Generally, manufacturers of herbal remedies and dietary supplements do not need FDA approval to sell their products. Just like a drug, herbs and supplements can affect the body’s chemistry, and therefore have the potential to produce side effects that may be harmful. There have been a number of reported cases of serious and even lethal side effects from herbal products. Patients should always check with their doctors before using any herbal remedies or dietary supplements.
There is no evidence that any herbal product, vitamin, or dietary supplement can improve erections or sexual performance in men or women. Despite this, many herbs and dietary supplements are marketed as aphrodisiacs. Aphrodisiacs are substances that are claimed to increase sexual drive, performance, or desire. There are several special concerns for people taking alternative remedies for erectile dysfunction.
Yohimbe. Yohimbe is derived from the bark of a West African tree. Side effects include nausea, insomnia, nervousness, and dizziness. Large doses of yohimbe can increase blood pressure and heart rate and may cause kidney failure.
Viramax is a commercial product that contains yohimbine, the active chemical ingredient of yohimbe, and three other herbs: catuaba, muira puama, and maca. It has not been proven to be either effective or safe, and interactions with medications are unknown
Gamma-Butyrolactone (GBL). GBL is found in products marketed for improving sexual function (such as Verve and Jolt). This substance can convert to a chemical that can cause toxic and life-threatening effects, including seizures and even coma.
Gingko Biloba. Although the risks for gingko biloba appear to be low, there is an increased risk for bleeding at high doses and interaction with vitamin E, anti-clotting medications, and aspirin and other NSAIDs. Large doses can cause convulsions. Commercial gingko preparations have also been reported to contain colchicine, a substance that can be harmful in people with kidney or liver problems.
L-arginine (also called arginine). Arginine may cause gastrointestinal problems. It can also lower blood pressure and change levels of certain chemicals and electrolytes in the body. It may increase the risk for bleeding. Some people have an allergic reaction to it, which in some cases may be severe. It may worsen asthma.
Dehydroepiandrosterone (DHEA). DHEA is a supplement related to certain male and female hormones. Studies show inconclusive results in its treatment for erectile dysfunction. DHEA may interact dangerously with other medications.
Spanish Fly. Spanish fly, or cantharides, which is made from dried beetles, is the most widely-touted aphrodisiac but can be particularly harmful. It irritates the urinary and genital tract and can cause infection, scarring, and burning of the mouth and throat. In some cases, it can be life threatening. No one should try any aphrodisiac without consulting a doctor.
Other Dietary Supplements Marketed for Erectile Dysfunction. There are numerous products marketed as “all-natural” dietary supplements and promoted as treatments for erectile dysfunction and sexual enhancement. The FDA has not approved any of these products. In recent years, the FDA has banned from the market many of these dietary supplements and warns that they contain the same or similar chemical ingredients used in PDE5 inhibitor prescription drugs.