A.Vogel is a Swiss herbal medicine brand offering a range of herbal remedies and supplements available in the UK. Whilst some individuals explore A.Vogel products—such as ginkgo biloba or circulatory support supplements—in the hope of improving erectile dysfunction (ED), no A.Vogel product holds a UK marketing authorisation or Traditional Herbal Registration indication for treating ED. Erectile dysfunction is the persistent inability to achieve or maintain an erection sufficient for satisfactory sexual performance. It can signal underlying cardiovascular disease, making medical assessment essential. Evidence-based NHS treatments, including phosphodiesterase type 5 (PDE5) inhibitors, offer proven efficacy for ED, whereas herbal remedies lack robust clinical evidence.

What Is A.Vogel and How Does It Relate to Erectile Dysfunction?

A.Vogel is a Swiss herbal medicine brand founded by naturopath Alfred Vogel in 1923. The company produces a range of herbal remedies and supplements available in the UK through health food shops, pharmacies, and online retailers.

There is no A.Vogel product that holds a UK marketing authorisation or Traditional Herbal Registration (THR) indication for the treatment of erectile dysfunction (ED). However, some individuals explore herbal remedies from A.Vogel's range—such as ginkgo biloba preparations or general circulatory support products—in the hope of improving sexual function, given that erectile function depends on adequate blood flow to the penile tissues. It is important to understand that no evidence supports the use of A.Vogel products specifically for erectile dysfunction.

Erectile dysfunction is defined as the persistent inability to achieve or maintain an erection sufficient for satisfactory sexual performance. ED is common and becomes more frequent with age. It can result from physical causes (such as cardiovascular disease, diabetes, or hormonal imbalances), psychological factors (including anxiety and depression), or a combination of both. Many men seek complementary or alternative approaches alongside—or instead of—conventional treatments, which has led to interest in herbal products.

It is essential to recognise that herbal remedies are not necessarily safer or more effective than licensed medicines. Some herbal products registered under the UK THR scheme meet quality and safety standards, but their indications are based on traditional use rather than robust clinical efficacy trials. Any man experiencing erectile dysfunction should seek medical assessment to identify underlying causes—ED can be an early warning sign of cardiovascular disease—and to receive evidence-based treatment recommendations.

References:

• NICE Clinical Knowledge Summary: Erectile dysfunction

• NHS: Erection problems (impotence)

• MHRA: Traditional Herbal Registration (THR)

Evidence for Herbal Remedies in Treating Erectile Dysfunction

The evidence base for herbal remedies in treating erectile dysfunction remains limited and inconsistent. Few herbal products have undergone the rigorous clinical trials required for licensed medicines in the UK, and the quality of available research varies considerably.

Ginkgo biloba, sometimes found in herbal product ranges, has been investigated for ED, particularly in men whose sexual dysfunction may be related to antidepressant use or poor circulation. The proposed mechanism involves improved blood flow through vasodilation and potential effects on nitric oxide pathways; however, these mechanisms are hypothetical and not robustly demonstrated in humans. Systematic reviews have found insufficient high-quality evidence to support ginkgo biloba as an effective treatment for erectile dysfunction. Studies have produced conflicting results, with many suffering from small sample sizes, poor methodology, or lack of placebo controls.

Other herbal ingredients and dietary supplements occasionally explored for ED include:

• Panax ginseng (Korean red ginseng): Some evidence from systematic reviews suggests modest improvements in erectile function, though studies are heterogeneous in quality and further research is needed.

• L-arginine: A dietary amino acid supplement (not a herbal remedy) that may enhance nitric oxide production; however, evidence for clinical benefit in ED remains inconclusive.

• Tribulus terrestris: Popular in some supplements but lacking robust evidence for efficacy in ED.

• Horny goat weed (Epimedium): Contains icariin, which may have phosphodiesterase type 5 (PDE5) inhibitor-like properties in laboratory studies, but human clinical studies are scarce.

No herbal products currently hold a UK marketing authorisation or THR indication for the treatment of erectile dysfunction. The NICE Clinical Knowledge Summary on erectile dysfunction does not recommend herbal or dietary supplements as treatments for ED due to the lack of robust evidence. Men should be cautious about relying on unproven remedies when effective, evidence-based treatments are available through the NHS.

References:

• NICE Clinical Knowledge Summary: Erectile dysfunction (section on complementary therapies)

• Systematic reviews on Panax ginseng, ginkgo biloba, and L-arginine for erectile dysfunction (e.g., Cochrane Library, Journal of Sexual Medicine)

NHS Treatment Options for Erectile Dysfunction

The NHS offers evidence-based treatments for erectile dysfunction following comprehensive assessment. NICE guidance (Clinical Knowledge Summary on Erectile Dysfunction) recommends a structured approach beginning with identifying and addressing underlying causes and modifiable risk factors.

Initial assessment by a GP typically includes:

• Detailed medical, sexual, and psychosocial history

• Medication review (as many drugs can contribute to ED)

• Physical examination including cardiovascular assessment and blood pressure measurement

• Baseline investigations guided by clinical presentation: cardiovascular risk assessment; HbA1c or fasting glucose; lipid profile; morning total testosterone (if features of hypogonadism are present or clinically indicated); thyroid function tests (if clinically suspected); further endocrine investigations guided by initial results

• Assessment of psychological factors and relationship issues

Lifestyle modifications form the foundation of ED management and may include:

• Weight loss if overweight or obese

• Increased physical activity (at least 150 minutes of moderate-intensity aerobic exercise weekly)

• Smoking cessation

• Reducing alcohol consumption to within recommended limits

• Optimising management of chronic conditions such as diabetes, hypertension, and hyperlipidaemia

First-line pharmacological treatment usually involves phosphodiesterase type 5 (PDE5) inhibitors. These medications include:

• Sildenafil (Viagra)

• Tadalafil (Cialis)

• Vardenafil (Levitra)

• Avanafil (Spedra)

These drugs work by enhancing the natural erectile response to sexual stimulation through increased blood flow to the penis. They are effective in a substantial proportion of men with ED.

NHS prescribing of PDE5 inhibitors varies across the UK:

• England: PDE5 inhibitors are subject to Selected List Scheme (SLS) restrictions and are generally available on NHS prescription only for men with specific underlying conditions (such as diabetes, prostate cancer treatment, spinal cord injury, spina bifida, poliomyelitis, multiple sclerosis, single gene neurological disease, severe pelvic injury, renal failure treated by dialysis or transplant, severe distress, or radical pelvic surgery). Otherwise, men may need private prescriptions.

• Scotland, Wales, and Northern Ireland: PDE5 inhibitors can generally be prescribed on the NHS without the same restrictions as in England.

• Over-the-counter (OTC) supply: Sildenafil 50 mg (Viagra Connect) is available for purchase from pharmacies following a suitability assessment by a pharmacist.

Important safety information for PDE5 inhibitors:

• Absolute contraindications: Use with nitrates (e.g., glyceryl trinitrate, isosorbide mononitrate) or guanylate cyclase stimulators (riociguat) is contraindicated due to the risk of severe hypotension.

• Cautions: Use with alpha-blockers requires caution due to additive blood pressure-lowering effects; PDE5 inhibitors should be used with caution in men with unstable cardiovascular disease.

• Common adverse effects: Headache, flushing, dyspepsia, nasal congestion, and visual disturbances. Men should be advised to read the patient information leaflet and Summary of Product Characteristics (SmPC).

Referral and further management:

• Refer to urology or andrology for persistent treatment failure, anatomical abnormalities (e.g., Peyronie's disease), or suspected urological causes.

• Refer to endocrinology for confirmed low testosterone, hyperprolactinaemia, or other endocrine disorders.

• Refer to cardiology if high or unstable cardiovascular risk is identified.

• Consider psychosexual therapy or counselling when psychological factors contribute significantly to ED, either alone or alongside medical treatments.

Second-line treatments for men who cannot use or do not respond to oral medications include vacuum erection devices, intracavernosal injections (alprostadil), intraurethral medication, or penile implants.

References:

• NICE Clinical Knowledge Summary: Erectile dysfunction

• British National Formulary (BNF): Drugs for erectile dysfunction

• Electronic Medicines Compendium (emc): Summaries of Product Characteristics for sildenafil, tadalafil, vardenafil, and avanafil

• NHS: Erection problems (impotence)

Safety Considerations When Using A.Vogel or Other Herbal Products for Erectile Dysfunction

Men considering A.Vogel or other herbal products for erectile dysfunction should be aware of several important safety considerations. The perception that herbal remedies are inherently safe because they are 'natural' is misleading—herbal products can cause adverse effects and interact with prescribed medications.

Regulatory context:

Some herbal products in the UK are registered under the Traditional Herbal Registration (THR) scheme, which assesses quality and safety but bases indications on traditional use rather than robust clinical efficacy trials. THR registration does not mean a product is proven effective for a medical condition. No A.Vogel or other herbal products hold a UK marketing authorisation or THR indication for the treatment of erectile dysfunction.

Drug interactions represent a significant concern. For example:

• Ginkgo biloba can increase bleeding risk, particularly when combined with anticoagulants (warfarin, direct oral anticoagulants) or antiplatelet drugs (aspirin, clopidogrel).

• Some herbal products may interact with antihypertensive medications, potentially causing dangerous blood pressure fluctuations.

• Herbal remedies can affect blood glucose control in people with diabetes.

• St John's wort (found in some herbal products for mood) interacts with numerous medications by inducing liver enzymes, reducing the effectiveness of many prescribed drugs.

Men should check for interactions with all prescribed and over-the-counter medicines and consult a pharmacist or GP before using herbal products.

Quality and contamination issues also warrant caution. Unlike licensed medicines, herbal products may vary in potency between batches. Some herbal supplements have been found to contain undeclared pharmaceutical ingredients, heavy metals, or other contaminants. Regulation of herbal products is less stringent than for prescription medicines.

Delayed diagnosis poses perhaps the greatest risk. Erectile dysfunction can be an early warning sign of serious underlying conditions, particularly cardiovascular disease. Men with ED have an increased risk of heart attack and stroke. By self-treating with herbal remedies without medical assessment, men may miss the opportunity for early diagnosis and management of potentially life-threatening conditions such as diabetes, hypertension, or coronary artery disease.

When to seek medical advice:

• Any man experiencing persistent erectile dysfunction should consult their GP for assessment and evidence-based treatment.

• Seek urgent medical attention if ED occurs suddenly alongside chest pain, breathlessness, or other cardiovascular symptoms.

• Seek emergency care if a painful erection lasts more than 4 hours (priapism), or if new penile deformity, severe curvature, or new neurological deficits develop.

• Men taking prescribed medications should discuss any herbal supplements with their GP or pharmacist before use.

• If considering herbal remedies, inform healthcare professionals to ensure safe, coordinated care.

Reporting suspected side effects:

The MHRA Yellow Card Scheme allows reporting of suspected side effects from herbal medicines and all other medicines. You can report suspected side effects directly via the Yellow Card website at yellowcard.mhra.gov.uk or by downloading the Yellow Card app. Reporting helps improve the safety monitoring of medicines and herbal products.

Men should remember that effective, evidence-based treatments for ED are available through the NHS, and professional medical assessment is essential for safe, appropriate management.

References:

• NICE Clinical Knowledge Summary: Erectile dysfunction (safety and red flags)

• MHRA: Yellow Card Scheme (yellowcard.mhra.gov.uk)

• MHRA: Traditional Herbal Registration and herbal medicines guidance

Frequently Asked Questions