Beware of erectile dysfunction scams

Many natural therapies promise to help with erectile dysfunction (ED), but there are reasons to be cautious.

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"Improve your sex life!" That's one of the most frequent promises offered by makers of herbal remedies, nutritional supplements, and hormones. But can they actually deliver on that promise? Or are they in effect ED scams?

The reality is that most of these products have not been studied scientifically for ED, and the FDA does not regulate their use and dosage. Moreover, questions about their safety are also a cause for concern, especially if you take any of them in large doses, or for weeks or months.

For instance, a 2015 review in The Journal of Sexual Medicine examined the scientific evidence for some of the most common ingredients in over-the-counter "nutraceuticals" marketed for men's sexual health to determine if these products are effective and safe. It found little or no evidence to support common health fraud claims they can improve ED or other aspects of sexual performance.

The researchers also noted that some products labeled "natural" actually contain traces of PDE5 inhibitors, medications in the same class that includes prescription ED drugs like Viagra. The report also cited one study that found 81% of tested over-the-counter products purchased in the U.S. and Asia contained PDE5 inhibitors, which could lead to serious health issues, like an unsafe drop in blood pressure in men with advanced heart disease or in those who take nitrates like nitroglycerin.

Spotting possible health fraud

Here is a roundup of some ingredients frequently used in top-selling natural products, and what the researchers in the 2015 review concluded about their effectiveness and safety. Remember: never take any over-the-counter supplement without first checking with your doctor.

• DHEA. The evidence to support a benefit from this hormone is weak.
• Fenugreek. One study noted a benefit in improving sexual arousal and orgasm, and other research has shown this herb to be safe over all.
• Ginkgo biloba. There are no convincing data to support the use of this herb in men with ED—and it has been linked with side effects, such as headaches, seizures, and bleeding.
• Ginseng. This herb is the most common ingredient in top-selling men's supplements, but there is no good evidence to show that it works. Moreover, it can cause headaches, upset stomach, constipation, rash, and insomnia and can lower blood sugar levels, so men with diabetes should avoid it.
• Horny goat weed. In spite of its colorful name, there is no evidence that the herb can improve sexual function, although it does appear safe.
• L-arginine. This amino acid has the theoretical potential to improve erectile function in some patients. However, a study of the possible benefits of L-arginine to treat heart attack survivors was stopped midway when early data showed six deaths among volunteers assigned to L-arginine, compared with none in the placebo group. Men—especially those at risk for heart disease—should avoid these supplements.
• Maca. In animal research, use of this root was associated with increased sexual behavior. Side effects like a mild increase in liver enzymes and blood pressure are rare.
• Tribulus. There is no evidence that this herb has any benefit in humans.
• Yohimbine. This has shown promise for improving male sexual function in some studies. However, it may cause high blood pressure (hypertension), headaches, agitation, insomnia, and sweating.

– By Matthew Solan
Executive Editor, Harvard Men's Health Watch

To find the latest in erectile dysfunction treatment, buy the Harvard Special Health Report Erectile Dysfunction.