Useless or Unsafe Sex Supplements
Both Krychman and Terlecki mention a few potentially hazardous sexual health supplements that clinicians should be aware of. These plant-based aphrodisiacs include chasteberry, potency wood/Muira Puama, Horny goat weed, and Ginkgo biloba all of which have only scant or sketchy evidence to back up their claims.[1,2]
The skin and venom of the Bufo toad contain a psychoactive and potentially lethal toxin. At this time, the FDA bans products containing Bufo toad. Another supplement that patients should avoid is Spanish fly, which causes vascular congestion of the genital tissues and inflammation of the urogenital tract. It might give the user a "rush," but it can be fatal and is therefore considered off-limits for human consumption.
The exogenous estrogens from soy, if ingested in high amounts, can also wreak havoc on the body. Krychman cited an example of a 44-year-old woman who presented to her gynecologist, complaining of increased "pelvic tension" during the past 5-6 months. It turned out that she had been ingesting enormous amounts of soy—in excess of 4 pounds a day. After eliminating soy, the patient's complaints resolved within months.
Many supplements have some in vitro evidence of antiplatelet effects that can lead to bleeding in the presence of certain drugs or supplements. One patient of Terlecki's who was experiencing nosebleeds was found to be taking ginkgo biloba, omega-3 supplements, and high-dose vitamin E.
"Certainly, drug interactions involving sex supplements have been reported," confirmed Hein, adding that, "In theory, combining certain supplements with an anticoagulant (eg, warfarin) or an antiplatelet agent (eg, aspirin or clopidogrel) can increase the risk of bleeding events." These events might be as minor as bruising or bleeding from the gums, but they can escalate into more serious gastrointestinal bleeding or hemorrhagic stroke.
To be on the safe side, Hein suggests that patients who want to try a supplement simply ask their pharmacist to check to see whether the supplement can potentially interact with any medications they are already taking. Pharmacists, he explained, are trained to be able to ascertain whether any potential interaction might represent a safety concern.
Let's Talk About Sex
So how do sexual medicine experts, such as Krychman, or urologists with a special interest in men's health, such as Terlecki, counsel patients who ask about supplements that purport to enhance sexual drive or performance?
"I would say, maintain a healthy degree of skepticism and recognize that doctors can't vouch for what they don't know," replied Terlecki. Patients should also recognize that they are gambling not only with their money when they purchase and use these products, but also with their health.
But the real bottom line is not which sexual health supplements might work, or which might be toxic. It is getting patients to feel comfortable speaking with healthcare providers about sexual issues, and getting clinicians comfortable with asking. A satisfying sex life is important, and even has implications for overall health, relationships, and quality of life.
"Sexual health and general health are very much intertwined," Krychman said. "If you have good sex, you are happier overall, your risk of chronic medical conditions is lower, you sleep better, and you have lower levels of stress."
Medscape Internal Medicine © 2019 WebMD, LLC
Any views expressed above are the author's own and do not necessarily reflect the views of WebMD or Medscape.
Cite this: Supplements for Sex: What To Know - Medscape - Apr 22, 2019.