Natural remedies for erectile dysfunction: which ones have evidence? Losing weight and exercising more, stopping smoking, pelvic-floor training and talking therapy have each helped men in clinical studies, and among supplements only L-arginine holds up when the trials are pooled. None works like a prescription medicine, and most herbs sold for erections have little or no trial evidence.
Which natural remedies have been properly tested?
Five, and each helped a particular group of men.
| Approach | Best evidence | Who was studied |
|---|---|---|
| Weight loss and exercise | A two-year randomised trial; a meta-analysis of four trials | Otherwise healthy obese men aged 35 to 55 |
| Stopping smoking | A one-year follow-up study | Smokers with ED and no other risk factors |
| Pelvic-floor training | One randomised trial | 55 men aged 22 to 78 |
| Talking therapy | A Cochrane review of 11 small trials | 398 men, mostly in group therapy |
| L-arginine | Meta-analyses of randomised trials (Rhim et al., 2019) | Men with mild to moderate ED |
How much can weight loss and exercise do?
Enough to bring back normal erections in about a third of men in the best trial. Obese men were coached to lose at least 10% of their body weight by eating less and increasing their physical activity; over two years their weekly exercise rose from 48 to 195 minutes on average and their erectile-function score from 13.9 to 17, while the comparison group's stayed flat (Esposito et al., JAMA 2004). Pooled, four lifestyle trials (597 men) gave an average gain of 2.4 points on the five-question score (Gupta et al., 2011): real, but modest. What to eat is covered in foods and erectile dysfunction.
Does stopping smoking improve erections?
For many smokers, yes. Among 281 smokers with ED and no other risk factors, erections improved within a year in at least 25% of the 118 who quit and in none of the 163 who kept smoking; older men and men with severe ED improved less (Pourmand et al., 2004). More in can quitting smoking reverse ED?
Do pelvic-floor exercises help erections?
They can, when the muscles are trained properly. In the one randomised trial, men did pelvic-floor exercises with biofeedback — a pressure sensor that shows whether you are squeezing the right muscles. After three months their erectile-function score was 6.7 points higher than in men given lifestyle advice alone; one man in four did not improve (Dorey et al., 2004).
Does counselling or sex therapy help?
Yes, when stress, worry or the relationship is part of the problem. Australian Prescriber advises that treatment starts with lifestyle changes and psychological or relationship problems, with sex therapy indicated "particularly when there is a significant psychological contribution" (Australian Prescriber, 2022). In a Cochrane review, group therapy cut the number of men whose ED persisted compared with a waiting list, and group therapy plus sildenafil beat sildenafil alone (Melnik et al., Cochrane 2007) — though the trials were small and old. See treatment for psychological ED.
Do any supplements or herbs work?
Very few. A 2024 network meta-analysis of 15 placebo-controlled trials (1,000 men) found that only L-arginine, on its own, beat placebo; a carnitine mix helped only when added to sildenafil (Barbonetti et al., 2024). The L-arginine, niacin and ginseng trials are in vitamins and supplements for erectile dysfunction.
- Yohimbine beat placebo in a 1998 meta-analysis of seven trials (Ernst and Pittler), but it has been linked with irregular heartbeat, blood-pressure problems, heart attacks and seizures (NCCIH), and in Australia it is a prescription-only ingredient (TGA).
- DHEA, a hormone, helped in one 40-man trial (Reiter et al., 1999) and not in a later 86-man trial (Morales et al., 2009).
- Acupuncture improved scores in a 2026 review of 21 trials whose evidence was rated very low to moderate in certainty (Yan et al., 2026).
- Ginseng, horny goat weed, tribulus, maca and other herbs have weaker, conflicting or animal-only evidence; each is ranked in our guide to natural remedies.
Are natural remedies safe?
Not automatically. Vitamins and herbal medicines are the TGA's own examples of listed medicines (AUST L on the label), which "are not individually evaluated by the TGA for quality, safety and efficacy before they are supplied" (TGA). Supplements carry potential interactions with medications and possible side effects, and the worst risk is a "herbal" pill that works fast because it hides sildenafil or tadalafil — see the TGA's hidden-drug warnings. That matters most if you take nitrates for angina (healthdirect). L-arginine with a prescribed tablet is covered in L-arginine with tadalafil or Cialis.
When should you see a GP instead?
When erection problems keep happening. ED is often the first sign of cardiovascular disease, diabetes, high blood pressure or high cholesterol (healthdirect), and Healthy Male calls it an early warning sign of serious disease that needs a full investigation (Healthy Male).
The short answer
The natural steps that work are the unglamorous ones: lose weight, move more, stop smoking, train the pelvic floor, and deal with stress or relationship strain. Among supplements only L-arginine has consistent trial support, and its effect is small. If you need a medicine's effect, the options are compared in alternatives to Viagra and Cialis.
