There is evidence that herbs have been used for medicinal purposes as far back as 60,000 years and have been used by all cultures (Freeman, 2009). Herbal medicine involves the use of specific parts of the plant such as the bark, fruit, root, stem seed or entire plant. The gathering, processing and distribution of herbs can vary greatly. In CAM, herbs are used in traditional Chinese medicine, Avuyerdic medicine, Homeopathy and in folk remedies by different cultures. In the United States herbs were identified as a “dietary supplement” in 1994 (AACE Nutrition Guidelines Task Force, 2003). As such they are not subject to the rigorous scrutiny imposed on pharmaceuticals by the Federal Drug Administration. Given the history and popularity of herbal medicine and supplements, it is not surprising their use is on the rise. According to Rowland, Burek, and Macias (2007) products for men are more common than for women. But what does the evidence tell us? Two herbs commonly used for the treatment or enhancement of sexual functioning in men include yohimbine and ginkgo. Yohimbine is derived from the bark of the yohimbe tree in Africa. It has been used in the treatment of erectile problems and is pending (FDA) approval as a prescription medicine for pupillary dilation. Yohimbine works by dialating the blood vessels in the penis and thereby increasing the blood circulation allowing for an erection. A meta analysis including seven randomized trials of 400 men with ED found yohimbine (15-43 mg/day) more effective than placebo for all forms of ED (Ernst & Pittler, 1998). Another herb gaining popularity is Ginkgo biloba extract (GBE). GBE is widely used for the treatment of dementia and circulatory disorders. It is believed to assist in the relaxation of vascular smooth muscles and assist with improved penile, clitoral, and vaginal vasocongestion helping with arousal disorders. While there have been studies conducted to evaluate the efficacy of GBE, they have not yielded significant or promising results. Additional herbs that have gained popularity in promoting sexual performance include damiana, ginseng, saw palmetto, tribulus terrestris, muira pauma, maca, Epimedium (horny goat weed), Black cohosh, and Dong Quai, Eurycoma Longiforia for males and chasteherry for females. However, the studies supporting the efficacy of these remain poor and mostly anecdotal. Consumers need to careful of claims made by companies and products promoting the claims of these supplements and aware of potentially negative or problematic interactions with other pharmacological treatments or medical conditions.
AACE Nutrition Guidelines Task Force (2003). American Association of Clinical Endocrinologist Medical Guidelines for the Use of Dietary Supplements and Nutraceuticals. Endocrine Practice, 9(5), 417-470. AACE Nutrition Guidelines Task Force (2003)
Freeman, L.W. (2009) Mosby's complementary & alternative medicine: A research-based approach (3rd ed.). Mosby
Rowland, D. L., Burek, M., & Macias, L. (2007). Plant-Derivatives and Herbs Used for the Promotion of Sexual Health and the Treatment of Sexual Problems. Annual Review of Sex Research, 18225-257.