What are the alternative treatments for impotence

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Many alternative agents are marketed for impotence. Very few have been studied and some can be harmful. Some, but not all, are discussed in this report. [ See Warning Box.]

Yohimbine
Yohimbine (Yocon, Yohimex) has been used as folk medicine for years. It appears to improve blood flow. Studies have been inconclusive about its benefits, but a recent analysis of seven trials reported that between 34% and 75% of men achieved favorable results when taking 5 mg to 10 mg. Side effects include nausea, insomnia, nervousness, and dizziness. Large doses can increase blood pressure and heart rate.

One death has been reported from taking tablets of the standard dosage (5.4 mg). More rigorous studies are needed to confirm its effectiveness, and men suffering from anxiety or hypertension are cautioned against its use. The American Urologic Association does not recommend yohimbine for treating impotence, although some experts believe it is an inexpensive and reasonable option for some men.
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Aphrodisiacs
Aphrodisiacs are substances that are supposed to increase sexual drive, performance, or desire. Some examples include the following:

• Viramax is a well-marketed product that contains yohimbine and three herbal aphrodisiacs: catuaba, muira puama, and maca. It has not been proven to be either effective or safe and interactions with medications are unknown.

• Foods that some people claim have aphrodisiacal qualities include chilies, chocolate, licorice, lard, scallops, oysters, olives, and anchovies. No evidence exists for these claims and certainly no one would ever advocate eating large amounts of such foods, which in cases such as licorice and lard, can be dangerous.

• Spanish fly, or cantharides, which is made from dried beetles, is the most widely-touted aphrodisiac and is particularly harmful. It irritates the urinary and genital tract and can cause infection, scarring, and burning of the mouth and throat. In some cases, it can be life threatening.

No one should try any aphrodisiac without consulting a physician.

Other Alternative Remedies

• In one small study, 78% of men who had impotence caused by impaired blood flow regained erections after taking ginkgo. More research is needed.

• Ginseng root is a traditional Asian remedy for stimulating sexual function, although no studies have been conducted on its efficacy.

• A dietary liquid supplement called ArginMax is being hailed as a natural sildenafil (Viagra) [ see above ]. The substance presumably increases production of nitric oxide, a substance that relaxes blood vessels. If ArginMax acts like sildenafil, it may also have similar interactions with nitrates and other drugs, in spite of claims for safety.

• An herbal supplement sold as Vaegra has no association with the prescription drug sildenafil (Viagra).

None of these substances are regulated and their quality is not controlled. Any substance that can affect the body’s chemistry can, like any drug, produce side effects that may be harmful.

Warnings on Alternative and So-Called Natural Remedies

It should be strongly noted that alternative or natural remedies are not regulated and their quality is not publicly controlled. In addition, any substance that can affect the body’s chemistry can, like any drug, produce side effects that may be harmful. There have been a number of reported cases of serious and even lethal side effects from so-called natural products.

For example, some products are marketed for improving sexual function (Verve, Jolt) that contains gamma-butyrolactone (GBL). This substance can convert to a chemical that can cause toxic and life-threatening effects, including seizures and even coma.

In addition, some so-called natural remedies have been found to contain standard prescription medication. Most problems reported occur in herbal remedies imported from Asia, with one study reporting a significant percentage of such remedies containing toxic metals. Even if studies report positive benefits, most, to date, are very small. In addition, the substances used in such studies are, in most cases, not what are being marketed to the public.

The following website is building a database of natural remedy brands that it tests and rates. Not all are available yet. http://www.ConsumerLab.com/

The Food and Drug Administration has a program called MEDWATCH for people to report adverse reactions to untested substances, such as herbal remedies and vitamins (call 800-332-1088).

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