February 2024

Toxic Love? Natural Ingredients Promoted for Sexual Health

Valentine’s Day is approaching, and love is in the air. Many patients are too embarrassed to discuss sexual health questions with their healthcare provider – which often makes the internet their main source for information. Tribulus, fenugreek, and Panax ginseng are three of the most commonly used natural ingredients in sexual enhancement supplements promoted online. Make sure you understand the evidence on these ingredients so that you can talk to patients with confidence and also credibly explain why buying these types of products online isn’t a good idea.

Tribulus has been traditionally used as an aphrodisiac in Chinese, Indian, and Greek traditional medicines. It contains the chemical protodioscin, which might affect levels of certain hormones like testosterone. Some clinical evidence shows that taking tribulus by mouth improves the sexual experience in both males and females with low sexual desire. Its extract has been used safely in doses of 750-1500 mg by mouth daily for up to 90 days. But there isn’t enough information about the safety of larger doses or longer-term use.

Fenugreek also contains protodioscin. Clinical research shows that taking a specific fenugreek seed extract by mouth appears to improve sexual desire and ability in males. And it seems to be well tolerated. Fenugreek seed powder has been used safely in doses of 5-10 grams daily, and fenugreek seed extract has been used safely in doses of 1 gram daily for up to 3 years.

As for Panax ginseng, clinical research shows that taking it by mouth for 8 weeks might improve sexual function in patients with erectile dysfunction, making it a popular ingredient in male enhancement products. But there are concerns about using it for more than 6 months. Its hormone-like effects could be harmful when used long-term.

Explain to patients that while there might be some evidence supporting the use of these individual ingredients in clinical research, identifying high-quality products and trustworthy manufacturers in this area remains a challenge. Supplements promoted online for sexual health and enhancement are notoriously tainted with drugs and other undeclared ingredients. And because dietary supplements aren’t regulated in the same way as prescription and OTC drugs, these tainted products aren’t typically caught until after they hit the market. The FDA recently issued a warning letter to Amazon for selling many sexual enhancement supplements that tested positive for the drugs tadalafil and sildenafil – the active ingredients in FDA-approved prescription drugs Viagra and Cialis. Remind patients that just because a product has thousands of 5-star reviews doesn’t mean it’s safe.

The information in this brief report is intended for informational purposes only, and is meant to help users better understand health concerns. This information should not be interpreted as specific medical advice. Users should consult with a qualified healthcare provider for specific questions regarding therapies, diagnosis and/or health conditions, prior to making therapeutic decisions. Copyright © 2024 NatMed. Commercial distribution or reproduction prohibited. NatMed is the leading provider of high-quality, evidence-based, clinically-relevant information on natural medicine, dietary supplements, herbs, vitamins, minerals, functional foods, diets, complementary practices, CAM modalities, exercises and medical conditions. Monograph sections include interactions with herbs, drugs, foods and labs, contraindications, depletions, dosing, toxicology, adverse effects, pregnancy and lactation data, synonyms, safety and effectiveness.