
• Headaches
• Flushing (usually in the face)

Even if your side effects aren’t severe, it’s a good idea to talk to your healthcare practitioner about any Levitra side effects you experience. They may want to adjust your dosage or suggest alternative pills like Viagra for you to try.

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2. Staxyn

Staxyn is the brand name for the generic medication vardenafil; another Viagra equivalent.

Staxyn is also a PDE5 inhibitor, as it’s simply vardenafil under a different brand name than Levitra. Side effects are primarily the same as with Levitra, but for clarification, these include:

• Nasal congestion
• Indigestion
• Dizziness
• Headaches
• Flushing (usually in the face)

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3. Cialis

Cialis, another of Viagra’s competitors, is the brand name version of a generic medication called tadalafil. Tadalafil also belongs to the family of PDE5 inhibitor medication. As with most Viagra like pills, Cialis requires a prescription to access.

In addition to ED, Cialis is also used to treat symptoms of benign prostatic hyperplasia (BPH), which is the same as an enlarged prostate. It works to help relieve frequent urination, painful urination, and reduce the chronic urge to pee.

The common side effects of Cialis include:

• Dizziness
• Headache
• Flushing (usually in the face)
• Upset stomach
• Blurred vision
• Changes in vision colour
• Runny
• Sinus congestion
• Sore throat
• Muscle aches
• Back pain

If you start to experience any serious side effects of Cialis, or any Viagra replacement medication, you should talk to your healthcare practitioner right away, or seek immediate medical attention.

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4. Intracavernosal injection

Not everyone responds well to PDE5 inhibitors. An intracavernosal injection (ICI) is a self-injection therapy, where you inject the medications that help achieve an erection directly into your penis.

While the idea of a needle directly into your penis might be off-putting, ICI is an extremely effective treatment for ED; particularly for those who’ve found Viagra substitutes and natural alternatives to Viagra ineffective for treating their erectile dysfunction.

As with any medication, ICI isn’t right for everyone. If you have motor problems that affect the motor control in your hands, ICI might not be the best choice for you.

Uncontrolled high blood pressure (hypertension) also increases your risks of adverse reactions when taking an ICI. If you’re taking MAO inhibitors, ICI may not be a safe option for use. Be sure to talk to your healthcare practitioner at Felix about these risks, if you’re considering ICI treatments instead of oral pills like Viagra.

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5. Penile implants

Generally reserved for individuals who haven’t had success with brands like Viagra, or any other type of treatment, a penile implant is a surgical option that can be used as a last resort.

The penile implant can be either a malleable or inflatable device, which changes in size. This involves manual activation through the use of a pump or malleable rod.

Unfortunately, implant devices don’t last forever. In most cases, penile implants have to be replaced around every 10 years or so.

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6. Hormone therapy

Sex hormones play an integral role in erectile dysfunction, and they can either be helpful or inhibiting, depending on your hormone levels. When you talk to a healthcare practitioner, they may suggest a blood test to determine if you’re experiencing any endocrine (hormonal) issues.

Having balanced endocrine levels is important for many parts of our daily lives, including being able to participate in sexual activities. Levels that are too low can end up leading to issues like erectile dysfunction, without some kind of hormone treatment plan.

During your consultation with your healthcare practitioner, they’ll go over all the aspects that could be contributing to your challenges, including hormones. This will be part of their assessment, when they ask you about your medical history and current medical needs.

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7. Counseling

Stress and anxiety can have a significant impact on sexual activities. Performance anxiety in particular is a cyclical issue, where the fear of being unable to perform actually reduces a person’s ability to get or maintain an erection.

Thankfully, this can be addressed through talk therapy. Whether it’s performance anxiety, life stressors, or even past trauma, there are a myriad of psychological challenges that can lead to ED.

Confronting these issues, and finding healthy coping mechanisms for those feelings can have a very positive impact on erectile dysfunction symptoms.

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Important Lifestyle changes

Lifestyle changes are usually doctor recommended alongside other treatments, like alternatives to Viagra (i.e., Cialis, etc.). However, these changes can also be recommended as the primary treatment of erectile dysfunction.

These types of lifestyle changes could include things like:

• Quitting smoking
• Reduce alcohol consumption
• Reduce cannabis use
• Quitting illicit drugs
• Reducing life stressors
• Making positive dietary changes
• Exercising more often or for longer periods of time

Regardless of whether you’re taking pills like Viagra, healthier lifestyle choices are almost always beneficial for you. In turn, you may be less likely to experience ED symptoms in the first place.

Other Viagra alternatives

There are other alternatives to pills like Viagra, which are available without a prescription. These treatments also don’t involve surgery or pharmaceutical interventions.

When it comes to other alternatives to treating erectile dysfunction, it’s always best to have a chat with your healthcare practitioner from Felix.

Some treatments that you read about online may not have any empirical evidence that they do work, and if done without proper supervision or instruction, could do more harm than good. Others are believed to potentially help, but it isn’t understood yet why these treatments may help with ED.

What’s best for you will really depend on what your healthcare practitioner believes is the best option for you, based on your medical history and current health needs. Here are a few alternatives that could be suggested:

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1. Acupuncture

Acupuncture is a form of traditional Chinese medicine that is used for a variety of ailments, erectile dysfunction being one of them. In fact, its use is on the rise in North America. Acupuncture is performed by stimulating ‘acupoints’ with fine needles, an electrical current, or localized injections.

It needs to be performed by someone with training in acupuncture medicine, and who is licensed to practice in Canada. The exact mechanisms of how acupuncture works are not entirely clear, but research indicates that it stimulates nerves, which help produce chemicals that reduce ED symptoms.

In addition to noting that there is no concrete evidence that acupuncture will function to help, it’s important to note that there are few adverse side effects connected with acupuncture. These include:

• Indigestion 
• Dizziness
• Dry mouth
• Facial redness
• Localized pain and/or irritation

If you’re considering acupuncture for erectile dysfunction, this is something you should speak with your healthcare practitioner about, before you try it for the first time. They can talk to you about any potential risks or side effects you can expect to experience.

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2. L-arginine

You might have heard of l-arginine around the gym, as it’s found in many different types of protein and dietary supplements. L-arginine is a type of amino acid, which are the building blocks of proteins. Your body runs on proteins; sexual performance is no exception.

Some people have begun claiming that L-arginine can be used as a treatment option for erectile dysfunction. Unfortunately, there is no concrete evidence that L-arginine on its own is an effective treatment for erectile dysfunction.

Yet some studies have shown that when it is used in conjunction with PDE5 inhibitors (Viagra, Cialias, etc.), patients reported better results than using PDE5s alone.

L-arginine works as a vasodilator (opening blood vessels, so blood can flow more easily). For some individuals, particularly those with cardiac issues, high blood pressure, or other vascular health concerns, L-arginine may not be a safe choice.

As with any ED treatment (Viagra substitutes or otherwise), it’s important that you talk to your healthcare practitioner about any risks or concerns that you have, before you start.

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3. Penis pumps

A penis pump (also known as a vacuum erection device or VED) is a device that is fitted over the penis. It uses a vacuum to draw blood into the penis tissue, resulting in an erection.

Pumps are often used in conjunction with a tension ring, which helps prevent the blood from leaving the penis again. While this method has been shown to be effective, there’s a high discontinuation rate, because of the adverse side effects.

These unpleasant side effects can include:

• Bruising on the penis
• Pivoting at the base of the penis
• Coldness or numbness in the penis
• Pain and discomfort
• Decreased ability or inability to ejaculate

If you’re considering using a pump, it’s definitely best to talk to your healthcare practitioner first. They’ll be able to go over any potential risks you could face, before you have to deal with those side effects first-hand.

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4. Tension rings

A tension ring (also known as a constriction band) is an elastic ring, which can be fitted around the base of the penis. This helps stop blood leaving, prolonging or assisting with maintaining an erection.

Like a pump, tension rings should be used with caution, since they can cause several adverse side effects like:

• Discolouration of the penis
• Bruising
• Numbness

If you’re considering using a tension ring, seek medical advice from your healthcare practitioner first about the risks that you might face, as well as any guidance that you might need to use a tension ring safely.

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