Over twelve ginseng species were identified, although mainly Asian or Korean ginseng (P. ginseng) and American ginseng (P. quinquefolius) have been used for their therapeutic properties. Ginseng is a perennial herbaceous plant of the family Araliaceae. Cessation of kratom use produced physical withdrawal symptoms similar to those of opiate addiction including pain, sleep disorders, muscle spasms, watery eyes, runny nose, hot flashes, fever, decreased appetite, diarrhea, and craving. Estos productos herbales ofrecen una solución natural Lifestyle changes can be effective in treating sexual problems. Your doctor can also help you determine which supplements, if any, might help you,” Dr. Simone says. “Do not self-diagnose and think that supplements are going to cure or prevent a problem from occurring,” Dr. Simone says. In additions to nutrients like amino acids, vitamins and minerals, they may contain herbs, such as horny goat weed, ginseng and maca root. To learn more about supplements, visit the National Institutes of Health. Although synephrine has become one of the most popular stimulants in weight loss products, cardiovascular adverse effects including increased blood pressure, tachycardia, ventricular fibrillation, transient collapse, myocardial infarction, and cardiac arrest have been reported . Anxiolytic and hypnotic effects are seemingly due to the combination of the action of the plant’s aroma on the limbic system through olfaction and the direct action of terpenes on GABAergic and serotoninergic (5-HT1A) receptors 39,202,203. Albeit its use is culturally well accepted, the betel nut is a strongly addictive substance and multiple adverse effects were reported (Table 1). It helps increase blood flow and endurance, which can result in enhanced performance and longer-lasting stamina. VigorLong is a powerful male enhancement supplement created to reignite confidence, stamina, and overall vitality in men. Further studies were retrieved from the reference list of selected articles and reports from international institutions such as the World Health Organization (WHO), the US Drug Enforcement Administration (DEA), and the European Monitoring Centre for Drugs and Drug Addiction (EMCDDA). Speciosa, P. ginseng, P. quinquefolius, P. johimbe, P. methysticum, P. olacoides, S. VigorLong In addition, P. ginseng was proved to increase testosterone, LH, and FSH in healthy volunteers through Rg1 and Rb1, enhancing libido. A total of 32 ginsenosides, including the abovementioned compounds, are found in in both American and Asian ginseng, but the two plants also possess specific ginsenosides. Asian ginseng is an emblematic plant of traditional Chinese medicine, and is listed in the Shennong Ben Cao Jing, the most ancient Chinese book of herbal medications. Psychological withdrawal symptoms reported by users included restlessness, tension, anger, and depression (Table 1). The possible stimulant and libido-enhancing effects of mitragynine may be due to the blockade of serotonergic 5-HT2A receptors and the postsynaptic stimulation of α2 adrenergic receptors (α2R) in the CNS . As expected, all the plants involved are libido-enhancing aphrodisiacs altering neurotransmission, although ginseng (P. ginseng and P. quinquefolius) and yohimbe (P. johimbe), and kanna (S. tortuosum) also enhance sexual potency. The psychiatric and neurological side effects caused by the consumption of herbal aphrodisiacs are mild, with mostly no consequences at therapeutic doses. These cases, however, were isolated and generally resulted from high ginseng doses or with the concomitant use of other substances (e.g., phenelzine, cannabis, herbal supplements); mania was not reported in clinical studies using ginseng alone or in combination. In March 2020, Srivatsav et al. reviewed the efficacy and the safety profile of several common aphrodisiacs used in the treatment of erectile dysfunction, but the study was not exhaustive and psychiatric and neurological adverse effects were not addressed . Other sources of aphrodisiacs affecting the CNS are available, such as synthetic or semi-synthetic drugs and natural substances of animal origin, which may also induce psychiatric or neurological effects. Proven By VigorLong Customer Reviews Other less common herbal aphrodisiacs might have eluded the search. Medical doctors should be aware of the potential drug interactions with aphrodisiacs and dietary supplements when prescribing a pharmaceutical drug. In addition, self-medication is frequent, as they are available without a prescription, and plant extracts provided by retail herbal stores may also be mislabeled or adulterated (e.g., heavy metals, pharmaceuticals) . However, they did not come as a complete surprise, because these plants have been used for centuries or millennia in traditional medicines and modern medicine has considerably benefited from these ingredients and preparations . Other plants have been little studied, although some of them are well-known remedies that have been used for many years. Dizziness, sleepiness, fatigue, agitation, insomnia, and headaches were reported.Rb1, Rb2, Rc, Re, Rf, and Rg1 are agonists of GABAA receptors and Rc is also an agonist of GABAB receptors.Herbal aphrodisiacs are readily available on the Internet and specialized shops and markets.Of 5255 potentially relevant reports, 4758 were excluded because they did not describe psychiatric or neurological adverse effects or because they were not written in English, French, or Italian language.Based on ethnopharmacological data, it can be hypothesized that muirapuama interacts with the dopaminergic system, increasing libido; the noradrenergic system, inducing antidepressant effects; and the serotonergic system, modulating appetite.The drugs approved to treat psychiatric and neurological conditions mainly target these neurotransmission pathways.By law, dietary supplements must contain at least one vitamin, mineral, amino acid, enzyme, or other substance used by the body. Few clinical reports and few data were found for the side effects of bitter orange (C. aurantium), muirapuama (P. olacoides), and kanna (S. tortuosum), and only preclinical reports were found for muirapuama. Kratom (M. speciosa) and yohimbe presented the highest rate of side effects, but yohimbe’s general toxicity is mainly cardiovascular, due to its effects on the NO pathway. Dizziness, sleepiness, fatigue, agitation, insomnia, and headaches were reported. There is also little information on the side effects of the Mexican poppy (Argemone mexicana L.) and Tongkat Ali (Eurycoma longifolia Jack.). The safety of maca (Lepidium meyenii Walp.) and ashwagandha or Indian ginseng (Withania somnifera (L.) Dunal) is well-documented. Based on ethnopharmacological data, it can be hypothesized that muirapuama interacts with the dopaminergic system, increasing libido; the noradrenergic system, inducing antidepressant effects; and the serotonergic system, modulating appetite. Sedation with drowsiness and dizziness is commonly reported in clinical trials with administration of kava or methysticin (Table 1), which may impair driving performances . In vitro studies of the hippocampus and other brain regions suggest that the sedative effects of kavalactones may be mediated by an increase in GABAA receptor binding sites 251,252. Kava extracts produce a similar activity profile as that of benzodiazepines, which interact with GABA receptors, inhibit the MAO-B, and inhibit dopamine and noradrenaline reuptake in the CNS, inducing libido-enhancing properties . American and Asian ginseng present a good safety profile with a few cases of mild gastrointestinal and sleep disorders. Rb1, Rb2, Rc, Re, Rf, and Rg1 are agonists of GABAA receptors and Rc is also an agonist of GABAB receptors. The content of ginsenosides is affected by seasons, geographical distribution, and processing (fresh ginseng, steamed ginseng or white ginseng, and sun-dried ginseng or red ginseng) . The presence of Rf, a PPD/PPT ratio lower than 2, and a Rb1/Rg1 ratio lower than 5 usually identify Asian ginseng. Most of the sexual enhancers of plant origin included in this review appeared to be safe at therapeutic doses, and few psychiatric and neurological side effects were reported. Considering the paucity of data and the frequent co-exposure to other psychoactive substances, conclusions can be hardly drawn regarding the psychiatric/neurological adverse effects of several of the plants included in this article. In fact, most clinical studies with ginseng or ginsenosides reported no psychiatric or neurological side effects or statistically insignificant effects compared to placebo, and were not included in Table 1 223,224,225,226,227. It is also important to consider that plants that do not induce psychiatric or neurological adverse effects are not necessarily harmless, and could exhibit another type of toxicity (e.g., cardiovascular, hepatic, and renal toxicity), which was not the focus of the present review. The plant, however, presents a good safety profile , and only one case of a manic-like episode following consumption in a patient without history of psychiatric disorders was reported .Both mitragynine and its oxidized metabolite 7-hydroxymitragynine are partial agonists of µ-opioid receptors (MOR) and competitive antagonists of κ- and δ-opioid receptors (KOR and DOR), which are involved in analgesia.There is also little information on the side effects of the Mexican poppy (Argemone mexicana L.) and Tongkat Ali (Eurycoma longifolia Jack.).Furthermore, if betel nut is taken in high quantities, transient extrapyramidal symptoms including rigidity, bradykinesia, and jaw tremor may occur 24,176,180.Adverse effects are mild and transient; psychiatric and neurological effects are reported in Table 1.Bitter orange tree’s leaves, flowers, fruits peels, and seeds have been used for centuries to treat tachycardia, rheumatism, insomnia, anxiety, epilepsy, and gastrointestinal disorders and to enhance sexual desire 187,188,189.Kava effects may be the result of a synergy of the six major kavalactones .Mental clarity combined with physical energy creates a powerful foundation for enhanced performance.In addition, VigorLong strengthens stamina and combats fatigue by supporting energy production at the cellular level.Additionally, only articles written in English, Italian, and French were included in the review, and reports written in another language were excluded. Maca is an edible herbaceous plant of the Andes Mountains and has been used for centuries for improving male and female sexual function. Zembrin®, a standardized hydroalcoholic extract, was found to be safe and well-tolerated in preclinical studies with mild adverse effects (Table 1) and is widely sold as a dietary supplement . Moderate to severe adverse effects like sweating, flushing, hypertension, tachycardia, palpitations, bronchospasm, chest pain, and atrial fibrillation are reported after deliberate or accidental ingestion, while lethal intoxications are extremely rare 245,246. There is increasing interest in botanic dietary supplements containing yohimbine extracts in the context of sexual and body enhancement . Why Choose VigorLong™? Excellent tolerability is generally reported after using ashwagandha for weeks at therapeutic doses, with statistically insignificant adverse effects compared to placebo 281,282. Positive effect in insomnia, anxiety, chronic stress, weight management, thyroid gland function, telomerase, cardio-respiratory endurance, muscle strength, recovery of male and female sexual function, and senescence was demonstrated in preclinical and clinical studies . The plant, however, presents a good safety profile , and only one case of a manic-like episode following consumption in a patient without history of psychiatric disorders was reported . Since the FDA does not approve supplements for treating medical conditions, companies cannot market them for that purpose. By law, dietary supplements must contain at least one vitamin, mineral, amino acid, enzyme, or other substance used by the body. Supplements are substances intended to be added to your diet and come in many forms, including in pill, powder or liquid. It’s important to know what supplements are and how they work. Talk to your doctor before trying a sexual enhancement supplement. Kanna’s main active compounds are mesembrine, mesembrenol, mesembrenol, and mesembrenone, which are synthesized in the plant through the condensation of phenylalanine and tyrosine amino acids. The dried aerial parts of the plant are commonly chewed or consumed as teas, decoctions, and tinctures and sometimes smoked or snuffed . Kanna, or Channa, is the traditional name of a succulent, perennial plant belonging to the Aizoaceae family (earlier Mesembrynantheaceae) that is indigenous to South Africa, where it is consumed by local tribes to relieve thirst and hunger and combat fatigue 264,265. Data showed that the maximal effect was reached 6 h after administration of a low dose of muirapuama extract and produces significant and long-lasting (up 12 h) effects in both chemical and thermal tests of nociception in mice. 2. Citrus aurantium L. (Bitter Orange) Consequently, the use of herbal supplements to enhance sexual drive has become increasingly popular, and more than 300,000 intoxications were reported to poison control centers over the last 20 years 6,7. Sexual enhancement supplements are a subset of dietary supplements, specifically marketed to address issues related to sexual health and performance. VigorLong works by naturally stimulating the body’s own testosterone production, which plays a key role in male sexual health. The drugs approved to treat psychiatric and neurological conditions mainly target these neurotransmission pathways. The modulation of neurotransmission is also involved in the mechanisms underlying many psychiatric and neurological disorders. Contrariwise, many aphrodisiac substances can improve sexual performance. Drug interactions are more concerning, considering that herbal aphrodisiacs are likely used together with other plant extracts and/or pharmaceuticals. The fruit, obtained from the palm tree, Areca catechu L., is commonly chewed in Southeast Asia and the South Pacific islands 155,156 for its antiparasitic, digestive, euphoric, and aphrodisiac effects 157,158. Betel nut is one of the most widely used addictive substances in the world and represents the fourth most consumed drug after nicotine, ethanol, and caffeine 23,154. A total of 137 records were included in the final review; species-by-species search results are detailed in a flow diagram in Figure 1. Libido-enhancing substances alter the concentrations of specific neurotransmitters (e.g., dopaminergic and serotoninergic pathways) or sex hormones (e.g., pituitary hormones and testosterone) in the central nervous system (CNS) . “Most supplements for sexual function have not been studied scientifically,” says Luigi Simone, MD, a primary care physician at Scripps Clinic in Encinitas.The psychiatric and neurological side effects caused by the consumption of herbal aphrodisiacs are mild, with mostly no consequences at therapeutic doses.Higher testosterone levels contribute to increased libido, stronger erections, and improved overall performance.The dried aerial parts of the plant are commonly chewed or consumed as teas, decoctions, and tinctures and sometimes smoked or snuffed .While many of these products say they can increase sexual desire or performance, it’s unclear if they are safe or actually work.Zembrin®, a standardized hydroalcoholic extract, was found to be safe and well-tolerated in preclinical studies with mild adverse effects (Table 1) and is widely sold as a dietary supplement .Peripherally, it was suggested that yohimbine enhances NO release from cavernosal endothelial cells, producing a relaxation of smooth muscle cells and consequent erection, increasing sexual potency 3,6,237. “Don’t be afraid to bring up a sexual health concern,” says Dr. Simone. “Most supplements for sexual function have not been studied scientifically,” says Luigi Simone, MD, a primary care physician at Scripps Clinic in Encinitas. While it may be tempting to buy pills and bottles to boost your sexual performance, you might want to think twice before putting down your money. Most users go for the 3 or 6-bottle packages to experience lasting performance improvements. Highly recommended for anyone who wants to boost their confidence and performance.”Brian W - Wyoming, USA This energy-boosting formula is developed with modern scientific insights to support stamina, strength, and overall male performance.Suitable for men in their 30s to 70s, VigorLong offers a safe yet effective way to elevate energy levels and physical endurance. VigorLong is a premium male enhancement supplement made from a blend of natural plant extracts and vital minerals. Similarly, herbal aphrodisiacs often contain multiple active ingredients with multiple mechanisms of action that are yet to be fully characterized. In addition, causality was often difficult to determine, especially in case reports and self-reports, in which co-administration of other substances and herbal formulations is prevalent. VigorLong is a powerful male enhancement supplement created to reignite confidence, stamina, and overall vitality in men.In vitro studies of the hippocampus and other brain regions suggest that the sedative effects of kavalactones may be mediated by an increase in GABAA receptor binding sites 251,252.Other less common herbal aphrodisiacs might have eluded the search.Other herbal aphrodisiacs that were not included in this literature review are commonly used, but data on their safety profile are also limited .According to Sandroni, aphrodisiacs can be classified into three categories according to whether they increase potency (i.e., effectiveness of erection in males), sexual pleasure, or libido (i.e., sexual desire) .Moderate to severe adverse effects like sweating, flushing, hypertension, tachycardia, palpitations, bronchospasm, chest pain, and atrial fibrillation are reported after deliberate or accidental ingestion, while lethal intoxications are extremely rare 245,246.High betel nut doses can cause typical muscarinic and extrapyramidal symptoms such as salivation, diaphoresis, diarrhea, gastrointestinal upset, emesis, vertigo, myosis, tremor, hyperthermia, bradycardia, and asthma attacks 156,158,166,168,176,178,179. Adverse effects are mild and transient; psychiatric and neurological effects are reported in Table 1. However, few data are available on the side effects of several plants included in this review, and more clinical studies with controlled administrations should be conducted to address this issue. Although aphrodisiacs are mainly obtained from plants, these substances may also be worthy of investigation. The mechanisms underlying psychiatric and neurological disorders are multifaceted, often involving multiple CNS pathways and receptors, and are not fully understood. In 2014, Singh et al. reported a cross-sectional survey investigating the correlation between frequency and quantity of kratom consumption, and the risk of addiction development and the severity of withdrawal symptoms and craving in regular user . Studies have found that 7-hydroxymitragynine is the main contributor to the plant’s toxicity and the development of addiction symptoms. Kratom is an herbal preparation obtained from the leaves of Mitragyna speciosa Korth, an evergreen plant of the Rubiaceae family that grows spontaneously in Southeast Asia, mainly in Thailand and Malaysia . It was demonstrated that these substances, after vaporization and inhalation, are effective for treating different forms of anxiety, sleep, and libido, and reduce seizures in animal models 38,39,198,199,200,201. These effects, coupled with the inhibition of monoamine oxidase A (MAO-A) caused by aromatic phenolic compounds of the plant, may also explain the antidepressant properties of the areca nut 24,169. It was demonstrated that these substances, after vaporization and inhalation, are effective for treating different forms of anxiety, sleep, and libido, and reduce seizures in animal models 38,39,198,199,200,201.Improving your sexual health doesn’t always require medication or supplements.In 2014, Corazza et al. reviewed the psychoactive effects of four popular sexual enhancers .However, sexual enhancers of plant origin have gained popularity over recent years, as natural substances are often regarded as a safer alternative to modern medications and are easily acquired without prescription.Kanna, or Channa, is the traditional name of a succulent, perennial plant belonging to the Aizoaceae family (earlier Mesembrynantheaceae) that is indigenous to South Africa, where it is consumed by local tribes to relieve thirst and hunger and combat fatigue 264,265.Neurological effects included seizures, extrapyramidal symptoms, and withdrawal symptoms.The alkaloids’ content is variable and depends on plant age, season, and geographical location . Yohimbe mainly was involved in intoxication cases, but its cardiovascular toxicity is more concerning than its psychiatric and neurological adverse effects. In addition, although Voacanga africana alkaloids may modulate neuronal excitability and have positive effects in Alzheimer’s disease 287,288, no neurological or psychiatric complications related to the plant were reported. Further investigation is necessary to clearly understand the possible neurological and psychiatric effects caused by these plants. In fact, the plant is widely sold over the Internet and specialized herbal shops to increase sexual performance, although its mechanism of action and effects were not clearly demonstrated. Sexual pleasure-enhancing substances cause tumescence and lubrication of the genital mucosa, therefore increasing sensation (e.g., cantharidin). In 2010, in the United States, approximately 29% of 428 infertile couples had utilized an alternative treatment after 18 months of observation, 59% of which had taken herbal therapy . Many prescription drugs and narcotics (e.g., antidepressants, anxiolytics, antihistamines, antihypertensives, adrenergic receptor blockers, antipsychotics, and opioids) can negatively impact sexual desire, inhibit erection, ejaculation, or orgasm, and so on. Substances increasing libido alter the concentrations of specific neurotransmitters or sex hormones in the central nervous system. Losing weight, reducing stress and a healthy lifestyle have all been shown to increase testosterone levels in men, Dr. Simone says. A few neurological side effects were reported in preclinical studies, including impairment of both short- and long-term memory and reduced locomotion 151,152 (Table 1). More interestingly, several cases of manic-like effects, such as confusion, agitation, irritation, nervousness, anxiety, and bizarre behavior, without history of psychiatric disorder, were reported following ginseng use 77,78,81,85,87,88,90,228. Of 5255 potentially relevant reports, 4758 were excluded because they did not describe psychiatric or neurological adverse effects or because they were not written in English, French, or Italian language. According to Sandroni, aphrodisiacs can be classified into three categories according to whether they increase potency (i.e., effectiveness of erection in males), sexual pleasure, or libido (i.e., sexual desire) . The US Food and Drug Administration confirmed that oral administration of bitter orange extracts is safe , and its derivatives have gained popularity as dietary supplements over the last few years 200,204. The mechanism of action of the plant’s ingredients, however, is not fully elucidated. These substances, especially d-limonene, modify the cell membrane of microbes and denature enzymes responsible for their germination and sporulation, showing antimicrobic and antifungal properties 191,196. Interactions with pharmaceuticals or other herbal supplements are more common and may pose a significant health threat. The review focused on selected plants and their active ingredients, which were included after a preliminary screening of the literature. Aside from sexual enhancement, these plants often have many other therapeutic applications and can be a part of the everyday diet of individuals. Psychiatric and neurological side effects included headaches and hypnotic effects and were mild. Terpenoids such as d-limonene, α-pinene, β-myrcene, linalyl acetate, and linalool are the main volatile components of the plant 193,194, and are distilled or extracted from blooms, leaves, and orange peel to obtain essential oils (EOs) . Bitter orange tree’s leaves, flowers, fruits peels, and seeds have been used for centuries to treat tachycardia, rheumatism, insomnia, anxiety, epilepsy, and gastrointestinal disorders and to enhance sexual desire 187,188,189. Indeed, areca alkaloids are converted into DNA alkylating nitrosamines, which cause cell proliferation and oxidative stress-dependent neurotoxicity, leading to oral carcinogenicity and exacerbating neurodegenerative disease symptoms 24,158,183,185. Most of the selected sexual enhancers appeared to be safe at therapeutic doses, although mild to severe adverse effects may occur in cases of overdosing or self-medication with unstandardized products. However, sexual enhancers of plant origin have gained popularity over recent years, as natural substances are often regarded as a safer alternative to modern medications and are easily acquired without prescription. Improving your sexual health doesn’t always require medication or supplements. Male sexual enhancement supplements may not be safe for everyone as they can cause side effects, allergic reactions and interactions with other medications. Although the consumption of these plants appears safe, further studies should be conducted to better understand their positive and negative effects. Although rare, psychiatric side effects were mostly reported and included anxiety, depression, psychosis, and mania. However, no psychiatric or neurological side effects related to damania were reported. Always talk to your doctor about any sexual health problems you may be experiencing. While many of these products say they can increase sexual desire or performance, it’s unclear if they are safe or actually work. Doctors may recommend supplements in specific situations where patients are not getting enough nutrients from their diet or have a certain health condition. New preparations such as capsules, resins, or tinctures are now available on the Internet and are purchased in Europe and in America for recreational use or as herbal products 209,210.A total of 137 records were included in the final review; species-by-species search results are detailed in a flow diagram in Figure 1.In fact, most clinical studies with ginseng or ginsenosides reported no psychiatric or neurological side effects or statistically insignificant effects compared to placebo, and were not included in Table 1 223,224,225,226,227.Although the plant contains a variety of indole alkaloids related to ibogaine, a well-known psychoactive substance from iboga (Tabernanthe iboga Baill.) that has also been used as an aphrodisiac , there is no evidence of positive effects on sexual function.Excellent tolerability is generally reported after using ashwagandha for weeks at therapeutic doses, with statistically insignificant adverse effects compared to placebo 281,282.Further studies were retrieved from the reference list of selected articles and reports from international institutions such as the World Health Organization (WHO), the US Drug Enforcement Administration (DEA), and the European Monitoring Centre for Drugs and Drug Addiction (EMCDDA).In March 2020, Srivatsav et al. reviewed the efficacy and the safety profile of several common aphrodisiacs used in the treatment of erectile dysfunction, but the study was not exhaustive and psychiatric and neurological adverse effects were not addressed .Maca is an edible herbaceous plant of the Andes Mountains and has been used for centuries for improving male and female sexual function.Your doctor can also help you determine which supplements, if any, might help you,” Dr. Simone says. Asian and American ginseng contain a variety of pharmacologically active triterpene saponins, named ginsenosides. The fresh root of ginseng can be directly chewed after peeling or soaked in wine for drinking and chewing. American ginseng medical use is more recent and has gained popularity in Western countries over recent decades. Asian ginseng grows in East Asian mountains, while American ginseng is an endangered species that grows in deciduous forests of the west half of North America. In addition, improvements in positive and negative symptoms of psychosis have been observed in schizophrenic areca nut chewers 155,172,173. It was demonstrated that arecoline enhances cognition and memory and significantly improves several behavioral disorders in patients with Alzheimer’s disease or schizophrenia, through the activation of postsynaptic M1 receptors 24,162,171. Arecoline is a partial muscarinic (M) agonist and possesses a higher affinity for M receptors than guvacoline 24,169. The betel nut contains a variety of active alkaloids responsible for its effects. Furthermore, the release of dopamine and other catecholamines causes stimulant and libido-enhancing effects 3,156,166,176,177. Psychiatric and neurological adverse events reported in the literature are displayed in Table 1; study conditions and co-exposures are also detailed. In 2014, Corazza et al. reviewed the psychoactive effects of four popular sexual enhancers . Potency-enhancing substances typically induce vasodilation, often through the nitric oxide (NO) pathway, inducing hypotension and potentially harmful cardiovascular effects (e.g., sildenafil and L-arginine). Natural substances are mistakenly believed to be a safer alternative to modern medications with no side effects. Nowadays, sexual performance anxiety, which contributes to psychogenic erectile dysfunction, is estimated to affect 9 to 25% of men in the United States, and phytotherapy is often employed as a treatment . Although several of these plants have been used for centuries in traditional medicines, they have not been as extensively studied as the other plants included in this review. These mild effects were not anticipated, considering the mechanism of action of these plants. Neurological effects included seizures, extrapyramidal symptoms, and withdrawal symptoms. In particular, substances of natural origin have been used worldwide for millennia in traditional medicines to boost sexual desire, sexual pleasure, or sexual behavior , and the use of psychoactive and/or stimulant drugs during intercourse, i.e., chemsex, is on the rise . Sexual enhancers increase sexual potency, sexual pleasure, or libido. “If you have sexual side effects from medication you can ask your doctor if you can change your medication. Treating underlying health issues like high blood pressure, heart disease or diabetes can help improve sexual function. “Your doctor can discuss any sexual concern you may have and determine if there is an underlying cause for your symptoms that needs to be treated.” In addition, mesembrine is also an agonist of GABAA, δ2-opioid, μ-opioid, cholecystokinin-1, E4-prostaglandin, and melatonin-1 receptors at high doses, and shows antinociceptive effects in animal models 266,270,271,272,273. Kanna alkaloids inhibit serotonin reuptake and PDE4A, potentially enhancing sexual potency and libido 267,268,269. In addition, higher doses, either acutely or subchronically (15 days), did not cause a worsening of adverse effects . The antinociceptive effects of the plant were investigated in thermal and chemical models of nociception in mice. Its consistent use promotes continued improvement in stamina, performance, and energy, making it a reliable companion for those looking to reclaim their youthful vitality and confidence. Mental clarity combined with physical energy creates a powerful foundation for enhanced performance.In addition, VigorLong strengthens stamina and combats fatigue by supporting energy production at the cellular level. Whether you're looking to elevate your stamina or reignite your drive, VigorLong is your go-to choice for total male enhancement. It’s a smart addition to any routine for those who want to take charge of their performance and restore a sense of youthful vigor. Fatty acids such as uncosanoic, tricosanoic, and pentacosanoic acids account for up to 20% of the total lipophilic components of the plant . The native communities have used its roots and barks as a treatment for depression, sexual dysfunction, and as a “nerve tonic” . Kava effects may be the result of a synergy of the six major kavalactones . The plant has also been used in traditional medicine, first as a treatment for venereal diseases, then later as a sedative and treatment for anxiety and sleep disorders, to decrease fatigue, and to relieve pain . Yohimbine has a relatively short half-life due to an extensive hepatic metabolism, which produces two main hydroxylated metabolites, 11- and 10-hydroxyyohimbine, that are rapidly excreted in urine 239,240. Additionally, only articles written in English, Italian, and French were included in the review, and reports written in another language were excluded. In particular, more clinical studies with controlled administrations, to have a better grasp on doses and co-exposures, should be conducted to address this issue. Herbal aphrodisiacs are readily available on the Internet and specialized shops and markets. There were no reports on the side effects of damania (T. diffusa), the Mexican poppy (A. mexicana), and Tongkat Ali (E. longifolia). Always talk to your doctor about any sexual health problems you may be experiencing.Sexual enhancement supplements are a subset of dietary supplements, specifically marketed to address issues related to sexual health and performance.The products, which are often sold on the internet, can be dangerous to health, and we therefore warn consumers against using them.Asian and American ginseng contain a variety of pharmacologically active triterpene saponins, named ginsenosides.Over twelve ginseng species were identified, although mainly Asian or Korean ginseng (P. ginseng) and American ginseng (P. quinquefolius) have been used for their therapeutic properties.The bark of the plant contains several structurally related indole alkaloids, yohimbine being the most abundant one (10–15% of total content), followed by its stereoisomers α-yohimbine, β-yohimbine, ψ-yohimbine, corynanthine, allo-yohimbine, and yohimbic acid 233,234.Since the FDA does not approve supplements for treating medical conditions, companies cannot market them for that purpose. Some supplements may even contain potentially dangerous impurities or hidden pharmaceutical drugs that can be dangerous. These products may not have evidence to back up their claims, and they could also lead to unwanted side effects. The products, which are often sold on the internet, can be dangerous to health, and we therefore warn consumers against using them. However, it was also demonstrated that areca alkaloids reduce GABA affinity for the GABAA receptor, and arecaidine and guvacine effects on GABA signaling may cause epileptic seizures 23,169,180,184. These effects are probably due to guvacine and arecaidine, which are strong inhibitors of γ-aminobutyric acid (GABA) reuptake and contribute to the reduction in spontaneous activity and body excitability 181,182,183. Furthermore, if betel nut is taken in high quantities, transient extrapyramidal symptoms including rigidity, bradykinesia, and jaw tremor may occur 24,176,180. High betel nut doses can cause typical muscarinic and extrapyramidal symptoms such as salivation, diaphoresis, diarrhea, gastrointestinal upset, emesis, vertigo, myosis, tremor, hyperthermia, bradycardia, and asthma attacks 156,158,166,168,176,178,179. Both mitragynine and its oxidized metabolite 7-hydroxymitragynine are partial agonists of µ-opioid receptors (MOR) and competitive antagonists of κ- and δ-opioid receptors (KOR and DOR), which are involved in analgesia. The alkaloids’ content is variable and depends on plant age, season, and geographical location . New preparations such as capsules, resins, or tinctures are now available on the Internet and are purchased in Europe and in America for recreational use or as herbal products 209,210. In these countries, the plant has been exploited for centuries for its stimulant and narcotic properties and is commonly self-administrated by manual laborers to combat fatigue and improve productivity . Data showed that low kratom doses (1–5 g) induce stimulating effects, involving the release of neurotransmitters by reversible blockade of calcium channels. Mitragynine also binds adenosine A2A receptors, dopamine D2 receptors, and serotonin receptors 5-HT2C and 5-HT7, but the physiological significance of these interactions is unclear . However, mitragynine affinity for opioid receptors is lower than that of morphine, while 7-hydroxymitragynine affinity is approximately 46 and 13 times higher than that of mitragynine and morphine, respectively . Other herbal aphrodisiacs that were not included in this literature review are commonly used, but data on their safety profile are also limited . Although the plant contains a variety of indole alkaloids related to ibogaine, a well-known psychoactive substance from iboga (Tabernanthe iboga Baill.) that has also been used as an aphrodisiac , there is no evidence of positive effects on sexual function. Recently, the plant also proved to induce anxiolytic and antidepressant effects in preclinical studies 283,284. For example, damiana (Turnera diffusa Willd. Ex. Schult.), a Central American shrub of the family Passifloraceae, has been traditionally used for centuries as a stimulant and aphrodisiac, to spark male sexual drive and increase performance, and is still widely marketed . The market for men’s sexual health supplements is growing as many men turn to them to tackle sexual issues. Its powerful blend targets energy, libido, and performance from the inside out. This leads to better performance and increased satisfaction.Finally, VigorLong supports long-term vitality by helping balance hormone levels and supporting overall male wellness. Higher testosterone levels contribute to increased libido, stronger erections, and improved overall performance. Whether you're looking to improve your performance or regain your youthful edge, VigorLong offers a reliable solution.VigorLong works by targeting the root causes of low energy and reduced libido. Peripherally, it was suggested that yohimbine enhances NO release from cavernosal endothelial cells, producing a relaxation of smooth muscle cells and consequent erection, increasing sexual potency 3,6,237. There is evidence suggesting that yohimbine increases libido by blocking α2R in the locus coeruleus, which is involved in the control of the erection. Yohimbine is a potent selective α2R antagonist with weaker α1R antagonist activity that blocks the presynaptic feedback inhibition of noradrenaline release, prolonging the excitatory effects of noradrenaline at postsynaptic α1R and β-receptors 237,238. The bark of the plant contains several structurally related indole alkaloids, yohimbine being the most abundant one (10–15% of total content), followed by its stereoisomers α-yohimbine, β-yohimbine, ψ-yohimbine, corynanthine, allo-yohimbine, and yohimbic acid 233,234. In fact, ginseng toxicity mainly comes from drug interactions with cytochromes P450 (CYPs) CYP3A4 and CYP2D6 inhibitors and serotoninergic drugs, intensifying sedative effects or inducing cognitive disorders or a serotonin syndrome 229,230,231. A few cases of headache following ginseng administration were reported without placebo control 84,91. Psychiatric and neurological side effects are rare, and causality is difficult to ascertain 77,79,80,82,83,84,85,86,87,89,90,91,92,93,94. Rg1 induces NO synthesis in endothelial cells and perivascular nerves, and increases vascular smooth muscle sensitivity to NO, prolonging the erection in males and enhancing sexual potency.