The Lowdown on Uplifting Herbs for Men
By Diane
Eicher
Well Journal
Since Viagra
emerged as the No. 1 drug for male sexual dysfunction, a host of
non-prescription remedies has been offered to the 30 million men seeking to
stoke their sexual vigor.
Not surprisingly,
the success of Pfizer's little blue pill has stimulated the market for herbal
products and nutritional supplements promising to deliver equal or greater vigor
than Viagra itself.
The
over-the-counter marketplace is filled with products that contain ingredients
like yohimbe extract, avena sativa, L-arginine, saw palmetto, tibulus terrestris,
ginseng and even the aptly named horny-goat weed.
The question
is: Do they actually work?
Difficulty in the
bedroom isn't the kind of thing men discuss at business lunches or on the golf
course, but personal plumbing problems are a hot topic in the anonymity of
certain Internet chat rooms.
"Do the
supplements advertised on TV to enhance performance really work?" asked a
plaintive participant in a recent online chat.
That question is
on the mind of many of the estimated 30 million American men -- nearly a quarter
of the adult male population -- who suffer from erectile dysfunction, the
inability from time to time to perform satisfactorily in sexual intercourse.
Though the
problem of erectile dysfunction is widespread, it remained largely a taboo topic
until a bold advertising campaign in 1998 launched Viagra, a little blue pill
heralded as a promising panacea for impotence.
Viagra burst on
the national scene with a pitchman no less prominent than Robert Dole, the
recently defeated Republican candidate for President of the United States.
Viagra was an instant hit, becoming the hottest new drug in 1998. Today, it is
on a trajectory to deliver $1.5 billion in sales for its manufacturer, Pfizer
Inc.
Beyond Viagra
Not surprisingly,
Viagra's success has stimulated the market for a host of herbal products and
nutritional supplements promising to deliver equal or greater vigor than Viagra
itself. The over-the-counter marketplace is filled with products that contain
ingredients like yohimbe extract, avena sativa, L-arginine, saw palmetto,
tibulus terrestris, ginseng and even the aptly named horny-goat weed.
The question is:
Do they actually work?
"The
judicious answer is that we don't know," said Dr. Barnaby Barratt,
president-elect of the American Association of Sexuality Educators, Counselors
and Therapists and director of the Midwest Institute of Sexology, based in
Detroit, MI. While he said there is "very good reason to believe that some
of these products do work for some people some of the time," there are
"far too few scientifically-conducted studies, so we have negligible
data." While the jury may be out on the effectiveness of these elixirs of
love, there is little doubt that many men are likely to be looking for a
pick-me-up as they age.
In a survey
conducted by the American Urological Association, erection difficulties were
reported by 19% of men in their 50s and 39% of men aged 60 and older. Eighty
percent of cases result either from such physical conditions as hormonal
imbalances, heart disease, diabetes, neurological disorders, nutritional or
lifestyle issues, according to medical research. The balance of cases is
attributed to stress, depression, anxiety or relationship problems.
Despite the open
atmosphere created by the Viagra phenomenon, the American Foundation for
Urologic Disease estimates that fewer than 10% of men are getting treatment.
Although Viagra
is the No. 1 prescription taken for erectile dysfunction, it has risks ranging
from nosebleeds to death. Its use is discouraged for men who have high blood
pressure or heart problems.
For those seeking
a non-prescription alternative to their problems, the choices are numerous --
and sometimes bewildering.
There are herbs
that "mimic" the response Viagra provides, "but the effect is not
as pronounced as Viagra," says Mark Blumenthal, a spokesman for the
American Botannical Society, a trade group representing herbal manufacturers.
"There's no herb singly that has the same properties" as the
prescription drug, "with the possible exception of yohimbe," says Mr.
Blumenthal. But Mr. Blumenthal said there haven't been good clinical studies on
it, even though it has long enjoyed a reputation as an aphrodisiac.
Mr. Blumenthal
says ginseng and yohimbe, which are contained in many products, are known to
stimulate the release of nitric oxide in the body, which in turn can increase
peripheral blood flow, including to the genitals. The proof of a product's
efficacy, says Mr. Blumenthal "would be whether men buy it the second
time."
Another
ingredient that often shows up in OTC aphrodisiacs is L-arginine, an amino acid
that has been shown to increase blood flow. One company reports that 88% of men
in a study conducted by a physician in Hawaii reported "better
erections" after taking an L-arginine-based product fortified with ginseng
and gingko biloba. The same product also is being tested on women, and
preliminary data suggests that three-fourths of those patients reported improved
sexual desire, while 52% reported more frequent orgasms.
Ancient
aphrodisiacs
Some of the
ingredients in today's "male enhancement" potions are herbs that have
been used for centuries to improve sexual health and interest, said Dr. Barratt,
who has a Ph.D. in psychology and sexology.
He cited avena
sativa - also known as wild oats - that has been used by men in some cultures to
improve the quality of their erections, and muira puama, a South American herb
favored by indigenous people in the Amazon to treat impotence. Horny-goat weed
is an ancient Chinese aphrodisiac.
But long-term
anecdotal and folk use doesn't prove efficacy, said Dr. Barratt. And there's
another factor to consider. "Almost everything has a placebo effect of up
to 30%," he noted, so it's possible that nearly a third of the men who try
such herbs perceive an improvement in their performance because they think the
pill works and not because of anything the pill actually does.
Dr. Barratt
suggests that men try another route to sexual satisfaction: instead of opening a
bottle of instant amore, try opening up the lines of communication.
"The penis
is hard-wired to the heart," he says. "Sexual performance is tightly
bound up with feelings, and not that many men are good at discussing their
feelings." Relying on a medication or an herb to fix a sagging love life
"distracts men" from looking at the anxiety or relationship
difficulties that may be at the root of their bedroom troubles, he adds.
Although the U.S.
Food and Drug Administration must approve a prescription drug like Viagra before
it goes on the market, some critics worry that herbals and dietary supplements
go on sale without any prior government review. While it's true that herbal
product manufacturers don't have to get FDA approval to sell a dietary
supplement, federal laws require manufacturers to make truthful claims on their
labels and empower the FDA to act against unsafe products, says Mr. Blumenthal.
Ray Sahelian, a
California physician who markets a line of herbal supplements, including Steel
Libido for men with sexual problems, vouches for the safety of products
containing such ingredients as L-anginine, yohimbe, muira puama and horny goat
weed. He cautions against using products with high doses of hormones, such as
DHEA and androstene dione.
While some of the
OTC products suggest the best results come from usage over three to four months,
Dr. Sahelian recommends "intermittent use" of them, adding, "I
would use them occasionally to increase interest and drive." Anyone
planning to take any supplement always should consult with his health care
practitioner, he emphasizes.
Dr. Ira Sherlip,
a professor urology at the University of California-San Francisco who is
president of the Sexual Medicine Society of North American, is downright
skeptical about the benefit of OTC sexual aids. "I don't know if they work,
nor does anyone else -- despite manufacturers' claims that they do," he
says. "I'd like for these manufacturers to show me the evidence. But there
is none."
Dr. Sherlip says
nearly every one of his patients who has tried a supplement "said it didn't
do anything." If a patient asks Dr. Sherlip whether he should try an OTC
aphrodisiac, "I discourage him, but if he wants to waste his money, that's
his business."
The judicious use
of a supplement may give a troubled man the lift he needs to begin resolving the
possible psychological causes of a sexual problem, says Dr. Sahelian. "I
don't see why men can't address both components at the same time -- the physical
and the psychological," he explains. "Sometimes improving performance
can help a man to start addressing those other issues."
Dr. Barratt's
advice falls somewhere in the middle. If a patient wants to try an OTC
supplement, "I tell them to be careful, take it in moderation, and don't
use it frequently," he says. "We don't know anything about the
long-term effects of these products."
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evaluated by the Food and Drug Administration. These products are not intended to
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and should not be construed as medical advice. This notice is required by the Federal
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Last modified:
July 22, 2011
