Sexual enhancement supplements have always been a bit of a joke: you walk into a supplement store (or chuck a search into Google) and voilà – hilariously titled drugs that supposedly give you the sexual prowess of a god await you. All you have to do is pop a little pill and your flagging stamina or general lack of desire will disappear.
But like all things that sound too good to be true, is there any evidence these supplements work – and could they be doing more harm than good?
What are sexual enhancement supplements?
Sexual enhancement supplements are usually sold as “natural” products containing various herbal ingredients.
There are horny goat weed pills, touted as a way to support sexual function and energy because the plant contains a protein which may increase blood flow to your genitals. There are various pun-titled candies with everything from royal jelly – a product of bees created to feed the queen – to various types of honey, coffee, ginseng and more in them. And there are supplements that appear almost identical to normal multivitamins, presumably because vitamins are generally important to good health and therefore must improve your sex life as well.
But as recent Therapeutic Goods Administration testing reveals, many of the products available to buy in retail stores and online have been found to be adulterated with prescription medications such as sildenafil, commonly sold as Viagra, and tadalafil, sold under the brand name Cialis. These are common erectile dysfunction medications that require a prescription from a GP to avoid harmful side effects.
How dangerous are the supplements?
As a general rule, there is no evidence to support the fact that ingredients like goat weed or royal jelly can improve sexual performance. But the problem is, when supplements are adulterated with prescription medications, the products can become quite dangerous. In 2007, Cialis was discovered in a herbal supplement for men in Australia and was ordered to be withdrawn from the market, with the TGA warning the product could have “serious health consequences, especially for patients with existing medical conditions such as heart problems, or persons at risk of stroke”.
And it’s not just a problem in Australia – there are worldwide concerns that prescription medications are readily being added to supplements. This problem is only getting bigger due to the proliferation of the online supplements hidden market thanks to influencers spruiking the products on social media.
Why are they being adulterated?
Dr Ian Musgrave, a molecular pharmacologist from the University of Adelaide, says the products are being adulterated because people want an effective supplement and “prescription drugs work”.
“Adding pharmaceutical drugs to herbal preparations with marginal efficacy … provides for a readily marketable product” that can be illicitly sold as effective “herbal” or “natural” remedies.
But these prescription drugs carry significant risks when taken without the advice of a doctor. Many of them work by influencing how blood flows around your body, which means that when combined with other medications they can cause extreme low blood pressure and other heart issues.
This isn’t an issue if you’re prescribed the pills by your doctor, who will carefully go through the potential problems with you before you use the medication, but can be a huge problem if you don’t know that you’re taking it. For example, combining Viagra and chest pain medications can cause really serious health problems.
The fact that there are supplements being sold on our shelves and online with potential hidden ingredients decades after the problem first emerged is concerning. Dr Musgrave says that part of the problem is that it is very hard to regulate the online illicit supplements market.
“Border Force is vigilant for unapproved medical products, along with illicit drugs, but the supplement market is very fluid, and the types and forms of supplements vary continuously”. He said it would require a “significant expansion” in both monitoring and personnel to ensure that we are safe from adulterated products.
What can you do to protect yourself?
Buying supplements online without a prescription can be potentially dangerous. Purchasing products in a chemist reduces the risk of adulteration, especially if products carry an AUST L number on them, which means they are registered with the TGA. But the best advice is to always see your doctor first before taking supplements – even if they claim to be “natural”.
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Dr Gideon Meyerowitz-Katz is an epidemiologist and science communicator and a senior research fellow at the University of Wollongong
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Antiviral is a fortnightly column that interrogates the evidence behind the health headlines and factchecks popular wellness claims
