Potency improvement supplements — evidence-based review (for educational purposes only, not medical advice)

Erectile problems are common and often treatable. Many people look for “natural” or over-the-counter supplements that promise to improve potency, boost testosterone, or enhance sexual performance. This review summarizes what is actually known from clinical research — in clear, plain language — and where the evidence is weak or uncertain.

Quick summary

• Some supplements (for example, L-arginine and Panax ginseng) show modest benefits in certain men, but effects are usually smaller than prescription medicines.
• Many products marketed for potency have little or no high-quality evidence behind them.
• Some “natural” supplements have been found to contain hidden prescription drugs, which can be dangerous.
• Erectile dysfunction (ED) is often linked to heart disease, diabetes, stress, or hormonal problems — treating the cause matters more than any supplement.
• Lifestyle changes (exercise, weight control, sleep, smoking cessation) have strong evidence for improving sexual function.

What is known

1. Erectile dysfunction is common and often medical

ED is defined as the persistent inability to achieve or maintain an erection sufficient for satisfactory sexual activity. According to major urology guidelines, ED becomes more common with age but is not simply a “normal” part of aging. It is strongly associated with:

• Cardiovascular disease
• Diabetes
• High blood pressure
• Obesity and metabolic syndrome
• Depression and anxiety

Because erections depend on healthy blood vessels and nerves, ED can be an early warning sign of vascular disease. In some men, it appears years before heart symptoms.

2. Prescription medications are the most effective treatments

Phosphodiesterase type 5 (PDE5) inhibitors — such as sildenafil, tadalafil, and others — are considered first-line therapy in clinical guidelines. They have been tested in large randomized controlled trials and show clear benefit for many men.

Supplements are usually compared indirectly to these drugs and generally show smaller effects.

3. Some supplements have limited supportive evidence

Panax ginseng (Korean red ginseng)

Several small clinical trials suggest possible improvement in erectile function compared with placebo. The effect appears modest. Mechanisms may include improved nitric oxide activity and vascular function. Evidence quality: moderate but limited by small sample sizes.

L-arginine

L-arginine is an amino acid involved in nitric oxide production, which helps blood vessels relax. Some studies show mild improvement in men with ED, especially when combined with other substances. Results are mixed, and not all studies show benefit.

L-citrulline

Converted into L-arginine in the body, L-citrulline may increase nitric oxide availability. Evidence is limited but suggests possible mild benefit in men with mild ED.

Yohimbine

Derived from tree bark, yohimbine has been studied for ED. Some older studies suggest benefit, but side effects (anxiety, increased heart rate, high blood pressure) can be significant. It is not considered first-line and may be unsafe for some individuals.

DHEA (dehydroepiandrosterone)

DHEA is a hormone precursor. Some small trials show possible benefit in men with low DHEA levels, but overall evidence is inconsistent. Long-term safety remains uncertain.

Zinc and testosterone boosters

Zinc supplementation may help only in men who are deficient. Over-the-counter “testosterone boosters” rarely increase testosterone meaningfully in men with normal levels. Claims often exceed scientific evidence.

4. Lifestyle interventions have strong evidence

Unlike most supplements, lifestyle changes have consistent support in guidelines:

• Regular aerobic exercise improves vascular health and erectile function.
• Weight loss improves testosterone levels and ED severity in overweight men.
• Smoking cessation improves blood vessel function.
• Good sleep supports hormonal balance.
• Psychological therapy helps when stress, anxiety, or relationship issues contribute.

You can read more about related cardiovascular risk in our overview of men’s health and heart disease risk factors.

What is unclear / where evidence is limited

• Long-term safety: Many supplements are not studied for long-term use.
• Product quality: Supplements are not regulated as strictly as prescription drugs. Independent testing has found hidden PDE5 inhibitors in some “herbal” products.
• Real-world effectiveness: Many trials are small, short, or industry-funded.
• Combination formulas: Multi-ingredient “male enhancement” products make it difficult to know which component, if any, is effective.
• Impact on severe ED: Supplements tend to show small improvements, mostly in mild cases.

Because ED can reflect broader health issues, it is important not to delay medical evaluation. See also our article on when erectile dysfunction requires medical assessment.

Overview of approaches

1. Evidence-supported medical treatments

• PDE5 inhibitors (prescription only)
• Vacuum erection devices
• Penile injections or intraurethral medications
• Hormone therapy (if true testosterone deficiency is confirmed)

These options are recommended in professional urology guidelines and should be discussed with a healthcare provider.

2. Supplements with limited evidence

• Panax ginseng
• L-arginine / L-citrulline
• DHEA (in selected cases)
• Yohimbine (caution advised)

No supplement should replace proper evaluation of cardiovascular risk factors or endocrine disorders. Supplements may interact with blood pressure medications, nitrates, antidepressants, and other drugs.

3. Lifestyle-based strategies

• Structured exercise program
• Mediterranean-style diet
• Weight management
• Stress reduction
• Sleep optimization

These approaches not only support sexual function but also reduce long-term cardiovascular risk. Learn more in our guide to lifestyle interventions for vascular health.

4. Psychological and relationship factors

Performance anxiety, depression, and relationship stress are frequent contributors. In such cases, counseling or sex therapy can be more effective than supplements.

For additional background on hormonal and metabolic contributors, see our review of male hormonal balance and sexual function.

Evidence table

Statement	Confidence level	Why
PDE5 inhibitors are effective for most men with ED	High	Large randomized trials and guideline endorsement
Panax ginseng may modestly improve erectile function	Medium	Multiple small trials, but limited sample sizes
L-arginine can help some men with mild ED	Medium	Mixed results; plausible biological mechanism
Over-the-counter “testosterone boosters” raise testosterone significantly	Low	Little high-quality evidence in men with normal levels
Lifestyle changes improve erectile function	High	Consistent data linking vascular health and ED
All herbal potency supplements are safe	Low	Documented contamination and drug adulteration cases

Practical recommendations

1. Start with a medical evaluation

See a healthcare provider if:

• ED persists for more than a few months
• You have diabetes, heart disease, or high blood pressure
• You experience chest pain or shortness of breath with exertion
• You notice decreased libido or symptoms of low testosterone

2. Prepare for your appointment

• List all medications and supplements you take.
• Note when symptoms began and whether they are consistent.
• Describe stress levels, sleep patterns, and relationship factors.
• Ask whether cardiovascular screening is appropriate.

3. Be cautious with supplements

• Buy only from reputable sources.
• Avoid products promising “instant” or “guaranteed” results.
• Do not combine supplements with prescription ED drugs without medical advice.
• Stop use and seek care if you experience chest pain, severe headache, or vision changes.

4. Focus on fundamentals

Regular exercise, a balanced diet, weight control, and quitting smoking often provide broader and more durable benefits than any single supplement.

Sources

• American Urological Association (AUA). Erectile Dysfunction Guidelines.
• European Association of Urology (EAU). Guidelines on Sexual and Reproductive Health.
• National Institutes of Health (NIH) Office of Dietary Supplements — fact sheets on supplements.
• U.S. Food and Drug Administration (FDA). Tainted Sexual Enhancement Products database.
• American Heart Association — cardiovascular risk and erectile dysfunction resources.

This article is for educational purposes only and does not replace professional medical advice. If you are concerned about erectile function or sexual health, consult a qualified healthcare provider.