Originally developed and studied by Pfizer as a treatment for high blood pressure and angina, Viagra was noticed to cause strong erections among studied participants. As it proved to be only minimally successful as an angina treatment Pfizer decided to market Viagra for erectile dysfunction (ED). Viagra now ranks as one of the most recognizable brands on the planet. The term "Herbal Viagra" has now come to mean any herbal preparation with an action similar to Viagra.

Although considered by many to have wonder drug status and is generally well tolerated, Viagra is not without side effects and may not suit every sufferer of erectile dysfunction. Headaches, visual disturbances, low blood pressure (usually transient), dizziness and interactions with other medications are the most common side effects. This is why Viagra is a prescription medication and users are wise to seek medical advice before use.

Due to its success, Viagra has blazed a trail for other ED treatments. Cialis and Levitra are chemically similar to Viagra but have slightly different activity. Levitra is considered to work slightly faster than Viagra. Cialis may work up to 36 hours after being taken which for some provides considerable advantages over Viagra. Many generic brands have now arrived on the market but the buyer should beware. Not all generic suppliers are reputable and take care to see that you are receiving a safe, high quality product.

Likewise there are some herbal preparations that contain in addition to various herbs, Sildenafil, the active ingredient of Viagra. Illegal activity like this gives herbal medicine an undeserved bad name. There are some nutritional products and herbal medicines that can be helpful to the ED sufferer and good alternatives to Viagra do exist.

Ideally a good herbal formulation will raise levels of the male hormone testosterone. Testosterone helps keep muscles lean and strong and also increases the libido and frequency and strength of erections. Bodybuilders aware of the illegality and side-effects of anabolic steroids often make use of testosterone raising herbs such as Tribulus to increase their muscle mass and strength. As a man ages testosterone levels drop away and circulation decreases. Keeping testosterone levels high and promoting improved blood circulation is an effective strategy that good herbal products strive for.

Viagra works by increasing levels of Nitric Oxide (NO) that relaxes the smooth muscle of blood vessels allowing increased blood flow. Similarly the herb commonly known as Horny Goat Weed (Epimedium Brevicornum) also promotes higher NO levels that improve blood circulation.

Herbal ingredients such as ginseng and cordyceps have both been traditionally revered for their aphrodisiac and energy promoting qualities and are often included in "Herbal Viagra" formulations. Ginseng also helps a man cope with stress in his life. High amounts of stress release adrenaline into the blood stream causing a constriction of blood vessels and elevated blood pressure. Constriction is the opposite of what is trying to be achieved, namely a relaxation of smooth muscle in blood vessels leading to improved circulation. Relaxing and reducing stress is obviously helpful in treating erectile dysfunction.

Perhaps the most potent of all male libido enhancing herbs is Tongkat Ali (Eurycoma longifolia). Native to Indonesia and Malaysia, Tongkat Ali has long been used by traditional herbalists to assist their patients regain their sexual potency. Known to raise testosterone levels, Tongkat Ali can remain active in the body up to 4 days after ingestion. This has the obvious advantage that it need not be taken immediately prior to sex for it to be effective.

There are several formulations that combine the best of these ingredients into capsule form. Two leading brands of "Herbal Viagra" are SZM for Men and Mega V Performance Supplement for Men. At the recommended doses there have been no reported side effects and no prescription is required. More pharmacists are now recommending these formulations as a first choice option rather than Viagra, Cialis or Levitra.