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Be ready for sex whenever you're in the mood
You may know it as the “little blue pill,” but have you heard of “Viagra gel” or “topical Viagra?”
Scrolling through online forums for erectile dysfunction (ED), you may have seen discussions about a so-called sildenafil gel or sildenafil cream referring to the active ingredient in Viagra®, one of the most popular medications for ED.
You massage these products onto the head of your penis and boom — you’re meant to get an erection soon after.
Sounds great, right? There’s just one problem. Sildenafil isn’t available as a topical gel. Not yet, anyway.
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One such product available over the counter (OTC) is Eroxon® StimGel, an ED gel inaccurately dubbed “topical Viagra.” Despite the moniker, Eroxon doesn’t contain sildenafil citrate — neither do any of the other erection gels and topicals commonly mislabeled as “Viagra gel.”
While there are a few studies on OTC erectile dysfunction gels as potential treatments for ED, there’s currently not enough research to confirm they work as well as FDA-approved prescription ED drugs.
If you’re one of the millions of men who experience erectile dysfunction, it’s good to know your options. Let’s talk about sildenafil gel for ED and other potential treatments.
Viagra (sildenafil citrate) is in a class of drugs known as phosphodiesterase type 5 (PDE5) inhibitors. These medications block the enzyme PDE5, which helps widen blood vessels to improve blood flow to the penis, making it easier to get and maintain an erection.
When it was approved by the U.S. Food and Drug Administration (FDA) in 1998, sildenafil was the first oral medication available specifically for treating erectile dysfunction. You need a prescription to buy and use sildenafil.
Sildenafil is pretty effective and safe when used correctly. But contrary to internet rumors, it’s only available as a pill — not as a gel.
Some studies have looked at the possibility of using a sildenafil gel for erectile dysfunction. However, no manufacturers have actually pushed for it to be FDA-approved. Because of this, it’s currently not possible to buy a sildenafil-based ED gel in the U.S.
Many people seem to confuse sildenafil gel with sildenafil jelly, which is taken orally and isn’t available in the United States. (Well, not unless you get it from a dodgy online shop — which we don’t suggest.)
It may also be confused with AndroGel® and alprostadil cream — more on these below.
If you’re looking for a topical treatment for ED, Eroxon StimGel is a newer FDA-approved option. Made by the UK-based pharmaceutical company Futura Medical, it’s the first topical ED treatment legally available over the counter in the United States.
But while some news outlets have dubbed Eroxon “topical Viagra,” the medication isn’t a PDE5 inhibitor like Viagra.
Instead of blocking the PDE5 enzyme, this erectile dysfunction gel physically cools and warms the penis, according to the manufacturer’s website. This is thought to stimulate nerve endings and release nitric oxide to encourage better blood flow to the area.
In a 12-week clinical trial of 250 men published on the manufacturer’s website, more than 60 percent saw improvement in ED symptoms, with some men getting erections within 10 minutes.
A fast-acting formula might sound appealing, given that Viagra takes around 30 minutes.
However, there are some interesting factors to consider:
Eroxon was the “placebo” in its first clinical trial. In the 12-week clinical trial, Eroxon was actually the “placebo.” The active drug consisted of nitroglycerin, a vasodilator. During the trial, researchers found that Eroxon (the placebo) performed almost as well as the active drug.
Eroxon isn’t a medication. The FDA calls Eroxon a “non-medicated hydro-alcoholic gel.” It contains ethanol, carbomer, propylene, glycerine, and potassium hydroxide. These chemicals are found in various cosmetics and function as thickening agents, moisturizers, and lubricants.
Other PDE5 inhibitors, specifically tadalafil, work better. In a second clinical trial comparing Eroxon (Med3000) to tadalafil (generic for Cialis), tadalafil showed a “greater improvement in erectile function.”
Some drug manufacturers make a version of sildenafil that’s sold as an oral jelly. This includes Kamagra Oral Jelly®, a flavored jelly from the Indian pharmaceutical company Ajanta Pharma.
If swallowing a tablet is difficult for you, Kamagra may sound appealing. However, sildenafil jellies haven’t been approved by the FDA, and they aren’t legally available in the United States.
The same goes for Osidea GL, another sildenafil gel from a Mexican manufacturer.
Still, you might come across U.S.-based online stores selling Kamagra. They may market these products as supplements for sexual performance.
To say this is a red flag is an understatement. Selling Kamagra in the United States is illegal, for one thing, and there’s no way to tell if the products are real or fake.
Kamagra is the most common imitation ED medication sold online, according to a 2010 review. The review also found that fake ED medications are often mislabeled and filled with contaminants — like talcum powder, commercial paint, and printer ink — as well as other dodgy ingredients.
Basically, it’s not something you’d want in (or on) your body.
Though these stores let you purchase ED medications without a prescription, buying from them is ill-advised. Sildenafil can be safe for many people, but it’s not suitable for everyone.
For instance, it can be dangerous to use sildenafil if you’re also taking nitrates or hypertension (high blood pressure) medication. This combination could lead to dangerously low blood pressure.
Although buying over-the-counter Viagra may sound convenient, landing in the hospital on date night is absolutely not. So pass on the Kamagra, and speak with a healthcare professional if you’re experiencing any form of sexual dysfunction.
If a flavored treatment sounds good to you, consider Hims chewable ED mints.
Some mixed up Viagra gel with AndroGel®, a topical gel prescribed to men with low testosterone levels.
AndroGel contains testosterone, a critical hormone for controlling your level of interest in sex. Although the link between testosterone and erections isn’t totally clear, this type of medication may offer benefits if you have a weak sex drive caused by low testosterone.
One small randomized study looked at the effects of testosterone gel on erectile dysfunction in men who didn’t get results from using sildenafil alone. The study only examined hypogonadal men, meaning they all had low hormone levels at the beginning of the trial.
The researchers concluded that testosterone gel, when combined with sildenafil, may improve erectile function in hypogonadal men.
While this is great news for guys with low testosterone levels, AndroGel probably shouldn’t be considered as a solo treatment for erectile dysfunction.
Sildenafil gel might also be confused with alprostadil cream.
Though it’s more of an erection cream than an erection gel, alprostadil can be an effective topical treatment for ED. You simply apply it before sexual activity and wait for it to do its magic (that is, boost blood flow to your penis).
A 2016 review of studies suggested alprostadil cream could be a potential second-line therapy for erectile dysfunction. In other words, it might help those who can’t (or don’t want to) use PDE5 inhibitors like sildenafil.
While alprostadil cream is sold in several countries, it’s not available in the United States. The FDA has approved some forms of alprostadil for the treatment of erectile dysfunction — injections and pellets, to be specific — but not alprostadil cream.
Right now, no gel-based version of sildenafil is available to the public in the United States.
Over the years, some researchers have looked at the effectiveness of topical sildenafil gel for erectile dysfunction, with largely mixed results.
A small 2005 study with less than 100 participants compared the effects of topical sildenafil to oral sildenafil to see which was a more effective treatment for ED.
Of the men treated with topical sildenafil, 12.5 percent achieved a “complete erection” after a short period of massage. Another 12.5 percent got a “moderate erection,” and the remaining 75 percent didn’t achieve an erection at all.
In comparison, 70 percent of those who got oral sildenafil achieved a complete erection, with 15 percent getting a moderate erection. Only 15 percent of the men in this group didn’t achieve an erection following treatment.
Put simply, the oral sildenafil tablet was significantly more effective than the topical sildenafil gel.
More recently, a 2022 review explored whether topical PDE5 inhibitors may help with erectile dysfunction. It concluded that these treatments can be “promising” in mild to moderate cases of erectile dysfunction.
Though we might eventually get a sildenafil-based erection gel, reviews like these are few and far between. More research is needed before topical sildenafil is offered to the public.
Let’s face it: Erectile dysfunction can be frustrating. The good news is that it’s almost always treatable with the right approach.
Several medications are currently available for the treatment of erectile dysfunction, including:
Oral sildenafil. Viagra and generic sildenafil tablets typically start working in less than an hour, providing relief from erectile dysfunction for up to four hours a dose.
Tadalafil. The active ingredient in Cialis, tadalafil is also available as a generic medication. It’s by far the longest-lasting treatment for ED — a single tablet works for up to 36 hours.
Vardenafil. The active ingredient in Levitra®, vardenafil comes in tablet form and lasts up to four hours like sildenafil.
Avanafil. Available under the brand name Stendra®, avanafil is a new ED medication. It works quickly, isn’t affected by food, and has a reduced risk of certain side effects.
Chewable ED meds. If the idea of swallowing a pill is unappealing, consider our chewable ED hard mints. They’re made with ingredients like sildenafil, tadalafil, and vardenafil.
Beyond taking medications, there are some ways to naturally protect erectile function. Making small but meaningful changes to what you eat, your sleep habits, and your exercise routine can have a positive impact on your sexual function.
If you’re experiencing erectile dysfunction, premature ejaculation (PE), or other issues relating to sexual performance, consider getting medical advice from a licensed healthcare provider.
Sildenafil is an effective ED treatment, but it’s currently only sold as a pill. At the moment, there’s no sildenafil-based erectile dysfunction gel on the market in the U.S.
Here’s a rundown of what we covered:
Sildenafil isn’t available as a gel. Though research has looked at the effectiveness of topical sildenafil gel for ED, no drug company has pushed for a gel-based version of sildenafil to undergo the FDA approval process.
Beware of dodgy sellers. If a store sells what it claims is sildenafil gel, run! Many online retailers sell counterfeit ED medication, which could be filled with harmful ingredients. Your health isn’t worth the gamble — go the legit route and speak with a licensed health professional.
Other treatment options are available. There are many safe, FDA-approved options for the treatment of erectile dysfunction, including oral medications. Plus, healthy lifestyle habits can support your sexual health.
While erectile dysfunction can be frustrating, it’s common and (fortunately) treatable. To learn about your options, see our guide on how to get hard or connect with a healthcare professional today.
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Dr. Kelly Brown is a board certified Urologist and fellowship trained in Andrology. She is an accomplished men’s health expert with a robust background in healthcare innovation, clinical medicine, and academic research. Dr. Brown was previously Medical Director of a male fertility startup where she lead strategy and design of their digital health platform, an innovative education and telehealth model for delivering expert male fertility care.
She completed her undergraduate studies at University of North Carolina at Chapel Hill (go Heels!) with a Bachelor of Science in Radiologic Science and a Minor in Chemistry. She took a position at University of California Los Angeles as a radiologic technologist in the department of Interventional Cardiology, further solidifying her passion for medicine. She also pursued the unique opportunity to lead departmental design and operational development at the Ronald Reagan UCLA Medical Center, sparking her passion for the business of healthcare.
Dr. Brown then went on to obtain her doctorate in medicine from the prestigious Northwestern University - Feinberg School of Medicine and Masters in Business Administration from Northwestern University - Kellogg School of Management, with a concentration in Healthcare Management. During her surgical residency in Urology at University of California San Francisco, she utilized her research year to focus on innovations in telemedicine and then served as chief resident with significant contributions to clinical quality improvement. Dr. Brown then completed her Andrology Fellowship at Medical College of Wisconsin, furthering her expertise in male fertility, microsurgery, and sexual function.
Her dedication to caring for patients with compassion, understanding, as well as a unique ability to make guys instantly comfortable discussing anything from sex to sperm makes her a renowned clinician. In addition, her passion for innovation in healthcare combined with her business acumen makes her a formidable leader in the field of men’s health.
Dr. Brown is an avid adventurer; summiting Mount Kilimanjaro in Tanzania (twice!) and hiking the incredible Torres del Paine Trek in Patagonia, Chile. She deeply appreciates new challenges and diverse cultures on her travels. She lives in Denver with her husband, two children, and beloved Bernese Mountain Dog. You can find Dr. Brown on LinkedIn for more information.
Education & Training
Andrology Fellowship, Medical College of Wisconsin
Urology Residency, University of California San Francisco
M.D. Northwestern University Feinberg School of MedicineB.S. in Radiologic Science, Chemistry Minor, University of North Carolina at Chapel Hill
Published as Kelly Walker
Cowan, B, Walker, K., Rodgers, K., Agyemang, J. (2023). Hormonal Management Improves Semen Analysis Parameters in Men with Abnormal Concentration, Motility, and/or Morphology. Fertility and Sterility, Volume 118, Issue 5, e4. https://www.sciencedirect.com/journal/fertility-and-sterility/vol/120/issue/1/suppl/S
Walker, K., Gogoj, A., Honig, S., Sandlow, J. (2021). What’s New in Male Contraception? AUA Update Series, Volume 40. https://auau.auanet.org/content/update-series-2021-lesson-27-what%E2%80%99s-new-male-contraception
Walker, K., Shindel, A. (2019). AUA Erectile Dysfunction Guideline. AUA Update Series, Volume 38. https://auau.auanet.org/content/course-307
Walker, K., Ramstein, J., & Smith, J. (2019). Regret Regarding Fertility Preservation Decisions Among Male Cancer Patients. The Journal of Urology, 201(Supplement 4), e680-e681. https://www.auajournals.org/doi/10.1097/01.JU.0000556300.18991.8e
Walker, K., & Smith, J. (2019). Feasibility Study of Video Telehealth Clinic Visits in Urology. The Journal of Urology, 201(Supplement 4), e545-e545. https://www.auajournals.org/doi/10.1097/01.JU.0000556071.60611.37