Disclaimer: None of the information in this article constitutes medical advice, and is just the opinion of the writer(s). We recommend that patients follow their doctor’s guidance in regard to erectile dysfunction treatment.
Many consumers compare the effects of natural and pharmaceutical treatments for erectile dysfunction (ED), often favoring natural treatments if they’re similarly effective. Horny goat weed and Viagra are two of the most popular treatments for ED.
But are they similarly effective based on clinical research? Is one safer than the other? Which do we recommend?
In this article we’ll answer all of these questions and more as we review clinical research to give our take on whether horny goat weed or Viagra is more likely to be effective for treating ED, and for enhancing sexual performance generally.
Can Horny Goat Weed Naturally Treat ED?
As we documented in our review on “does horny goat weed really work?”, there have actually been legitimate medical trials on this plant for enhancing sexual function.
One such trial, published in the Asian Journal of Andrology, found that the active chemical compound in horny goat weed, called icariin, inhibits an enzyme called PDE5 which results in greater blood flow to the penis.
However this was a test tube study, so the quality of evidence is weaker than a trial with human or animal subjects.
A 2011 medical review on horny goat weed found that the herb increased testosterone levels in animal studies, but this doesn’t necessarily mean the same effects will apply to humans.
Another medical review found that icariin improved erectile function in animal studies and test tube studies.
Overall, we consider horny goat weed to be potentially effective for ED, but there isn’t enough human research to say so conclusively.
Does Viagra Work for ED?
Viagra is one of the most well-studied pharmaceutical treatments for ED, having initially been approved by the FDA in 1998. The generic name for this medication is sildenafil, and we’ll use these terms interchangeably as they refer to the same active drug ingredient.
A meta-study published in the Drugs journal found that Viagra was effective for improving the frequency, hardness and duration of erections in human trial participants, and that the drug transiently reduced blood pressure levels.
A clinical trial on Viagra found that at a dose of 50 milligrams (mg), the drug increased erection duration by over 800% compared to a group taking placebo pills.
A meta-review published in the Therapeutics and Clinical Risk Management journal analyzed data from over 1,000 patients using Viagra over long periods of time (4 years). Over 94% of the patients responded that they were satisfied with the drug at each yearly assessment, and that it improved their sex life.
Viagra is clearly highly effective for the treatment of ED, and moreso than horny goat weed. But how do the risks compare? We’ll review that in the next section.
Which Has a Better Side Effect Profile?
Just because a supplement is sold over-the-counter (OTC) like horny goat weed doesn’t necessarily make it safer than a prescription drug.
We can’t identify any long-term clinical trials on the safety of horny goat weed in humans, however the plant has been used medicinally for thousands of years so we consider it to be likely safe if dosed appropriately.
Our main concern regarding the safety of horny goat weed is that it’s typically sourced from China, a country with relatively high levels of environmental pollution, and there are documented issues with the purity of horny goat weed supplements.
ConsumerLab is an independent testing laboratory that tested three popular horny goat weed supplements in a review, and failed all three for different reasons.
One horny goat weed supplement violated FDA guidelines by failing to accurately label the plant parts, so testing couldn’t be conclusive. Another only contains 10% of the active ingredient as was claimed. The third had a high level of lead.
Therefore we consider this to be a riskier supplement than average.
Viagra has been extensively safety tested, as we referenced in our review of Rugiet, another prescription ED treatment that contains the active ingredient in Viagra.
A medical review on Viagra reported that the most common side effects were headache, flushing and upset stomach. The drug’s FDA label contains no “black box” warning, which is required when a drug has life-threatening side effects.
Overall we consider Viagra to be less likely to cause serious side effects than horny goat weed given that the drug is extensively safety tested and there are no sourcing or contamination issues.
For consumers who are set on purchasing horny goat weed, the product we recommend is Gaia Herbs Male Libido which contains horny goat weed as the first active ingredient, because this brand regularly passes ConsumerLab testing. Here’s a link to the product’s official Amazon listing.
Is Generic Viagra Cheaper?
For consumers interested in trying Viagra, we would recommend speaking with your doctor about generic sildenafil instead.
Brand-name and generic drugs contain the same active drug ingredient and are equally effective, but generic versions are often much cheaper.
GoodRx reports the average retail price of Viagra to be $822.09 currently. Most patients with health insurance will pay significantly less than this but it proves how expensive brand-name drugs can be.
On Cost Plus Drugs, which is Mark Cuban’s generic drug venture, sildenafil is available for as low as $4.80 for 30 tablets at a 20 mg dose.
Our Clean Men's Health Picks
Bulletproof Magnesium is our top overall testosterone support pick, because magnesium is a mineral that is clinically shown to increase free and total testosterone in athletes and in sedentary individuals.
Bulletproof Magnesium costs under $17 at the time of updating this article.
Momentous Tongkat Ali is our top herbal testosterone support pick, and costs under $20 at the time of updating this article.
Tongkat ali's effects on testosterone were reviewed in a 2022 meta-study, and the researchers concluded that "A significant improvement in total testosterone levels after [tongkat ali] treatment was mostly reported in both healthy volunteers and hypogonadal men."
Panax ginseng was shown in a clinical trial published in The Journal of Urology to increase erectile function scores were "significantly" compared to participants taking placebo pills.
Illuminate Labs sells a Panax Ginseng Extract supplement which is third-party tested, and costs only $15 on a subscription basis.
