By: Dr Weriwoyingipre Silver Yeibake
Paediatrics, Federal Medical Centre Yenagoa, Bayelsa State, Nigeria
Email: silveryeibake@gmail.com
Why are they used?
An aphrodisiac is a substance claimed to increase sexual desire, arousal, erection, orgasm or sexual performance. This could be medicines from other sources or from herbs.
Many Nigerians use herbal products to improve sexual desire, erection, fertility, stamina, or sexual performance. These products may be sold as bitters, honey mixtures, capsules, powders, liquids, or locally prepared remedies.
Commonly mentioned plants include bitter kola (Garcinia kola, orogbo), African black pepper (Piper guineense, uziza or iyere), African ginger (Mondia whitei, mukombero), Fadogia (Fadogia agrestis), and Massularia (Massularia acuminata, pako-Ijebu, orin-Ijebu or atori).
Traditional knowledge is valuable and may guide research, but long-standing use alone does not prove that a product is effective or safe. The World Health Organization recommends evaluating traditional medicines for quality, safety, and efficacy. [1]
Common plants and what is known
Massularia acuminata (pako-Ijebu, orin-Ijebu, atori) has shown possible effects on sexual behaviour, testosterone, nitric oxide, and other erectile-function pathways in rats. Human benefit has not been established.
Fadogia agrestis has increased sexual behaviour and testosterone levels in animal studies. There is insufficient evidence to recommend it as a testosterone booster in humans.
Garcinia kola (orogbo, bitter kola) has shown possible antioxidant and vascular effects in laboratory studies. There is no convincing human evidence that it treats erectile dysfunction or permanently enlarges the penis.
Kola nut (Cola acuminata and Cola nitida, obi, goro or gworo) contains caffeine. It may increase alertness but is not proven to be an aphrodisiac. Excessive intake may cause anxiety, insomnia, palpitations, and high blood pressure.
Piper guineense (uziza, iyere or etinkeni) is used as a spice and traditional medicine. Evidence for sexual enhancement is mainly experimental, not clinical.
Mondia whitei (mukombero) has shown possible pro-sexual and hormonal effects in animal studies. Its effective human dose and long-term safety are unknown.
Carpolobia luteal (angalagala) is traditionally used as a sexual stimulant, but adequate human evidence is lacking.
Ginger (*Zingiber officinale*, *ataalẹ* or *citta*), garlic (*Allium sativum*, *ayu* or *tafarnuwa*), onion (*Allium cepa*, *alubosa* or *albasa*), clove (*Syzygium aromaticum*, *kanafuru* or *kanumfari*), grains of paradise (*Aframomum melegueta*, *ataare*), Aidan fruit (*Tetrapleura tetraptera*, *aridan* or *prekese*), and castor plant (*Ricinus communis*, *ewe lapalapa*, *ogiri* or *cika-gida*) are also used in traditional preparations. However, evidence that they treat sexual dysfunction is limited, and some concentrated preparations may be harmful.
Local names vary between Nigerian languages and communities. The same name may refer to different plants. Scientific names should therefore be used to confirm plant identity.
How might they work?
Some plant constituents may influence blood flow, nitric-oxide signalling, hormones, antioxidant pathways, sexual behaviour, or metabolic health. These proposed mechanisms are biologically plausible, but a laboratory or animal finding is not proof of benefit in humans.
A standardised research extract is also not the same as an unlabelled product bought from a market, roadside vendor, shop, or social-media seller.
Natural does not mean harmless
Herbal medicines, like all medicines, are useful only when the correct product is used correctly and at an appropriate dose. A natural substance is not automatically safe, mild, or suitable for everyone.
Plants produce active chemicals to defend themselves against insects, fungi, bacteria, parasites, herbivores, and other environmental threats. Some of these substances may have medicinal value in humans. The same substances can also cause toxicity, allergy, organ injury, or drug interactions when taken in excessive amounts, prepared incorrectly, or used in inadequately tested products. WHO guidance specifically warns against assuming that all natural remedies are harmless. [2]
Herbal medicines should therefore be accurately identified, properly prepared, clearly labelled, quality-tested, and used with professional advice.
Hidden medicines and adulteration
Some products marketed as herbal contain undeclared pharmaceutical drugs. In particular, sildenafil—the active ingredient in Viagra—has been detected in Nigerian herbal aphrodisiacs.
In one study of 50 products collected across four north-western states, 16 products, or 32%, contained sildenafil. [3] Another study found sildenafil in five of ten liquid herbal preparations sold in Sokoto. These findings do not mean that every herbal product is adulterated, but they show that the word “herbal” cannot guarantee safety.
Undeclared sildenafil may cause headache, flushing, indigestion, dizziness, visual disturbances, palpitations, or dangerously low blood pressure. It can be especially dangerous when taken with nitrate medicines used for angina, or when combined with other sexual-enhancement products.
Contamination and illness
Herbal products may also contain heavy metals, microorganisms, pesticides, or other contaminants. Nigerian studies have raised concerns about lead, cadmium, mercury, arsenic, chromium, and cobalt in some sexual-enhancement products and their possible reproductive-health effects. [4][5]
Persistent erectile difficulty or low libido may be related to diabetes, hypertension, cardiovascular disease, obesity, medication effects, hormonal disorders, depression, anxiety, stress, alcohol use, or relationship problems. Unregulated products may delay diagnosis and treatment.
What should consumers do?
Consumers should discuss persistent sexual problems with a qualified healthcare professional and disclose all medicines, supplements, and herbal products they use.
Avoid products that promise immediate, permanent, or guaranteed results, or that lack an ingredient list, batch number, expiry date, or identifiable manufacturer. Do not combine different aphrodisiacs or use herbal sexual-enhancement products with sildenafil, tadalafil, or similar medicines unless advised by a clinician.
Stop using a product and seek urgent medical attention for chest pain, fainting, severe dizziness, serious visual symptoms, severe allergic symptoms, yellowing of the eyes, or an erection lasting more than four hours.
Key message
Herbal does not automatically mean safe, and traditional use does not automatically prove effectiveness. Herbs, like all medicines, can help when the right product is used correctly and at the right dose. They can also cause harm when misidentified, contaminated, adulterated, or misused. Seek medical advice for persistent symptoms and avoid unlabelled sexual-enhancement products.
References
1. World Health Organization. General guidelines for methodologies on research and evaluation of traditional medicine. Geneva: World Health Organization; 2000. WHO/EDM/TRM/2000.1. Available from: https://iris.who.int/handle/10665/66783.
2. Adefegha SA, Oboh G, Adedipe AO, et al. Aqueous extract of *Massularia acuminata* exerts erectogenic effect by modulating critical enzymes and hormones in streptozotocin-induced erectile dysfunction in rats. *Andrologia*. 2022;54(10):e14629. doi:10.1111/and.14629.
3. Tauchen J, Franková A, Maňourová A, Valterová I, Lojka B, Leuner O. *Garcinia kola*: a critical review on chemistry and pharmacology of an important West African medicinal plant. *Phytochem Rev*. 2023;1–47. doi:10.1007/s11101-023-09869-w.
4. Yakubu MT, Awotunde OS, Ajiboye TO, Oladiji AT, Akanji MA. Pro-sexual effects of aqueous extracts of *Massularia acuminata* root in male Wistar rats. *Andrologia*. 2011;43(5):334–340. doi:10.1111/j.1439-0272.2011.01080.x.
5. Yakubu MT, Akanji MA, Oladiji AT, Adesokan AA. Androgenic potentials of aqueous extract of *Massularia acuminata* stem in male Wistar rats. *J Ethnopharmacol*. 2008;118(3):508–513. doi:10.1016/j.jep.2008.05.020.
6. Yakubu MT, Akanji MA, Oladiji AT. Aphrodisiac potentials of aqueous extract of *Fadogia agrestis* stem in male albino rats. *Asian J Androl*. 2005;7(4):399–404. doi:10.1111/j.1745-7262.2005.00052.x.
7. Deeh PBD, et al. Ethnomedicinal, phytochemical, pharmacological and toxicological profile of *Mondia whitei*: a review. *Fitoterapia*. 2024;177:106119. doi:10.1016/j.fitote.2024.106119.
8. Bella AJ, Shamloul R. Traditional plant aphrodisiacs and male sexual dysfunction. *Phytother Res*. 2014;28(6):831–835. doi:10.1002/ptr.5074.
9. Lawal AT, Musa A, Usman MA. TLC and IR detection of sildenafil as an undeclared adulterant in some herbal aphrodisiac products marketed in northwest Nigeria. *West Afr J Pharm*. 2023;31(1):119–128. doi:10.60787/wapcp-31-1-211.
10. Alhassan AM, Abdulkarim B, Arkilla MB, Malami I. Analysis of sildenafil citrate in herbal aphrodisiac preparations marketed in Sokoto metropolis. *Caliphate J Sci Technol*. 2023;5(1):32–37. doi:10.4314/cajost.v5i1.5.
11. Tama AL, Musa A, Usman MA, Awwalu S. Evaluation of sildenafil as an undeclared adulterant in herbal aphrodisiac preparations by HPLC. *Saudi J Med Pharm Sci*. 2020;6(2):168–172. doi:10.36348/sjmps.2020.v06i02.010.
12. Igweze ZN, Amadi CN, Orisakwe OE. Unsafe herbal sex enhancement supplements in Nigerian markets: a human risk assessment. *Environ Sci Pollut Res Int*. 2019;26:22522–22528. doi:10.1007/s11356-019-05511-5.
13. Iwuozor KO. Heavy metal concentration of aphrodisiac herbs locally sold in south-eastern Nigeria. *Pharm Sci Technol*. 2019;3(1):22–26. doi:10.11648/j.pst.20190301.13.
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