Erectile dysfunction (ED) supplements are popular products in online marketplaces, but they are not always what they seem to be.
It is important for clinicians to understand these products and counsel men appropriately, according to a recent study in the Journal of Sexual Medicine.
While effective medical therapies for ED, such as phosphodiesterase type 5 (PDE5) inhibitors, have been available for over 15 years, some men are reluctant to discuss sexual problems with their healthcare provider. Medications, which can be costly, are not always covered by insurance and do not work for all men.
For these reasons, many men search the internet for affordable products that can be discreetly delivered without a prescription. ED supplements can be easily purchased on sites like Amazon.com, but they are not regulated the U.S. Food and Drug Administration (FDA), and they might contain undisclosed ingredients that can be harmful.
For this study, researchers investigated the 6 highest-ranked ED supplements sold by Amazon as of September 29, 2018 and took note of the ingredients. They also examined the first two pages of reviews for each product and used the ReviewMeta review analyzing service to filter out suspicious reviews (e.g., incentivized reviews and reviews of unverified purchases).
The top six erectile dysfunction supplements at that time were:
- Korean Panax Ginseng
- Leyzene with Royal Jelly
- Horny Goat Weed Extract
- Boost Elite
- Extra-Strength L-Arginine
Overall, the products had an average of 2,121 reviews. Each product received a rating between 1 and 5 stars. The products’ overall ratings ranged from 3.4 to 4.5 stars with an average of 3.92 stars. Twenty-one active ingredients were reported; ginseng, L-arginine, tongkat ali, and horny goat weed were the most common.
The researchers conducted a literature review on each of the active ingredients reported. Of the 413 studied identified, 68 involved human subjects. Of these, only 12 looked at individual ingredients and found an improvement in erectile function.
The research team then applied the ReviewMeta filter to all 12,840 reviews submitted for the 6 products. Of these, 48% were “considered untrustworthy.” Once the suspicious reviews were removed, the number of reviews touting certain sex health benefits decreased substantially. For example, reviews that mentioned greater sexual satisfaction fell by 90%. Those reporting more erection confidence fell by 89%, and 88% fewer reviews noted more enjoyment with intercourse.
“The removal of nearly one-half of all reviews associated with these products raises concerns about the veracity of comments linked to these products,” the authors wrote.
“[P]atients should be cautioned before considering [ED supplement] use, particularly in light of the availability of highly effective FDA-approved drugs and increasingly affordable therapeutic options,” they added.
The Journal of Sexual Medicine
Balasubramanian, Adithya, BA, et al.
“An Analysis of Popular Online Erectile Dysfunction Supplements”
(Full-text. Published online: April 26, 2019)
“Supplements for Sex: What to Know”
(April 22, 2019)