Yohimbe tree bark: Herbal Viagra better gotten by Rx

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Long before Viagra, there was yohimbe, derived from the bark of the West African tree, Pausinystalia yohimbe. Valued as an aphrodisiac in folkloric medicine for centuries and widely used in Europe for the past 75 years, yohimbe is said to stimulate sexual appetite and enhance performance in men. Can it really perk up a sagging love life?

What It Might Do: Small amounts of yohimbine, the active compound in yohimbe bark, increase sexual drive in male rats. The same results have not been shown in humans. However, claims that yohimbine can alleviate impotence have garnered more reliable scientific support. A recent review of seven well-controlled clinical trials found yohimbine more effective than a placebo in treating erectile dysfunction of both psychological and physical origin. One-third to almost one-half of men reported some benefit.

How It Works: Yohimbe bark contains several alkaloid compounds. The main one, yohimbine, may increase blood flow to the penis, and may also affect the central nervous system, specifically in the lower spinal cord region where sexual responses are conveyed.

If You Take: The isolated compound yohimbine is sold as a prescription drug under the brand names Yocon and Aphrodyne. The usual dose is 5.4 milligrams, three times a day. Benefits may not appear for two to three weeks, yet most drug manufacturers do not recommend long-term use. The whole herb is readily available as a dietary supplement, but nonstandardized preparations may not deliver consistent amounts of the active ingredient and may also contain other alkaloids that are potentially harmful.

Caution: Yohimbe is not an herb to mess around with. It can cause major changes in blood pressure, increased heart rate, tremors, anxiety and panic attacks, even psychosis, in susceptible people. Nausea, vomiting, insomnia, dizziness, increased urination and skin flushing have also been reported. Side effects may actually be fewer with the prescription drug form.

Ironically, yohimbe is not recommended for men who may seek it most--older men and those with cardiovascular disease, hypertension and prostate problems. Neither should it be used by those with liver or kidney disease, psychiatric illness or in combination with mood-altering drugs like antidepressants. With both the herb and the drug, it's important to avoid foods containing tyramine, like aged cheeses, red wine and liver, and drugs containing phenylpropanolamine. And get your blood pressure checked regularly.

EN Weighs In: Yohimbe bark is one of the best studied herbs for relief of impotence and may be a treatment option for some men (after medical evaluation). In this case, however, EN favors the isolated herb compound in prescription form over the whole herb available over the counter. That ensures consistent amounts of the herb's active ingredient in a pure state, with fewer side effects.
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