SexRx: Yohimbine and Your Sex Life
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SexRx: Yohimbine and Your Sex Life

Yohimbine is an alkaloid that is found in the bark of a West African evergreen tree—the yohimbe tree. Yohimbine may help treat impotence that can be caused by a variety of factors, including medication side effects.

Commonly Used Product Names

  • Yohimbine hydrochloric acid (HCL)—a tablet available only by prescription
  • Yohimbe bark—available without a prescription in the following forms:
    • Capsule
    • Concentrated drops
    • Decoction (an extract obtained from boiling)
    • Tablet
    • Tea
    • Tincture

Yohimbe bark is often not standardized based on yohimbine content. It is, therefore, a less reliable source than the prescription tablet.

Sexual Effects

Yohimbine has a long history of being used as an aphrodisiac. More recently, some studies have suggested that it may have the following pro-sexual effects:

  • Helps to obtain and maintain erection
  • Enhances quality of erection
  • Helps retarded ejaculation

How Yohimbine Can Affect Sexual Function

The exact mechanism by which yohimbine helps sexual function is not clear. Two effects of yohimbine that likely contribute to its improvement of sexual function are:

Blocking of Presynaptic Alpha-2 Adrenergic Receptors

These are the receptors that the neurotransmitter norepinephrine uses as it moves through nerve cells to stimulate the sympathetic nervous system. When these receptors are blocked, the parasympathetic nervous system will dominate. One of the effects of the parasympathetic system is to increase blood flow to the penis. This aids the development and maintenance of an erection.

Increasing Release of Vasopressin

This substance, also called antidiuretic hormone (ADH), is believed to facilitate erectile function.

It usually takes two to three weeks of daily use before yohimbine begins to take effect. It should not be used for more than ten weeks.

A recent study found that low doses of yohimbine plus L-arginine glutamate was an effective treatment for low-level erectile dysfunction. However, subsequent studies have not confirmed this finding.

Side Effects

Since the effective level of yohimbine is close to its toxic level, it is not clear that its benefits outweigh its risks. Side effects include:

  • Anxiety
  • Nervousness
  • Panic attacks
  • Tremors
  • Elevated blood pressure and heart rate
  • Salivation
  • Nausea
  • Irritability
  • Insomnia
  • Urinary frequency
  • Excessive sweating
  • Fatigue

Cautions

Medications

Yohimbine may cause adverse reactions when taken with certain medications. These include:

  • MAO inhibitors—When combined with yohimbine, MAO inhibitors can cause dangerously high blood pressure.
  • Antidepressants—Yohimbine can interact with most types of antidepressants.
  • Antihypertensives—Yohimbine may increase blood pressure-lowering effects.
  • Nasal decongestants
  • Phenylpropanolamine-containing diet aids

Health Conditions

If you have kidney disease, you should not take yohimbine.

If you have one of the following conditions, talk to your doctor before taking yohimbine:

Yohimbine is not usually prescribed for women. It should never be taken during pregnancy.

Dietary Considerations

Yohimbine is classified as an MAO inhibitor. When taking MAOIs, you should avoid the following foods:

  • Foods with a high-tyramine content, such as
    • Cheese
    • Alcohol
    • Pickled or marinated or smoked or cured or fermented foods
    • Organ meats
    • Nuts, peanut butter
    • Fava beans
    • Onions
    • Avocados
    • Canned figs
    • Chocolate
    • Excess amounts of caffeine
  • Foods containing monosodium glutamate (MSG)

RESOURCES:

Family Doctor.org
http://familydoctor.org/

National Center for Complementary and Alternative Medicine
http://nccam.nih.gov/

CANADIAN RESOURCES:

Health Canada
http://www.hc-sc.gc.ca/index_e.html/

Men's Health Centre
http://www.menshealthcentre.net/

References

Crenshaw TL, Goldberg JP. Sexual Pharmacology: Drugs that Affect Sexual Function . WW Norton & Company; 1996.

Guay AT, Spark RF, Jacobson J, Murray FT, Geisser ME. Yohimbine treatment of organic erectile dysfunction in a dose-escalation trial. Int J Impot Res. 2002;14:25-31.

Lebret T, Hervé JM, Gorny P, et. al. Efficacy and safety of a novel combination of L-arginine glutamate and yohimbine hydrochloride: a new oral therapy for erectile dysfunction. Eur Urol. 2002;41:608-613.

Peirce A, American Pharmaceutical Association. The American Pharmaceutical Association Practical Guide to Natural Medicines . New York, NY: Morrow; 1999.



Last reviewed June 2008 by Rosalyn Carson-DeWitt, MD

Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.

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