Sexual Supplements: What Patients Should Know
Can a supplement improve a person’s sex life?
Looking at store shelves and media advertising, one might think so. Around the world, people spend millions of dollars on dietary supplements each year. Many of the products are advertised as sexual enhancement products, claiming to boost libido, increase sexual pleasure, or give a man firmer erections.
Supplements are attractive for many reasons. For one, they’re discreet. A man searching for solutions for erection problems might order a supplement online, and nobody has to know he’s seeking help. For another, they’re easy to find in drugstores, convenience stores, and health food stores. And third, people think they might find a solution to a problem and can avoid discussing such a personal issue with another person, even if it is a doctor.
However, consumers need to approach these products with a great deal of skepticism. They often do not live up to manufacturers’ claims, and some can be dangerous.
Below are some things to think about before taking a sexual enhancement supplement.
Sexual enhancement supplements may contain ingredients like the following:
- Tribulus terrestris
- Horny goat weed
- Yohimbine (sometimes called yohimbe)
- Vitamin B6
- Vitamin B9 (folate)
- Vitamin D
FDA doesn’t test or approve dietary supplements
Unlike drugs, dietary supplements do not go through a testing or approval process with the U.S. Food and Drug Administration (FDA). In addition, manufacturers are not required to give the FDA any backup to their safety claims.
The supplement may not be as effective as claimed
Are sexual enhancement supplements effective? This is a difficult question to answer, as the sexual effects of these substances may not be widely studied—at least not in humans. For example, in a 2019 Journal of Sexual Medicine paper, researchers examined 413 studies on sexual enhancement supplements. Only 17% of the studies involved humans.
Lack of peer-reviewed study—or any kind of study in humans—raises questions as to whether supplements are as effective as their manufacturers claim.
Product reviews are another concern. When researching supplements online, consumers may see vast praise from reviewers, with claims like “It completely cured my erection problems!” or “Sex is better than ever!” However, the internet is rife with unreliable reviews. Some companies pay reviewers to give positive reviews, even if the reviewer did not have a positive experience (or any experience) with the product.
In the above study, researchers used review analysis software to filter out reviews that met the criteria for being unreliable. Once the questionable reviews were removed from the analysis, positive claims dramatically fell. The authors wrote:
After filtration, we observed a 77% decrease in reviews reporting improved erection strength, an 83% decrease in reviews reporting improved ability to maintain erection, a 90% decrease in reviews reporting increased sexual satisfaction, an 88% decrease in reviews reporting increased enjoyment with intercourse, and an 89% decrease in reviews reporting increased erection confidence.
In short, claims on effectiveness may not be backed up by scientific study, and positive reviews might not be truthful.
Products may include hidden ingredients, which could be dangerous.
Supplements may include ingredients that are not listed on the package label. (These are called undeclared ingredients.) There have been cases where sexual enhancement supplements have included erectile dysfunction drugs like sildenafil and tadalafil. These drugs are effective for many men, but not all men can take them safely. They can be especially dangerous for men who take nitrates. But if the ingredients are not declared, it’s difficult for people to know if a product contains substances that could harm them.
Sex problems may be related to another health issue, which could be dangerous.
A sexual problem is often a sign of an underlying medical condition. And often, treating that underlying condition solves the problem.
For example, erectile dysfunction can be an early symptom of diabetes or heart disease. It’s also common in men with obesity. For many men, taking steps to control blood sugar, blood pressure, weight, and other health issues leads to better erections—and better sex.
Seeing a doctor for a sexual issue can help solve the problem and lower the risk of having other health issues, and perhaps avoid a major health crisis, in the future. It’s a win-win situation.
Also, adopting healthy habits can go a long way in improving erections—and sex in general. Many people feel more energetic, confident, and attractive when they take good care of their health.
When faced with a sexual problem, trying a supplement may seem like an easy plan to try. But it’s important to do some homework first:
See a doctor. Sexual issues are common, and one of the best ways to start addressing them is getting a full check up with a doctor. If another health condition, like diabetes or heart disease, is causing the sexual issues, then it’s important to treat that. (Sexual problems often improve when the underlying cause is treated.)
Ask a doctor or pharmacist about the supplement. These experts can provide information on the safety of a product’s ingredients and what side effects may occur. They can also answer any questions.
Read the supplement label and packaging insert. If anything looks amiss, the manufacturer should be able to give more information.
Check the FDA’s list of tainted sexual enhancement products. The FDA maintains a public list of supplements that could be risky.
With good information, people can make informed decisions. And the best information for a person’s individual situation comes directly from their doctor, not from a supplement manufacturer that doesn’t know the consumer and might not have patients’ best interests at heart.
Jenkins, Lawrence C., MD, MBA, et al.
“AUA2022: REFLECTIONS: The Safety and Efficacy of Sexual Supplements”
(August 1, 2022)
“Can Testosterone Supplements Improve Your Sex Drive?”
(Updated: September 30, 2022)
Harvard Health Publishing / Harvard Medical School
“Can supplements save your sex life?”
The Journal of Sexual Medicine
Balasubramanian, Adithya BA, et al.
“An Analysis of Popular Online Erectile Dysfunction Supplements”
(Full-text. Published April 26, 2019)
Medical News Today
“Natural remedies and supplements for erectile dysfunction”
(Updated: January 10, 2023)
“Dietary supplements for urologic conditions may pose risks to patients”
(January 25, 2023)
U.S. Food and Drug Administration
“Questions and Answers on Dietary Supplements”
(October 26, 2022)
“Tainted Sexual Enhancement Products”
(Content current as of February 7, 2023)