At a recent talk on erectile dysfunction, a middle-age man asks the discussion leader whether he'd heard of a certain product.
"You, um, spray it on your penis, and it becomes instantly hard."
"If it was that good," Dr. Rafael Wurzel says gently, "everybody would be using it and Pfizer would be out of business." Pfizer, of course, makes Viagra, the pill that has resurrected the sex lives of millions and popped the lid on a once-shameful problem.
Latching onto that wildly successful prescription drug is a long line of over-the-counter sexual "enhancers," some of which are labeled "herbal Viagra" or "Viagra alternative." The radio and Internet are full of ads for this big slice of the $16-billion-a-year herbal-supplement industry.
Men buy Veromax and Viapro because they can't afford the $6 to $10 a pop for Viagra, or they can't take it for medical reasons. Others are attracted to herbal aphrodisiacs because they don't like drugs or they're too ashamed to admit their problem to a medical professional.
But physicians and scientists say herbal sex boosters are mostly snake oil and that some can even be harmful.
"They are really exploiting the new awareness about erectile dysfunction," says Wurzel, head of urology at New Britain General Hospital and a longtime specialist.
The herbal remedy that receives the most positive reviews is yohimbe, which comes from the bark of an African tree. Before Viagra was available, urologists routinely prescribed drugs containing yohimbe's primary active constituent, yohimbine. But it's a 90-pound weakling compared with Viagra. Studies have shown yohimbine to be 25 percent to 30 percent more effective than a placebo, while Viagra has a success rate of more than 80 percent, according to Wurzel.
All the rest of the over-the-counter aphrodisiacs, ancient and new, from horny goat weed to saw palmetto, are of dubious or no value as sexual enhancers, according to the pharmaceutical/medical establishment.
But people who sell herbs for a living say the doctors and drug scientists who pooh-pooh herbal remedies are either protecting their territory or simply ignorant.
Ed Haisha, director of marketing and public relations for Omni Nutraceuticals, a company that distributes Veromax, says the supplement has been tested in laboratories approved by the U.S. Food and Drug Administration. Veromax has received a "certificate of analysis," proving that "what you say is in the bottle is in the bottle," Haisha says.
Herbal supplements do not work for everybody, he says, but that doesn't mean they're ineffective.
"Does Tylenol work for everyone? Does ibuprofen work for everyone? No," Haisha says.
Doctors recommend that men see their physicians before using any herbal supplement so they can check for health problems and screen for potential adverse reactions.
But that can be difficult, experts say, since some of the herbal-supplement companies change ingredients on the fly.
"If you have fleeting ingredients, how do you screen for interactions?" says Susan Smolinske, associate professor at Wayne State University and the author of several papers on dietary supplements.
Smolinske and other health professionals say they're concerned about the lack of oversight. No government agency is responsible for inspecting herbal supplements for claimed ingredients or contamination with heavy metals and other toxins.
Herbal-supplement sellers can shout to the sky about improving function and performance, but they cannot promise to cure impotence or any other medical condition. If they do, they can be penalized by the FDA or the Federal Trade Commission. The FDA regulates all claims made on drug labeling; the FTC oversees advertising.
Two years ago, the FTC penalized American Urological Corp. for its marketing of "Vdegra," which they claimed could eliminate impotence in 68 percent to 94 percent of men.
Wurzel says men looking to remedy their sexual problems should remember that, unlike drug companies, herbal-supplement makers do not have to spend millions of dollars and put their products through years of rigorous testing.
His advice: "Be extremely skeptical."
— Susan Coburn, special to the Stamford Advocate
